At VoyageMD we have been involved in publishing some new ideas around blood glucose monitoring with American and European colleagues. Here are the links:
http://www.journalofdst.org/November2011/PDF/Abstract/VOL-5-6-CLA1-KERR-ABSTRACT.pdf
http://www.journalofdst.org/November2011/PDF/Abstract/VOL-5-6-REV1-KLONOFF-ABSTRACT.pdf
What do they mean:
Self-monitoring of blood glucose is not easy but the results obtained could be much more valuable for people living with diabetes the results lead to positive action. It is likely that positive action will be possible with the introduction of new technologies:
Device manufacturers could include tools to accomplish the following:
o Systems for supporting behaviour change to help people lose weight
o Using new social media to deliver education and peer support and for providing immediate feedback on a device.
o Translate blood glucose test results into understandable information and advice for diabetes management
o Bolus and basal insulin calculators for patients using multiple daily injections of insulin
o Devices for supporting home monitoring and care at a distance from specialist centres
o Aids for interpretation of SMBG data in the form of pattern recognition of hypoglycemia and/or hyperglycemia recurrence.
o Subsequent developments could include specific prompts for clinicians about potential reasons for these events occurring (e.g., inadequate insulin dosing, wrong time of administration of a bolus dose, or insulin stacking due to too frequent bolus dosing)
Also we need to move away from random measurements of blood glucose to provide a more structured approach such as focusing most of the testing between clinic visits in the 1-2 weeks before seeing the doctor.
The bottom line: SMBG is remains a very good idea provided it is thought through and structured. Random testing just for the sake of it is a waste of money.
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