Tools of Self-Care: Self-Monitoring of Blood Glucose and Tele-Health Resources
The therapy of diabetes was dramatically changed in the late twentieth century with the development of self-monitoring of blood glucose (SMBG). Prior to the advent of this technology, the only glucose tool available to patients was to measure urine glucose. This provided only a poor estimate of blood glucose, often representing the value of several hours earlier, and it was unpopular with patients. Today, in the United States, all people with Type 1 diabetes and most with Type 2 diabetes do some SMBG. In this chapter, we will discuss the history, technology, and clinical usage of SMBG and their integration with computers and mobile devices in the emerging field of tele-health.
KeywordsSelf-monitoring of blood glucose Urine monitoring Glucose meters Reactive strips Lancing devices Smart meters Glucose oxidase Glucose dehydrogenase Tele-health Blood glucose monitoring apps Food apps Insulin dose calculators
Alternate site testing (sites other than the finger)
Blood glucose monitoring
Total amount of carbohydrate in meal
Carbohydrate to insulin ratio
Flavin adenine dinucleotide
Reduced flavin adenine dinucleotide
Food and Drug Administration
Glucose dehydrogenase with the cofactor flavin adenine dinucleotide
Glucose dehydrogenase with the cofactor nicotine adenine dinucleotide
Glucose dehydrogenase with the cofactor pyrroloquinoline quinone
Glucagon-like intestinal peptide-1
Intensive insulin therapy, usually an insulin therapy with a long-acting insulin plus rapid-acting insulin at each meal, also called multiple daily insulin
Inulin on board. The amount of insulin remaining in the injection/infusion site
Median (or mean) absolute relative deviation
Multiple daily insulin therapy, see IIT
Insulin sensitivity factor
International Standards Organization
Sodium-glucose linked transporter. The proteins that reabsorb glucose from the renal tubule
Self-monitoring of blood glucose, a process in which the patient checks their own blood glucose using a blood glucose monitor
Desired blood glucose level
Very large integrated circuit
- 1.American Chemical Society. Al and Helen Free and the development of diagnostic test strips. http://www.acs.org/content/acs/en/education/whatischemistry/landmarks/diagnosticteststrips.html. 8 April 2016. Accessed 1 Sept 2016.
- 3.FDA. Safety: GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) Glucose Monitoring Technology. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm177295.htm. 13 Aug 2009.
- 8.Hortensius, J, Slingerland, RJ, Kleefstra, N, Logtenberg, SJJ, H. Groenier, K, Houweling, ST, Bilo, HJG. Self-monitoring of blood glucose: the use of the first or the second drop of blood. Diabetes Care 2011; 34(3): 556–560.Google Scholar
- 11.Ito T, Kamoi K, Minagawa S, Kimura K, Kobayashi A. Patient perceptions of different lancing sites for self-monitoring of blood glucose: a comparison of fingertip site with palm site using the OneTouch Ultra Blood Glucose Monitoring System. J Diabetes Sci Technol. 2010;4(4):906–10.CrossRefGoogle Scholar
- 14.The T1D Exchange Data Set. www.t1dexchange.org. Queried 21 Sept 16.
- 16.Bolus on Board. http://www.diabetesnet.com/diabetes-control/rules-control/bolus-board. Accessed 24 Sept 2016.
- 18.Welschen LMC, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, Stalman WAB, Bouter LM (for the Cochrane Group). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin (Review). The Cochrane Library. 2009(1):1–30.Google Scholar
- 19.Training, Research and Education for Nurses in Diabetes, UK. Blood glucose monitoring guidelines. http://www.trend-uk.org/documents/TREND_BG_Consensus_May_Final_HIGHRES.pdf. Accessed 27 Sept 2016.
- 21.American Diabetes Association (ADA)/American Geriatrics Society (AGS) Consensus Report on Diabetes in Older Adults 2012. http://www.ndei.org/ADA-AGS-diabetes-older-adults-2012.aspx.html. Accessed 27 Sept 2016.
- 24.Sutter Medical Foundation. Type 2 diabetes adult outpatient insulin guidelines. http://www.srfmr.org/uploads/provider_resource/1331853259-8b5d35db700e0a8b9/Outpatient%20Insulin%20Guidelines%202.17.2011.pdf. Accessed 27 Sept 2016.
- 25.Polonsky WH, Fisher L, Schikman CH, Hinnen DA, Parkin CG, Jelsovsky Z, Petersen B, Schweitzer M, Wagner RS. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study. Diabetes Care. 2011;34(2):262–7. https://doi.org/10.2337/dc10-1732.CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Gurlek A, Erbas T, Gedik O. Frequency of severe hypoglycaemia in type 1 and type 2 diabetes during conventional insulin therapy. Exp Clin Endocrinol Diabetes. 1999;107:220–4.Google Scholar
- 34.Schaefer A. The best diabetes apps of 2016. http://www.healthline.com/health/diabetes/top-iphone-android-apps. Accessed 4 Oct 2016.
- 35.Smith J. Best diabetes apps of 2016. http://www.gottabemobile.com/2016/08/26/best-diabetes-apps/. Accessed 4 Oct 2016.
- 36.UF Diabetes Institute. Diabetes Tracker Apps. http://diabetes.ufl.edu/patient-care/my-diabetes/diabetes-resources/diabetes-apps/ Accessed 4 Oct 2016.
- 37.AppCrawlr. Best iOS apps for insulin calculator. http://appcrawlr.com/ios-apps/best-apps-insulin-calculator. Accessed 8 Oct 2016.
- 40.MDDI. 8 FDA-blessed wearables and apps changing healthcare – BlueStar. http://www.mddionline.com/article/8-FDA-blessed-wearables-apps-changing-healthcare-bluestar. Accessed 8 Oct 2016.
- History of BGM: American Chemical Society. Al and Helen Free and the development of diagnostic test strips. http://www.acs.org/content/acs/en/education/whatischemistry/landmarks/diagnosticteststrips.html. 8 April 2016. Accessed 1 Sept 2016.
- McCullough Dk. Patient education: self-blood glucose monitoring in diabetes mellitus (Beyond the Basics). http://www.uptodate.com/contents/self-blood-glucose-monitoring-in-diabetes-mellitus-beyond-the-basics.
- Welschen LMC, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, Stalman WAB, Bouter LM (for the Cochrane Group). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin (Review). The Cochrane Library. 2009;(1):1–30.Google Scholar