Consensus Recommendations for Improving SMBG Accuracy, Utilization, and Research
Year: 2008 Authors: Irl B. Hirsch, Bruce W. Bode, Belinda P. Childs, Kelly L. Close, William A. Fisher, James R. Gavin, Barry H. Ginsberg, Charles H. Raine, Carol A. Verderese Institutions: Seattle,WA, Atlanta,GA, Wichita,KS, San Fransisco,CA, London,Ontario,Canada, Wyckoff,NJ, Orangeburg,SC, Lakeville,CT
Current clinical guidelines for diabetes care encourage self-monitoring of blood glucose (SMBG) to improve glycemic control. Specific protocols remain variable, however, particularly among non–insulin-using patients. This is due in part to efficacy studies that neglect to consider (1) the performance of monitoring equipment under real-world conditions, (2) whether or how patients have been taught to take action on test results, and (3) the physiological, behavioral, and social circumstances in which SMBG is carried out. As such, a multidisciplinary group of specialists, including several endocrinologists, a health psychologist, a diabetes nurse practitioner, and a patient advocate (the Panel), discuss within this review article how the potential of SMBG might be fully realized in today’s healthcare environment. The resulting recommendations cover technological, clinical, behavioral, and research considerations with the aim of achieving short- and long-term benefits, ranging from fewer hypoglycemic episodes to lower complication-related costs. The panel also made suggestions for designing future studies that increase the ability to discern optimal models of SMBG utilization for individuals with diabetes who may, or may not, use insulin.
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