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Review
. 2012 May 1;6(3):665-73.
doi: 10.1177/193229681200600323.

The role of self-monitoring of blood glucose in glucagon-like peptide-1-based treatment approaches: a European expert recommendation

Oliver Schnell  1 , Hasan Alawi, Tadej Battelino, Antonio Ceriello, Peter Diem, Anne-Marie Felton, Wladyslaw Grzeszczak, Kari Harno, Peter Kempler, Ilhan Satman, Bruno Vergès
Affiliations
Review

The role of self-monitoring of blood glucose in glucagon-like peptide-1-based treatment approaches: a European expert recommendation

Oliver Schnell et al. J Diabetes Sci Technol. .

Abstract

The role of glucagon-like peptide (GLP)-1-based treatment approaches for type 2 diabetes mellitus (T2DM) is increasing. Although self-monitoring of blood glucose (SMBG) has been performed in numerous studies on GLP-1 analogs and dipeptidyl peptidase-4 inhibitors, the potential role of SMBG in GLP-1-based treatment strategies has not been elaborated. The expert recommendation suggests individualized SMBG strategies in GLP-1-based treatment approaches and suggests simple and clinically applicable SMBG schemes. Potential benefits of SMBG in GLP-1-based treatment approaches are early assessment of treatment success or failure, timely modification of treatment, detection of hypoglycemic episodes, assessment of glucose excursions, and support of diabetes management and diabetes education. Its length and frequency should depend on the clinical setting and the quality of metabolic control. It is considered to play an important role for the optimization of diabetes management in T2DM patients treated with GLP-1-based approaches.

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Figures

Figure 1
Figure 1
Scheme 1, less intensive testing in T2DM. The scheme focuses on paired meal testing (preprandial and postprandial) once per day to identify dynamics of glucose levels in response to a meal. Frequency/duration of testing, according to individual aspects: one paired meal testing monthly/1 week monthly/3–7 days weekly/continuous paired testing.
Figure 2
Figure 2
Scheme 2, intensive testing. Seven tests per day over a minimum of 3 days up to 7 days for educational purposes or for adjustment of therapy or diet. The scheme focuses on the dynamics of glucose levels per day to identify the variability of glucose levels. Frequency/duration of testing: minimum 3 days weekly to 1 week monthly/continuous SMBG.
Figure 3
Figure 3
Allocation of scheme 1 and scheme 2 to different clinical scenarios. Intensity of testing is increasing with treatment escalation and deterioration of glycemic control. Declining intensity of testing with treatment de-escalation and improvement of glycemic control.
See this image and copyright information in PMC

References

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