Self-monitoring of blood glucose: Psychological barriers and benefits

Abstract

Diabetes is to a large extent a self-managed disease and, in this context, self-monitoring of blood glucose (SMBG) is essential, at least for insulin-treated patients. In practice, the uptake of SMBG is generally low: many patients fail to self-regulate their treatment appropriately. By contrast, a minority of diabetes patients very frequently self-test their blood glucose levels each day to achieve strict glycaemic control. These differences in usage of self-monitoring are largely explained by psychological and social factors. We present a 5-step biopsychosocial model of SMBG - from decision to test (or not), to evaluation of outcomes - that may help to identify and address perceived barriers and benefits from the patient's perspective. Understanding the fundamental psychological principles that underlie SMBG behaviour is a prerequisite to the effective education and counselling of patients who experience problems with SMBG. New technologies are likely to increase the precision of measurement and patient convenience, but not the fundamental challenge of managing negative feedback as part of self-regulating behaviour. Copyright © 2008 FEND.