The role of self-monitoring of blood glucose during the treatment of type 2 diabetes with medications targeting postprandial hyperglycemia.South Med J. 2007 Nov; 100(11):1123-31.SM
Intensive treatment has been shown to improve glycemic control and reduce the risk of diabetic complications in controlled clinical trials; however, glycemic control has substantial room for improvement in the diabetic population. Management strategies have traditionally focused on achieving A1c targets, with fasting glucose levels serving as the primary measure of day-to-day glycemic control. Considerable evidence indicates that postchallenge plasma glucose, a surrogate for postprandial hyperglycemia, is an independent cardiovascular risk factor, highlighting the fact that optimal glycemic control requires management of both fasting and postprandial glucose levels. Self-monitoring of blood glucose (SMBG) is an important adjunct for optimizing glycemic control, owing to its ability to differentiate between fasting and postprandial hyperglycemia and to provide feedback on the effects of food choices, medications, and exercise. New and emerging medications specifically targeting postprandial hyperglycemia offer the ability to customize pharmacologic therapy to address specific glycemic defects. Periodic glucose profiles and regular SMBG will remain an important tool for both patients and healthcare professionals when using these newer approaches.