Assessing glycaemic control: self-monitoring of blood glucose

Diabetes Mellitus is a chronic, lifelong metabolic disorder characterized by an elevated blood glucose level resulting from an absolute or relative shortage of insulin. Self-monitoring of blood glucose (SMBG) has escalated over the years following the outcomes of evidence demonstrating a strong correlation between tight blood glucose control and the significant reduction of diabetes-related complications. While glycosylated haemoglobin (HbA1c) measures mean glycaemic exposure during the preceding 2-3 months, it does not provide day-to-day changes in glucose levels. SMBG represents an important adjunct to HbA1c because it distinguishes among fasting, preprandial (before a meal) and postprandial (after a meal) hyperglycaemia and provides immediate feedback about the effect of food choices, activity and medication on glycaemic control. The successful outcome of glycaemic control cannot be effectively achieved without the input of the nurse. The nurse's role is to identify people with diabetes who are most likely to benefit from SMBG and provide them with appropriate education, problem solving skills and ongoing support.