Self Monitoring of Blood Glucose (SMBG)
Self monitoring of blood glucose is an opportunity for people with diabetes to take
control of their health. The main goal of treatment is to keep blood glucose levels
in the normal or near-normal range. Monitoring blood glucose levels is one of the
best ways of determining how well a diabetes treatment plan is working.
Self monitoring of blood glucose allows a person to know their blood glucose level
at any time and helps to prevent the immediate and potentially serious consequences
of very high or very low blood glucose. Monitoring also enables tighter blood glucose
control, which decreases the long-term risks of diabetic complications.
Three keys to success in monitoring your blood sugar anywhere are:
- Keeping your glucometer and supplies with you at all times so that you always have
them when you need them
- Making it a habit to check your blood sugar level by building it into your daily
- Checking your glucometer's accuracy when you visit your doctor by comparing
your results with your doctor's results
Why monitor your blood sugar
- Monitoring your blood sugar level takes the guesswork out of your daily diabetes
- Testing your blood sugar at home helps you know when your blood sugar is
low. Low blood sugar can lead to an emergency. If your blood sugar drops just below
the level that is safe for your body and you quickly eat something containing sugar,
your blood sugar will rise and you may prevent an emergency.
- When your blood sugar is high: Over time, high blood sugar levels cause permanent
damage to the eyes, heart, kidneys, blood vessels, and nerves. If you are pregnant,
high blood sugar levels may cause problems for you and your baby. Low blood sugar
levels are even more dangerous for your fetus.
- What your blood sugar level is before a meal: If you take short-acting insulin,
you can use these results to determine how much insulin to take.
- How different types of food affect your blood sugar.
- How exercise affects your blood sugar: Exercise usually lowers your blood
- What your blood sugar is when you are ill: Severe illness or stress usually
causes higher blood sugar levels.
- When your insulin dose may need adjusting: If your blood sur levels remain
high over a period of time or you have frequent low blood sugar, your insulin dose
may need adjustment.
Studies have proven that people with Type 1 and 2 diabetes who maintain normal or
near normal blood glucose levels have a lower risk of diabetes-related complications.
The frequency of monitoring; Seven time profile is ideally recommended.
Targets (more than 50% values within target range)
Age less than six years
100-200 mg/dl before every meal and bedtime
Age six to twelve years
80-180 mg/dl before every meal and bedtime
Age more than twelve years
80-140 mg/dl before every meal
Less then 160 mg/dl after two hours of each meal
100-160 before bed.
Reference: Staged diabetes management, Module 2
How to Test
- Wash hands with soap and clean water. Dry hands.
- Prepare the lancing device by inserting a fresh lancet. Lancets that are used more
than once are not as sharp as a new lancet, and can cause more pain , injury to
the skin and infections.
- Prepare the blood glucose meter and test strip (instructions for this depend upon
the type of glucose meter used).
- Use the lancing device to obtain a small drop of blood from the fingertip or alternate
site (like the skin of the forearm). Alternate sites are often less painful than
the fingertip. However, results from alternate sites are not as accurate as fingertip
samples when the blood glucose is rising or falling rapidly.
- Patients who have difficulty getting a good drop of blood from the fingertip can
try rinsing the fingers with warm water, shaking the hand below the waist, or squeezing
("milking") the fingertip.
- Apply the blood drop to the test strip in the blood glucose meter. The results will
be displayed on the meter after several seconds.
- Dispose off the used lancet in a puncture resistant sharp container or any glass
jar (not in household trash because any one can be hurt by it).