Self Monitoring of Blood Glucose - SMBG Chart

Self-monitoring of blood glucose (smbg) is very crucial for those diabetics who are on insulin or on certain oral anti-diabetic drugs which can cause hypoglycemia. To achieve best glycemic control it is essential to know how your daily blood glucose levels are fluctuating in an entire day.

It is easier for a diabetes specialist to adjust drugs or to adjust insulin dose if good smbg record is maintained by the patient.

Normally we check fasting and 2 hr post prandial blood sugar levels in the lab for routine follow-up. There is a bright chance of sugar excursions in the other post meal readings which get unnoticed. Even in case of hba1c or glycated hemoglobin test we get an average result of blood glucose of last 3 months.

In practice, I have seen several patients who had to fast and post prandial blood glucose lab tests in the normal range but hba1c levels below 7 is not achieved because they might have high blood sugars in other post meals which have got unnoticed.

To achieve the best blood glycemic control it is important to control blood sugar levels within normal limits during the entire day and not just fasting or post breakfast levels.

Interpretation of smbg chart:

In the above image of smbg chart, I have mentioned 7 point charting system where you can fill your blood glucometer readings which you take on several spots in an entire day.

Seven points includes:

    Fasting or before breakfast reading
    2 hrs after breakfast

    Before lunch
    2 hrs after lunch
    Before dinner
    2 hrs after dinner or bedtime
    At mid night 3.00 am

This seven point smbg charting approximately covers entire day glucose fluctuations to some extent (of course not as accurate as cgms).

I have also mentioned a comment column in the above smbg chart where you can note down change in food or change in insulin dose or any other changes that you have made which probably caused unusual readings like for example if hypoglycemia occurs at before lunch reading and you have skipped breakfast or had very little snack at breakfast you can mention that.

You do not need to check daily all the 7 points, you can check any one or 2 points randomly depending upon your sugar control.

More uncontrolled blood sugars require more frequent smbg glucometer monitoring.

Monitoring of blood glucose at home in case of diabetic pregnancy or gestational diabetes is also important where frequent monitoring and smbg charting of glucometer readings helps a lot to the patient.

I hope this article will help you to control your blood sugar levels more efficiently.

If you find that some of the post-meal or pre-meal readings are high or low, please consult your diabetologist with smbg chart to adjust your medication or insulin dosage.

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Awareness is prevention!