Advice use of self-monitoring for : insulin dose
self-adjustment; education on effects of life-style on blood glucose; coping with illness
and new situations; hypoglycaemia management and avoidance :
Assess ability to use self-monitored information as part of routine care
Assess skills yearly or if self-monitoring problems
Check meters yearly or if self-monitoring problems
Evaluate reliability of self-test results ( if indicated ) by :
assessment of self-test technique
comparison with acute results obtained at consultation
consistency with the results of glycated haemoglobin estimation
review of the quality of self-test record diaries
Unreliable records suggest a failure of patient education
by the diabetes health-care team
Achieving
effective self-monitoring
Use :
for all people with Type 1 diabetes
reagent strips with or without meters, or electrode strips
Provide appropriate training and regular review of technique
Recommend :
results are recorded ( with date and time, insulin dose, hypoglycaemia )
to provide a cumulative record as a basis for day-to-day changes in therapy
different patterns of testing according to need :
four or more times a day during illness, life-style changes,
pre-conception, in pregnancy, with hypoglycaemia unawareness
at night ( 0200-0400 h ) if unrecognized night-time hypoglycaemia is
suspected
one or two multi-point profiles a week ( on different types of day )
once daily testing is the minimal acceptable frequency ( different
times of day )
day-time tests preprandially and 1-2 h after meals
regular bed-time tests in people prone to nocturnal hypoglycaemia
testing to cope with variations in eating or activity
special equipment for those with visual impairment
urinalysis for glucose where blood glucose monitoring is not possible or
the patient does not wish to continue with it
urinalysis for ketones when hyperglycaemia, illness, or vomiting is
present
