Practical approaches for self-monitoring of blood glucose: an Asia-Pacific perspective

Abstract

Comprehensive glycemic control is necessary to improve outcomes and avoid complications in individuals with diabetes. Self-monitoring of blood glucose (SMBG) is a key enabler of glycemic assessment, providing real-time information that complements HbA1c monitoring and supports treatment optimization. However, SMBG is under-utilized by patients and physicians within the Asia-Pacific region, because of barriers such as the cost of monitoring supplies, lack of diabetes self-management skills, or concerns about the reliability of blood glucose readings. Practice recommendations in international and regional guidelines vary widely, and may not be detailed or specific enough to guide SMBG use effectively. This contributes to uncertainty among patients and physicians about how best to utilize this tool: when and how often to test, and what action(s) to take in response to high or low readings. In developing a practical SMBG regimen, the first step is to determine the recommended SMBG frequency and intensity needed to support the chosen treatment regimen. If there are practical obstacles to monitoring, such as affordability or access, physicians should identify the most important aspects of glycemic control to target for individual patients, and modify monitoring patterns accordingly. This consensus paper proposes a selection of structured, flexible SMBG patterns that can be tailored to the clinical, educational, behavioral, and financial requirements of individuals with diabetes.

Keywords: :

• Diabetes education
• Diabetes mellitus
• Diabetes self-management
• Glucometer
• Insulin
• Self-monitoring of blood glucose (SMBG)

Transparency

Declaration of funding

The development of this manuscript was supported by an unrestricted educational grant from Roche Diagnostics (Asia Pacific).

Declaration of financial/other relationships

S.C. discloses that he is a principal investigator in clinical trials sponsored by Merck Sharp & Dohme, Roche, Novo Nordisk, and Novartis, has served as a consultant to Roche, AstraZeneca, Serdia, and Lilly/Boehringer Ingelheim, and on speaker bureaus for AstraZeneca and Zydus. L.J. discloses that he has been the recipient of research/grant funding from Roche and AstraZeneca, and has served as a consultant/advisor to Eli Lilly, Bristol-Myers Squibb, Novartis, Novo Nordisk, Merck, Bayer, Takeda, Sanofi, Roche, Boehringer Ingelheim, and AstraZeneca. E.K.T. discloses that he has served as a consultant/advisor to Roche, Eli Lilly, Boehringer Ingelheim, Servier, and Novo Nordisk. S.S. and N.-C.Y. declare that they have no relevant relationships to disclose.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Technical, editorial and manuscript drafting assistance was provided by G. Toh of Research2Trials Clinical Solutions Pte Ltd, Singapore. All authors have read and approved the final manuscript and take full responsibility for the accuracy of its content.