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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Self-monitoring of blood glucose (SMBG) has become increasingly important in the treatment plan of people with diabetes. Identifying sources of error in SMBG can have a significant clinical impact. The objective of the present study was to evaluate the testing skills in diabetic children and adolescents. The study included 100 patients (46 females and 54 males) with an age of 8-18 years and a mean duration of diabetes of 4.5 years. They were autonomous for SMBG: an experienced diabetes nurse had taught earlier how to proceed. The daily frequency of SMBG was 4 in 79 patients, 3 in 11, and 2 in 10. The observations of their performance of blood glucose monitoring skills were done twice, during 2 consecutive visits at the diabetes clinic at a mean interval of 2 months. Each patient was observed by a specialized nurse who scored the child's testing behavior with an observation grid, according to 45 items. After the first observation, children and adolescents were given feedback on the identified errors. The second observation allowed scoring the improvements. During the first observation, nearly 90% of the patients made 3 or more mistakes, 69% more than 5, and 10% more than 10. During the second observation, these frequencies fall to 17, 2, and 0%. The main errors were the following (first vs second observation, in % of patients): not washing hands: 54 vs 3; incorrect setting for hour and date: 47 vs 2, and 17 vs 2; no knowledge of the meaning of "HI" (blood glucose > 500 or 600 mg/dL): 55 vs 3; no knowledge of the meaning of "LO" (< 10 or 20 mg/dL): 49 vs 1; insufficient blood drop: 19 vs 10. Younger children, with a shorter duration of diabetes and of autonomy for SMGB, need closer supervision. Errors were unrelated to frequency of SMBG, and glycated haemoglobin. To conclude, it is important to periodically assess diabetic children and adolescents' SMGB technique in order to correct the mistakes, mainly in younger children. The use of an observation grid allows an accurate analysis of the numerous possible errors.
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PMID:[Sources of errors in blood glucose self-monitoring in 100 young diabetics]. 1280 73

The self-monitoring of blood glucose (SMBG), traditionally performed by "point-of-care" (POC) devices called portable glucose monitors (PGM) is now considered an integral part of managed care of diabetic patients, especially type 1 diabetics and those on insulin therapy. In patients with type 2 diabetes, SMBG can help to achieve a better glycaemic control, although there is not sufficient evidence to attest that strict monitoring in these patients is associated with an improved outcome. The outcome of several clinical studies, especially in diabetics on insulin therapy, has shown that SMBG plays a key role in preventing complications in the short, medium and long term. According to the current recommendations, SMBG is aimed to achieve and maintain glycaemic control, prevent and identify hypoglycaemia, prevent severe hyperglycaemia, adjust lifestyle changes and establish the need to begin treatment with insulin in gestational diabetes mellitus. However, as clearly highlighted by the American Diabetes Association (ADA) and the National Academy of Clinical Biochemistry (NACB), patients and healthcare personnel should be trained on the appropriate use of the device, as well as on the correct interpretation of data. Moreover, definite analytical targets and appropriate acceptance criteria for performance should be fulfilled before a new device is introduced in the hospital environment, or recommended to the patients. Performance limitations such as hematocrit extremes and analytical interferences should be clearly acknowledged by the operators, before taking test results for granted. The current article aims to review the current indications for SMGB and highlight the most important criteria for the appropriate use of PGMs.
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PMID:Overview on self-monitoring of blood glucose. 1916 74