Home blood glucose monitoring: How often?

Abstract

Multiple daily home blood glucose monitoring (HBGM) on a long‐term basis places a heavy burden on people with diabetes. This study questions whether multiple daily testing is superior to once‐daily testing for the purposes of clinical decision‐making once a patient is established on insulin therapy. The HBGM data of 12 IDDM patients treated with three or more insulin injections daily were studied to determine whether once‐daily HBGM at a variable time each day (Var1/day) gave adequate information for clinical use. How the type of patient and the different prescribing habits of health professionals affected the outcome were also examined. We found that there was no significant difference in the estimate of mean blood glucose levels derived from Var 1/day and four times daily (4/day) HBGM data. Comparison of insulin dosage adjustments made by six health professionals (based on pairs of glycaemic profiles derived from these two frequencies of monitoring) showed some discrepancies. However, the discrepancies were not greater than those found when the same health professionals adjusted insulin dosage on two different occasions using the same glycaemic profile. By contrast, insulin adjustment was more dependent on whether the patient was suitable for tight glycaemic control (p < 0.05) and on the prescribing habits of health professionals (p < 0.05). Once‐daily HBGM at a variable time of the day gave adequate information for clinical intervention and has the advantage of reducing the heavy demand on people with diabetes. Copyright © 1993 John Wiley & Sons, Ltd.