title: Self-monitoring of blood glucose in diabetes mellitus: arguments for an individualized approach.
abstract: BACKGROUND
  The utility of glucose self-monitoring in different types and stages of diabetes is controversial, as there is only sparse relevant evidence from randomized controlled clinical trials. In this analysis, the authors aim to develop individualized recommendations based on clinical needs and the available literature.
  
  
  METHODS
  The PubMed database was searched for articles that appeared up to 30 September 2008 containing the terms "measurement," "control","monitoring," and "hypoglycemia"; the retrieved articles were supplemented by other articles that were cited in them. A directed search was also made for the recommendations of the German, European, American, and international diabetological societies. Conclusions were then drawn about the useful modalities and extent of glucose self-monitoring on the basis of the clinical features of the major types of diabetes and the main treatment strategies for them.
  
  
  RESULTS
  With the exception of intensified treatment strategies (which rely on blood-sugar regulation with insulin), only a few evidence-based recommendations can be derived from randomized clinical trials and meta-analyses. Nonetheless, a strategy for self-monitoring according to the patient's individual needs can be derived from the characteristics of therapeutic regimens: depending on the type of diabetes from which the patient suffers, the predicted number of glucometer strips required for self-monitoring will vary from almost none to roughly 400 per month.
  
  
  CONCLUSIONS
  The decision to use glucose self-monitoring, as well as the type and extent of self-monitoring that will be used, should be based on the individual patient's type of diabetes, treatment regimen, and clinical characteristics. Like any other type of therapeutic intervention, self-monitoring should have a well-documented, rational justification.
authors.affiliation: Diabeteszentrum Bad Lauterberg, 37431 Bad Lauterberg, Germany. M.Nauck@diabeteszentrum.de
authors.forename: Michael A
authors.initials: MA
authors.lastname: Nauck
authors.forename: Andrea
authors.initials: A
authors.lastname: El-Ouaghlidi
authors.forename: Irfan
authors.initials: I
authors.lastname: Vardarli
mesh_terms: D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000639:trends*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D012646:Self Administration / Q000379:methods* / Q000639:trends*
chemical_list: D007328:Insulin