Why is it important to check a patient's blood glucose levels?

From the Guidelines

Checking a patient's blood glucose levels is crucial for monitoring and managing diabetes, preventing complications, and guiding treatment decisions. Regular blood glucose monitoring helps healthcare providers assess how well a patient's diabetes management plan is working, allowing for timely adjustments to medication, diet, or exercise regimens. For patients with diabetes, target blood glucose ranges typically aim for 80-130 mg/dL before meals and less than 180 mg/dL two hours after meals, though individual targets may vary based on age, comorbidities, and other factors.

Key Points to Consider

• Monitoring can be done through finger-stick tests using a glucometer (typically 1-7 times daily depending on the treatment plan) or continuous glucose monitoring systems that provide readings every few minutes, as recommended by the most recent study 1.
• Uncontrolled blood glucose levels can lead to serious short-term complications like hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), as well as long-term complications including cardiovascular disease, kidney damage, nerve damage, and vision problems.
• Blood glucose monitoring is particularly important during illness, stress, or changes in routine, as these factors can significantly affect glucose levels, and healthcare providers should be aware of medications and other factors that can interfere with glucose meter accuracy, such as high-dose vitamin C and hypoxemia 1.
• The physiological basis for monitoring is that insulin resistance or insufficient insulin production disrupts the body's ability to regulate glucose metabolism, requiring external monitoring to maintain homeostasis.

Recommendations for Practice

• Healthcare providers should ensure that patients receive ongoing instruction and regular evaluation of technique, results, and their ability to use data from self-monitoring of blood glucose to adjust therapy, as suggested by 1.
• Providers should be aware of the differences in accuracy among glucose meters and only use U.S. Food and Drug Administration–approved meters with unexpired strips, purchased from a pharmacy or licensed distributor 1.
• Patients should be taught how to use SMBG data to adjust food intake, exercise, or pharmacologic therapy to achieve specific goals, and the ongoing need for and frequency of SMBG should be reevaluated at each routine visit to avoid overuse, particularly if SMBG is not being used effectively for self-management 1.

From the FDA Drug Label

Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose more frequently, especially prior to activities such as driving. You have been instructed to test your blood regularly for glucose Studies have shown that some chronic complications of diabetes such as eye disease, kidney disease, and nerve disease can be significantly reduced if the blood sugar is maintained as close to normal as possible.

It is important to check a patient's blood glucose levels to monitor and control their diabetes, as well as to prevent and detect hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Regular blood glucose monitoring can help identify patterns and trends in blood sugar levels, allowing for adjustments to be made to insulin doses, meal plans, and exercise programs. This can help prevent complications of diabetes, such as eye disease, kidney disease, and nerve disease. 2, 2, 2

• Key points:
  • Monitor blood glucose levels regularly
  • Prevent and detect hypoglycemia and hyperglycemia
  • Adjust insulin doses, meal plans, and exercise programs as needed
  • Prevent complications of diabetes

From the Research

Importance of Blood Glucose Monitoring

• Checking a patient's blood glucose levels is crucial for effective management of diabetes, as it helps to prevent complications associated with the condition 3, 4, 5.
• Blood glucose monitoring provides information on the effectiveness of blood glucose metabolism and guides interventions to achieve optimal glucose control within the body 5.
• Monitoring glucose levels is essential for adjusting hypoglycemic therapy, particularly in insulin users, and for identifying patterns and trends in blood glucose control 3, 4.

Benefits of Regular Blood Glucose Monitoring

• Regular monitoring of blood glucose levels can help to reduce the risk of complications and improve quality of life in patients with diabetes 3, 4, 5.
• Self-monitoring of blood glucose (SMBG) can result in improved glycemic control, reduced hypoglycemia, and a better quality of life for people with diabetes 6.
• Blood glucose monitoring can also help to identify hyperglycemia and diabetes induced by glucocorticoids in nondiabetic and diabetic patients, allowing for personalized hypoglycemic therapy 7.

Methods of Blood Glucose Monitoring

• Self-monitoring of blood glucose (SMBG) is a widely used method for monitoring glucose levels, but it has limitations such as patient inconvenience and sporadic nature 3.
• Continuous glucose monitoring (CGM) provides a more comprehensive picture of glucose levels, but it is expensive and requires constant calibration 3.
• Newer flash continuous glucose monitoring (FCGM) systems offer an alternative glucose monitoring strategy that is more affordable and does not require calibration 3.