What Primary Care Providers Can Do to Address Barriers to Self-Monitoring of Blood Glucose

• Published in: Clinical diabetes Vol. 31; no. 1; pp. 34 - 42
• Main Authors: Fisher, William A, Cornman, Deborah H, Kohut, Taylor, Schachner, Holly, Stenger, Patricia
• Format: Journal Article
• Language: English
• Published: Alexandria American Diabetes Association 01.01.2013
• Subjects: Behavior; Diabetes; Diabetics; Glucose; Glucose monitors; Health aspects; Motivation; Physicians; Practice; Success; United States
• ISSN: 0891-8929; 1945-4953
• DOI: 10.2337/diaclin.31.1.34

SMBG can help people with diabetes understand the effects of food and exercise on blood glucose and assist them to make healthy choices; provide insights to patients and clinicians concerning the effectiveness of therapies; and provide direction in efforts to achieve and maintain glycémie control.5,9-11 SMBG will be most effective in improving glycémie control among individuals with diabetes who have learned appropriate self-management actions to take on the basis of SMBG results and who undertake such actions consistently.2·5 Despite the substantial potential benefits of SMBG, however, adherence to recommended frequency and patterns of self-monitoring is suboptimal and inconsistent among many individuals with diabetes.5,9-11 A fundamental goal of the clinical management of diabetes involves facilitating diabetes self-care practices that lead to positive health outcomes.'2 SMBG is seen as a tool that can provide useful information to patients and health care providers (HCPs), assisting patients to become active self-managers and HCPs to make timely and informed treatment adjustments to optimize therapy and improve metabolic outcomes.13 The International Diabetes Federation supports this concept in the first recommendation of its Guideline on Self-Monitoring of Blood Glucose in Non-Insulin-Treated Type 2 Diabetes, which states, "SMBG should be used only when individuals with diabetes (and/or their caregivers) and/or their HCPs have the knowledge, skills, and willingness to incorporate SMBG monitoring and therapy adjustment into their diabetes care plan in order to attain agreed treatment goals. According to Miller and Rollnick, the originators of this approach, "The strategies of Motivational Interviewing are more persuasive than coercive, more supportive than argumentative ...