Type 1 diabetes
It is recommended that all people with Type 1 diabetes undertake self monitoring of blood glucose. The use and frequency of testing, and target blood glucose level should be agreed between the person with Type 1 diabetes and their health care team. Information on Flash Glucose Monitoring can be found here.
Type 2 diabetes
Use of Self Monitoring of Urine Glucose not recommended
This is not recommended for routine clinical practice
Use of Self Monitoring of Blood Glucose not recommended
People with Type 2 diabetes who are diet or tablet controlled (except as below).
Short term use of Self Monitoring of Blood Glucose
The need for self monitoring of blood glucose should be reviewed after the indication for its use has resolved, or at 6 monthly intervals. In particular, attention should be paid to whether someone is utilising the results of glucose monitoring appropriately.
- At diagnosis if there is diagnostic uncertainty around diabetes type or rate of progression.
- People with Type 2 diabetes treated with sulphonylureas who have had symptoms of hypoglycaemia or are at risk of hypoglycaemia.
- People with Type 2 diabetes commencing glucocorticoid treatment.
- People who have had pancreatic surgery and/or pancreatitis.
- At times during intercurrent illness e.g. following surgery, acute illness.
- People with Type 2 diabetes in pregnancy or gestational diabetes.
- Where someone wishes to gain insight into their diabetes, and how blood glucose varies with dietary modification and exercise.
Long term use of Self Monitoring of Blood Glucose
- People with Type 2 diabetes treated with insulin who should be using self monitoring of blood glucose to guide their insulin doses, and manage symptoms of hypoglycaemia. Information on Flash Glucose Monitoring can be found here.
- People with Type 2 diabetes treated with sulphonylureas who drive and wish to monitor blood glucose before or during driving.
Background Evidence
Evidence supporting patient benefit from self monitoring of blood glucose (SMBG) in Type 2 diabetes is poor, with two recent randomised controlled trials showing no improvement in HbA1c in patients with non-insulin treated Type 2 diabetes who were newly diagnosed (ESMON et al. BMJ 2008) or stably treated (DiGEM Farmer et al. BMJ 2007). The ESMON study also showed SMBG increased depression scores. The data for self monitoring of urinary glucose is poor, but there is no evidence that urine testing is better than no intervention. Based on a review of evidence SIGN Guideline 116 on the Management of Diabetes (2010) stated that routine self monitoring of blood glucose in people with Type 2 diabetes who are using oral glucose-lowering drugs (with the exception of sulphonylureas) is not recommended.
Monitoring Management
Health care professionals issuing blood glucose meters should:
- Provide clear guidance regarding use of the meter including advice on interpretation of the blood glucose results
- Provide contact details for the healthcare professional responsible for providing advice regarding diabetes management
- Assess and agree target blood glucose range, frequency of testing and duration of monitor use taking account of individual need
Meter companies provide monitoring diaries, technical support, and notification of safety hazards relative to their product
Blood Glucose Meters for use by NHS Staff and People with Diabetes
A list of blood glucose meters for use by NHS staff and people with diabetes can be found here
Last Update February 2019