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Glucose monitoring 

Glucose monitoring
Glucose monitoring

John C. Pickup

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date: 28 June 2022

Blood glucose concentrations are measured in diabetes to detect hyper- and hypo-glycaemia. Health care professionals need this information to diagnose diabetes, or states of impaired glucose tolerance, to adjust therapy and correct hyper- and hypo-glycaemia in established diabetes, to interpret signs and symptoms in patients (e.g. is confusion due to hypoglycaemia or another cause?), and to assess the risk of tissue complications developing in the future (the severity and duration of hyperglycaemia is clearly related to microvascular disease). The patient with diabetes measures blood glucose concentrations to take corrective action with food and insulin, to maintain good control, to check the safety of everyday activities (e.g. not driving when hypoglycaemic), to assess the impact of events and lifestyle and on control (exercise, diet, illness, psychological stress), and to ensure a good quality of life and the ‘peace of mind’ that knowledge of the blood glucose concentration gives.

Glucose monitoring has traditionally been performed by intermittent sampling of blood glucose concentrations, either in hospital or by the patient testing their own blood glucose concentrations at home using finger-prick capillary blood samples applied to reagent strips and inserted into portable glucose meters – self-monitoring of blood glucose (SMBG). In addition, in the last decade or so, continuous glucose monitoring (CGM) has entered clinical practice as a supplement to SMBG, albeit with limited uptake at present. CGM is based on the implantation of needle-type glucose sensors, or microdialysis probes, into the subcutaneous tissue for measurement of interstitial glucose concentrations.

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