Self blood glucose monitoring: an adjunct to dietary and insulin management of the patient with diabetes.

The primary goal of diabetes management is to maintain blood glucose as near to normal as possible. Composition, size, and spacing of meals and snacks all have a substantial impact on blood glucose fluctuations and can be altered to improve glycemic control. Recent research studies focusing on the blood glucose response of various carbohydrate containing foods have found that responses vary considerably. Because the glucose response is influenced by numerous factors, it is difficult to predict how specific individuals will respond to a particular food. A technique known as self-blood glucose monitoring can be used by patients with diabetes to quantitate their own postprandial glucose rise from various foods. The technique itself is portable and relatively simple and is an accurate means of obtaining blood glucose values without using a clinical laboratory. Self-blood testing provides the patient with immediate feedback on the impact of dietary manipulation. Blood glucose records can be used in conjunction with diet records to make adjustments in the type and amount of food or insulin dose that would elicit the best glycemic response. The dietitian thus plays an integral role in identifying patterns in the blood glucose profile and assisting the patient in making intelligent dietary choices to improve diabetes control.