Quality Standards for Diabetes Care Toolkit

Blood glucose monitoring

Information on maintaining self-monitoring of blood glucose is also provided with the suggestion that the ‘frequency of blood glucose testing can be reduced once the patient is established on insulin and blood glucose levels are stable, but should still be such as to show the blood glucose profile over the course of the day’.
In addition:

if the patient chooses to test less frequently, ask them to vary testing across different times of the day

patients may choose to test in other patterns, (eg, four times a day on one or two days of the week)

maintenance SMBG can be combined with checking HbA1c levels (3–6 monthly) to assess glycaemic control and the need for medication changes.

Adherence is also an issue for self-monitoring of blood glucose levels. The WHO adherence report (2003) refers to research showing that recommended monitoring of glucose levels was occurring for only 26% of children and adolescents with type 1 and 40% of adults with type 1 diabetes. Finnish and US studies found that 6–7% of adults never tested their glucose levels. Another study of adolescents found that up to 80% made significant mistakes in estimating glucose concentrations in urine, with purposeful under and over reporting also being identified.
In studies of people in the US with type 2 diabetes, it was found that 67% of participants were not following recommendations for testing, and in an Indian study only 23% were performing blood glucose monitoring at home.