Login

Type 1 diabetes

It is recommended that all people with Type 1 diabetes undertake self monitoring of blood glucose (SMBG). The use and frequency of testing, and target blood glucose level should be agreed between the person with Type 1 diabetes and their health care team.

Type 2 diabetes

Over £100m is spent on blood glucose test strips within the UK, yet evidence supporting patient benefit from self monitoring of blood glucose (SMBG) in Type 2 diabetes is poor, with two recent randomised controlled trials showing no improvement in HbA1c in patients with non-insulin treated Type 2 diabetes who were newly diagnosed (ESMON et al. BMJ 2008) or stably treated (DiGEM Farmer et al. BMJ 2007). The ESMON study also showed SMBG increased depression scores. The data for self monitoring of urinary glucose is poor, but there is no evidence that urine testing is better than no intervention.

Recommendation

Long term use of SMBG

• People with Type 2 diabetes treated with insulin who should be using SMBG to guide their insulin doses, and manage symptoms of hypoglycaemia.
• People with Type 2 diabetes treated with sulphonylureas who drive and wish to monitor blood glucose before or during driving.

Short term use of SMBG

The need for SMBG should be reviewed after the indication for its use has resolved, or at 6 monthly intervals. In particular, attention should be paid to whether someone is utilising the results of glucose monitoring appropriately.

• At diagnosis if there is diagnostic uncertainty around diabetes type or rate of progression.
• People with Type 2 diabetes treated with sulphonylureas who have had symptoms of hypoglycaemia.
• People with Type 2 diabetes commencing glucocorticoid treatment.
• People with Type 2 diabetes in pregnancy or gestational diabetes.
• Where someone wishes to gain insight into their diabetes, and how blood glucose varies with dietary modification and exercise.

Use of SMBG not recommended

People with Type 2 diabetes who are diet or tablet controlled (except as above).

Use of self monitoring of urine glucose

This is not recommended for routine clinical practice

Back to the top of this page

Monitoring Management

Health care professionals issuing blood glucose meters should:

• Provide clear guidance regarding use of the meter including advice on interpretation of the blood glucose results
• Provide contact details for the healthcare professional responsible for providing advice regarding diabetes management
• Assess and agree target blood glucose range, frequency of testing and duration of monitor use taking account of individual need

Meter companies provide monitoring diaries, technical support, and notification of safety hazards relative to their product

Blood Glucose Meter for use by NHS Tayside Staff

The Ascencia Contour, will be issued to, and solely used by healthcare professional in NHS Tayside. All staff must be trained in order to use meter appropriately and undertake quality control.

Blood Glucose Meters for use by Patients

A balance needs to be maintained which restricts the number of different meters recommended or issued to patients but still allows for provision of a meter that is suitable for individual patient need in relation to user acceptability and ease of use

At present, six meters are on the Network Formulary as suitable alternatives:

First Line Meters:

Back to the top of this page

©2010All Rights Reserved