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Essentially all individuals with diabetes should monitor their blood glucose level. SBGM is invaluable because of the instant and accurate data it provides, plus patient acceptance has been helped by the ease of use and accuracy of modern meters. Common objectives of its use are:

• Detection of hypoglycemia, especially in individuals with hypoglycemia unawareness.

• Improved decision making regarding adjustments of care in response to dietary and exercise changes.

• Enhanced effectiveness of patient-provider dialog regarding efficacy of the current therapy, and help in designing strategies to attain the glycemia targets.

• A level of patient self-sufficiency and problem solving that did not exist prior to their being able to determine a blood glucose level. This is true in emergent situations; when patients don't feel well, they can determine what role, if any, glycemia is playing. Also, patients can be safely managed at home during illness or acute hypo- or hyperglycemia that before SBMG would have led to seeking emergent medicaJ attention. This concept is true for chronic management as well. Intensive diabetes management strategies and the current mantras of "self-care" and "self-management" could not exist without SBMG.

Advantages

• Allows die patient to practice self-management, resulting in increased independence, self-confidence, and motivation.

• Provides reliable, objective, and quick test results for improved treatment decisions.

• Instant feedback on diet, exercise, and medication effects, anytime, anywhere.

• Detects or confirms asymptomatic hypoglycemia or hyperglycemia.

Disadvantages

• Discomfort of pricking the finger. Meters have recently come onto the market that use alternative sites (most commonly the forearm) that are advertised as being painless. However, these alternative sites are not as accurate as fingertip testing when blood glucose levels are rapidly changing, such as after meals or during the development of hypoglycemia.

• Cost is a major barrier for many people. Although insurance reimbursement for diabetes medications is growing, many plans still do not cover test strips, which cost $0.60 to $0.80 each.

• Requires a degree of mental acuity and manual dexterity that is sometimes lacking in the chronically ill or elderly.

• Incorrect technique or equipment malfunction can lead to erroneous test results and inappropriate decision making. However, over the last few years meters have become easier to use and more reliable, and require less blood for accurate testing. In the past, using too small a blood sample was a major cause of inaccurate results.

• Persistently high or labile blood sugars can lead to patient frustration. Paradoxically, the patient's motivation for better diabetes control can be hurt by "bad blood sugars," leading to avoidance of testing.

• Inconvenience of carrying supplies and taking the time to test and record information. Most meters now have memories that allow later written documentation.

should be checked for accuracy, especially when their log results are inconsistent with other indices of glycemia such as HbA|C.

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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