The Fourth Cornerstone of Treatment: Self-Monitoring of Blood Glucose (SMBG)
People with diabetes must understand that taking and recording blood glucose values a regular intervals (to include fasting, before meals, two-hours after meals, at bed time and, if necessary, one or two times in the night on occasion to determine changes through the night) are necessary activities to obtain the information needed to determine effectiveness of the treatment regimen. Sharing the documentation of the values (and times obtained) is an important component of every visit with the health care provider, so it is absolutely critical that the individual writes the information on paper and shares it with the health care provider at the time of the visit.
The reason this information is necessary is that decisions relative to the degree of blood glucose control must be made based on patterns of blood glucose changes, not on one or two isolated events. One can make sound decisions about whether the regimen a patient is following is effective in maintaining blood glucose control only on the basis of patterns of blood glucose changes.
Relative to the above, the health care provider must be sure the patient knows:
- When to take his/her blood glucose (Should be at least twice/day – always fasting and the other at varied times e.g. before a meal, two hours after a meal, bedtime, etc.)
- Why it is important for the patient to document the date, time, and value on paper (preferably a log that can be taken to clinic visits)
(The healthcare provider will want to try to identify patterns of blood glucose changes. This is possible only if the patient takes and documents blood glucose readings frequently and at various times each day.)
- How to perform the test correctly
- How to verify that his/her glucometer is working properly
It is equally important to make sure the patient can afford a glucometer and the strips needed to obtain the blood glucose tests recommended. Not verifying facts may lead to failure on the part of the patient to take and record this necessary information which can have significant consequences. (Search "Free glucometer" to find opportunities to obtain a free blood glucose meter. Companies are willing to give away meters, knowing that patients will subsequently need to purchase the strips that are used in the meters).