Monitoring blood glucose levels at home is termed as SMBG (self-monitoring of blood glucose), in the early 1990s, the first meter for self-monitoring capillary blood glucose was released. Although SMBG is widely practiced in other countries, its use in India is very limited; there seems to be a lack of education about the purpose of SMBG and the correct process and schedule to be followed. SMBG helps both the patient and health care expert to better adjust to therapy and assess the responses.

The benefits are most pronounced when there is willingness and determination to test sugar on patient’s part and this becomes even more effective when they have been given enough education on the importance of testing blood sugar at home and maintaining a log. Frequency of testing blood glucose and the blood glucose targets varies from patient to patient which doctors and his team decide jointly.

Self-monitoring of blood glucose (SMBG) is important because:

• It gives a better understanding of line of treatment for individual patient.
• It gives more clarity to a healthcare provider to better interpret the results and educate the patients accordingly.
• Most patients prone to hypoglycaemia are able to prevent it,threby helps preventing development of hypoglycaemic unawareness
• It gives an understanding of food choices and their impact on blood glucose levels, in a way SMBG silently educates a patient on making appropriate food choices depending on numbers you see on glucometer.
• Helps individualization of exercise therapy for people with type 1, type 2 and gestational diabetes and diabetes with other comorbid conditions.

 SMBG increases life expectancy and improves diabetic patients’ quality of life by preventing complications associated with diabetes. We should bear in mind that the HbA1c parameter for glycemic exposure for the last three months might not be as relevant as is currently believed. It should be common practice to carefully consider SMBG, as it shows real-time variability of blood glucose.

The frequency of testing blood glucose completely depends on persons hyperglycaemic status and the kind of treatment advised, for eg. A person on insulin will need to test more frequently than a person on oral diabetes medications. However, the best person is your doctor or health care provider to guide about frequency and targets of blood glucose tests, which depends on persons age, duration of diabetes, comorbid conditions and the therapy advised.

The expected values for normal fasting blood glucose concentration are between 70 mg/dL and 100 mg/dL and 2 hours post meal is <140mg/dl. When fasting blood glucose is between 100 to 125 mg/dL and post meal blood glucose in between 140-199mg/dl, it indicates prediabetes and changes in lifestyle and monitoring glycaemia are recommended.

The American Diabetes Association (ADA) recommends the following target blood sugar levels for people with diabetes: Between 80 and 130 milligrams per decilitre (mg/dL) before meals. Less than 180 mg/dL two hours after meals. However, blood glucose targets needs to be individualized based on age, activity and co morbid conditions and other treatments an individual with diabetes is going through eg. Steroids, immunosuppressant, anti-depressants etc.