Self-monitoring of blood glucose levels in diabetes. Principles and practice.

Self-monitoring of blood glucose levels has become popular due to the limitations in the use of urine testing for assessing the status of diabetes control. Furthermore, the recent emphasis on the importance of diabetes regulation entails that patients tailor the insulin doses based on blood glucose levels. This review discusses the methodology of capillary blood glucose monitoring and its application to insulin adjustments. When performed properly, self-monitoring is accurate, reliable, and effective. It can also be beneficial in detecting hypoglycemia and may have a positive psychological impact as well. The reduction in the frequency of office and laboratory visits makes self-monitoring potentially cost-effective. Although useful for a broad segment of the type I diabetic population and for an increasingly large number of individuals with type II diabetes, self-monitoring may have a limited role in patients with severe, irreversible complications.