Using Meal-Based Self-Monitoring Blood Glucose (SMBG) Data to Guide Dietary Recommendations in Patients With Diabetes

Abstract

The purpose of this article is to describe how self- monitoring of blood glucose (SMBG) data is a useful tool for identifying and managing postprandial hypergly- cemia (PPHG). PPHG and postprandial glucose excur- sions occur frequently in patients with diabetes even when hemoglobin A1C is controlled below 7.0%, and convey increased risk of cardiovascular morbidity and mortality. Consequently, effective management of diabe- tes must include control of postprandial glucose levels. Postprandial plasma glucose (PPG) depends on the com- position of meals, specifically the amount of carbohy- drates. Reduced-carbohydrate diets offer short-term improvements in glycemic control and other metabolic parameters, but await the support of long-term efficacy and safety studies. Glucose profiling and paired-meal SMBG are useful tools for detecting PPHG and glucose excursions. They provide immediate feedback to patients on the effect of foods and meals, thereby allowing appro- priate food and medication adjustments to improve post- prandial glycemic control