Self-monitored blood glucose: the essential biofeedback signal in the diabetic patient's effort to achieve normoglycemia.

Seventeen pregnant diabetic women participated in a special outpatient program during which they learned to self-monitor blood glucose (BG) and to vary insulin dosage on the basis of the results. The Ames Eyetone reflectance meter and the Boehringer Reflomat were used for BG analysis. BG was self-monitored at least twice a day, with a 24-h profile once a week. The average mean BG from 220 wk of pregnancy was 101 mg/dl. No macrosomia has been seen in deliveries so far. Delivery has been later than is usual in our hospital. The number of necessary days of hospitalization was reduced by 45, as compared with a previous intensive outpatient program for pregnant diabetic women without self-monitoring. An important element of the program was a weekly group session in which individual experiences were shared and discussed in detail. Patients were enthusiastic about the program.

[Blood sugar self-profiles. Improvement in diabetes control in outpatients (author's transl)]. / Blutzuckerselbstabnahme. Verbesserung der Diabeteseinstellung durch ambulante Tagesprofile.

15 insulin-dependent diabetics who had been hospitalised for evaluation and modification of their treatment regimen were trained to take their own blood samples with 10 microliter glass capillaries. Blood sugar self-profiles were analysed from each patient twice in hospital and afterwards at home. Urine samples were also self-tested for sugar. The profiles were carried out reliably and seem to cause a minimum of trouble to the patient. This method of feedback, with comparison of blood and urine sugar values, increased the patient's understanding and ability to vary his own insulin dosis. The analysis of 3 daily profiles for each patient showed increasing improvement in metabolic control. This also increased motivation to keep to a regimen in which insulin dosage, physical activity, and nutrition are in balance. For the first time daily profiles were introduced which could be carried out under the normal conditions of the patient's daily life.