Experts will debate how often patients with type 2 diabetes should check their blood glucose.
We know that type 2 patients on multiple daily insulin doses should routinely monitor glucose.
But evidence is mixed about whether routine checks improve A1C or reduce hypoglycemia in other patients with type 2 diabetes.
Plus testing can be costly...and results often go unused.
On the other hand, advocates say studies have flaws...and monitoring can help patients see the impact of meds and lifestyle changes.
Use a "common sense" approach...since monitoring is more art than science. Consider glycemic control, risk of hypoglycemia, etc.
As a rule of thumb, advise routine monitoring only if the results will be used to make treatment changes.
For example, in type 2 patients with poor glycemic control, advise checking glucose 3 to 4 times a week to see if med changes are making headway...or checking daily when titrating basal insulin.
But less frequent checks are often okay for patients at or close to A1C goal...along with checking for hypoglycemia symptoms or acute illness.
Generally suggest fasting checks. But if fasting results are normal and A1C is high, occasional postprandial monitoring can show if sugars after meals are driving up A1C...and can educate about the impact of diet.
Train patients how to use their meter...troubleshoot problems... and track and share results. Also teach target ranges... 80 to 130 mg/dL before meals or less than 180 mg/dL after meals.
Get more tips in our chart, Self-Monitoring of Blood Glucose in Type 2 Diabetes, and see our chart, Continuous Glucose Monitoring FAQs, for CGM advice. Also share our handout, Understanding Blood Sugar Numbers.
- JAMA Intern Med 2017;177(7):920-9
- Cochrane Database Syst Rev 2012;(1):CD005060
- Diabetes Care 2018;41(Suppl 1):S55-S64
- Endocr Pract 2016;22(2):231-61
- Chart: Self-Monitoring of Blood Glucose in Patients with Type 2 Diabetes
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FAQ:
Continuous Glucose Monitoring
- Patient Education: Understanding Your Blood Sugar Numbers