Main Newsletter
Mastery Series
Therapy Series
 
Bookmark and Share | Print Article | Items for the Week Previous | All Articles This Week | Next
This article originally posted and appeared in  BG ControlType 1 DiabetesInsulinGlucose MonitoringIssue 681

Frequency of Blood Glucose Testing in Type 1's: How Often is Enough?

"Good diabetes control can be achieved in routine diabetes care with flexible intensified insulin therapy based on continuing patient education."...
Advertisement

As we know, self-monitored blood glucose (SMBG), as well as the knowledge of proper insulin use and requirements, is essential for proper metabolic control in patients with diabetes mellitus type 1. However, the question that this study tries to answer in particular is, what frequency of self monitoring of blood glucose is considered necessary for the most favorable glycemic control? 

This study focused especially on well-educated patients who understand the daily management of diabetes type 1 and the specific insulin requirements given. How often and to what extent SMBG should be executed on a daily basis remains unclear.

The study design used patients with type 1 diabetes and implemented a flexible and intensified insulin therapy. Intensive or flexible therapy involves using a constant supply of insulin to serve as the basalinsulin as well as providing mealtime insulin in doses relative to the nutritional load of the meals. Supplying extra insulin was also allowed when glucose levels were exceedingly high and in need of proper correction. These three components of the insulin regimen are commonly referred to as basal insulin, bolus insulin, and high glucose correction insulin methods.

Researchers evaluated HbA1c values and the directly preceding computerized SMBG-frequencies over a 12 month period. To approximate the relationship between HbA1c and SMBG-frequency the researchers used a fitted piecewise linear spline model with a change in slope at 4 SMBGs per day. The authors of the study recommended a minimal self monitoring blood glucose frequency of 4 times a day for best results.

The final study included a total of 150 patients who underwent the SMBG and HbA1c analysis. The study population used in the study had a median baseline HbA1c of 7.1% (interquartile range 6.6, 7.8). The final statistical assessment included a multivariable analysis which adjusted for gender and psychological problems. It was finally concluded that each added self monitoring blood glucose measurement by each patient was associated with an estimated difference in HbA1c of −0.19% (95% confidence interval (CI) −0.42, 0.05) for ≤4 SMBGs per day and of −0.02% (95% CI −0.10, 0.06) for >4 SMBGs per day.

What this statistical analysis ultimately illustrated was that optimal metabolic control was possible for diabetic type 1 patients with routine diabetes care, flexible and intensified insulin therapy coupled with continuing patient education and a minimum of 4 SMBGs checks per day.

A.Minder, D. Albrecht, J. Schäfer, and et al. "Frequency of blood glucose testing in well-educated patients with diabetes mellitus type 1: How often is enough?" Division of Endocrinology Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.. Elsevier Ireland Ltd, 31 May 2013. Web. 4 Jun 2013.

Advertisement


 

Bookmark and Share | Print | Category | Home

This article originally posted 13 June, 2013 and appeared in  BG ControlType 1 DiabetesInsulinGlucose MonitoringIssue 681

Past five issues: Diabetes Clinical Mastery Series Issue 225 | Issue 765 | Diabetes Clinical Mastery Series Issue 224 | Issue 764 | Diabetes Clinical Mastery Series Issue 223 |

2014 Most Popular Articles:

Significant Weight Loss and Drop in A1c with New Combo of Lorcaserin and Phentermine
Posted January 16, 2015
ADA Issues New Standards of Medical Care for Diabetes
Posted January 02, 2015
New Guidelines Recommend Off-Loading to Increase Likelihood of Diabetic Foot Ulcer Healing
Posted December 26, 2014
Handbook of Diabetes, 4th Ed., Excerpt #25: Specific Circumstances that Affect Diabetes Control
Posted January 04, 2015
FDA Approves Weight-management Drug Saxenda
Posted December 26, 2014
Dr. Timothy Garvey on Qsymia and Other New Therapies for Weight Loss
Posted January 12, 2015
Advancement in the Artificial Pancreas
Posted December 26, 2014
Type 2 Diabetes Risk Lower for Blood Type O
Posted December 26, 2014
Increased Mortality with Combining Sulfonylurea and Insulin
Posted December 26, 2014
Early Insulin Therapy Makes an Impact
Posted December 26, 2014


Browse by Feature Writer & Article Category.
A. Lee Dellon, MD | Aaron I. Vinik, MD, PhD, FCP, MACP | Beverly Price | Charles W Martin, DD | Derek Lowe, PhD | Dr. Brian Jakes, Jr. | Dr. Fred Pescatore | Dr. Tom Burke, Ph.D | Eric S. Freedland | Evan D. Rosen | Ginger Kanzer-Lewis | Greg Milliger | Kristina Sandstedt | Laura Plunkett | Leonard Lipson, M.A. | Louis H. Philipson | Maria Emanuel Ryan, DDS, PhD | Marilyn Porter, RD, CDE | Melissa Diane Smith | Michael R. Cohen, RPh, MS, ScD, FASHP | Paul Chous, M.A., OD | Philip A. Wood PhD | R. Keith Campbell, Professor, B.Pharm, MBA, CDE | Richard K. Bernstein, MD | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

Cast Your Vote
Will you prescribe inhaled insulin (Afrezza) when it becomes available this year?
CME/CE of the Week
Jeffrey M. Robbins, DPM

Category: General Diabetes
Credits: .5
Search Articles On Diabetes In Control