Home blood glucose monitoring, or self-monitoring of blood glucose (SMBG), is an essential component of treatment for type 1 diabetes. People with type 1 diabetes need to monitor their blood glucose at least 4 to 10 times a day to titrate insulin doses, determine correction insulin doses, assess accuracy of carbohydrate counting, as well as to prevent and treat hypoglycaemia. Blood glucose monitoring for type 1 diabetes is discussed in a separate section.
For people with type 2 diabetes, not everyone is required to perform home blood glucose monitoring. It is useful, but not necessary, for people with newly diagnosed diabetes to understand the effect of diet and activities on their blood glucose, for people on sulfonylurea treatment, and for people who intend to fast during Ramadan without insulin treatment. However, home blood glucose monitoring is essential for people with type 2 diabetes who are treated with insulin. The best method to monitor home blood glucose is called a "structured home blood glucose monitoring", also commonly known as "structured self-monitoring of blood glucose (structured SMBG)".
Structured SMBG
Structured SMBG is a system where people with diabetes are educated on how to monitor and how to respond to their home blood glucose readings. Important components of structured SMBG include:
1. Timing of SMBG
2. Frequency of SMBG
3. Blood glucose targets
4. How to respond to blood glucose readings
An example of structured SMBG is where a person with diabetes who are treated with once-daily basal insulin is advised to monitor blood glucose before breakfast (timing) everyday (frequency) to keep the blood glucose within 4 to 7 mmol/L (blood glucose target). The person is advised to increase the dose of basal insulin by 2 units every 3 days if the blood glucose is persistently above 7 mmol/L, or reduce the dose by 4 units if he or she experiences hypoglycaemia (response to blood glucose readings).
The same process of structured SMBG with different sets of instructions can be done for people who are treated with premixed insulin, basal bolus insulin, during pregnancy, as well as during Ramadan fasting.
People at Risk of Hypoglycaemia
Another group of people who will benefit from home blood glucose monitoring is people who are at risk of hypoglycaemia. This is especially true for people with diabetes who are older, frail, with advanced complications, and who are acutely ill. This is discussed separately in the "Hypoglycaemia" section.