Assessment of glycemia in diabetes mellitus--self-monitoring of blood glucose.

Self-monitoring of blood glucose (SMBG) is an integral component of diabetes self-care and, if use optimally, essential to obtaining glycemic control. There are many methods currently available and the use of glucometers can provide readily available information on blood glucose patterns over time. However, some barriers to the use of SMBG, such as its cost, are significant. Other barriers, such as pain, patient denial or insufficient encouragement from the health care professional, should be overcome. While we find pre-prandial testing to be more informative, there are instances where post-prandial testing may be useful such as in pregnancy or in patients with early stages of glucose intolerance. In the future, continuous glucose monitoring will become available, and ultimately an insulin delivery device will be linked to continuous monitoring making the "closed loop" artificial pancreas a reality. At present, SMBG is an under-utilized but important part of modern diabetes care and should be recommended for all people with diabetes.

Correlation of neuropathy with corneal sensitivity and lacrimal gland secretion in type 2 diabetes mellitus patient.

AIM: To evaluate correlation between blood glucose control, corneal sensitivity and lacrimal secretion in type 2 DM with peripheral neuropathy. METHODS: A cross sectional study has been conducted in 20 type DM with peripheral neuropathy and 20 without peripheral neuropathy at the Department of Internal Medicine and Ophthalmology, Ciptomangunkusumo Hospital, Faculty of Medicine University of Indonesia, from August through November 2002. All subject underwent a comprehensive medical examination, including esthesiometer Semmes-Weinstein 10 g, HbA1c, Schirmer test, and corneal sensitivity measurements. RESULTS: The mean corneal sensitivity was significantly lower in diabetic patients with neuropathy (p=0.000). HbA1(c) was related to corneal sensitivity (p=0.016). CONCLUSION: In type 2 DM with peripheral neuropathy, corneal sensitivity was demonstrated to be significantly decrease, all of which seems to be due to the status of blood glucose control.