Assessment of glycemia in diabetes mellitus--self-monitoring of blood glucose.

Self-monitoring of blood glucose (SMBG) is an integral component of diabetes self-care and, if use optimally, essential to obtaining glycemic control. There are many methods currently available and the use of glucometers can provide readily available information on blood glucose patterns over time. However, some barriers to the use of SMBG, such as its cost, are significant. Other barriers, such as pain, patient denial or insufficient encouragement from the health care professional, should be overcome. While we find pre-prandial testing to be more informative, there are instances where post-prandial testing may be useful such as in pregnancy or in patients with early stages of glucose intolerance. In the future, continuous glucose monitoring will become available, and ultimately an insulin delivery device will be linked to continuous monitoring making the "closed loop" artificial pancreas a reality. At present, SMBG is an under-utilized but important part of modern diabetes care and should be recommended for all people with diabetes.