Tests of Glycemia in Diabetes

Tests of Glycemia in Diabetes American Diabetes Association DCCT, Diabetes Control and Complications Trial GSA, glycated serum albumin GSP, glycated serum protein MNT, medical nutrition therapy SMBG, self-monitoring of blood glucose Monitoring of glycemic status, as performed by patients and health care providers, is considered a cornerstone of diabetes care. Results of monitoring are used to assess the efficacy of therapy and to guide adjustments in medical nutrition therapy (MNT), exercise, and medications to achieve the best possible blood glucose control. This position statement presents the recommendations of the American Diabetes Association on the tests used most widely in monitoring the glycemic status of people with diabetes and addresses both patient and physician/laboratory-based testing. It does not address tests for diabetes screening and diagnosis. The recommendations are based on both the American Diabetes Association’s technical review, “Tests of Glycemia in Diabetes” (1), and the National Academy of Clinical Biochemistry’s laboratory medicine practice guideline on the subject (2). BLOOD GLUCOSE TESTING BY PATIENTS Within only a few years, self-monitoring of blood glucose (SMBG) by patients has revolutionized management of diabetes. Using SMBG, patients with diabetes can work to achieve and maintain specific glycemic goals. Given the results of the Diabetes Control and Complications Trial (DCCT) and other studies, there is broad consensus on the health benefits of normal or near-normal blood glucose levels and on the importance, especially in insulin-treated patients, of SMBG in treatment efforts designed to achieve such glycemic goals. The subject of SMBG has been addressed extensively by two American Diabetes Association Consensus Conferences, which provide a comprehensive review of the subject (3,4). Recommendations Based principally on the DCCT results, it is recommended that most individuals with diabetes should attempt to achieve and maintain blood glucose levels as close to normal as is safely possible. Because most patients with type 1 diabetes can achieve this goal only by using SMBG, all treatment programs should encourage SMBG for routine daily monitoring. Daily SMBG is especially important for patients treated with insulin or … [Full Text of this Article]