Building Competency in Diabetes Education THE ESSENTIALS

MONITORING| 7-4

BACKGROUND

Monitoring glucose levels is one of the essential diabetes self-management strategies. It provides information regarding the potential for adverse events, effects ofmedication, nutrition, exercise and stress on theblood glucose levels and gives the patient and theHCP awindow into the overall blood glucosemanagement. This information enables the patient to make informed choices and take action based on objective evidence. The capacity to monitor glucose levels (blood glucose and sensor glucose) provides a degree of control in diabetes management that was previously not possible. However, knowledge and skill are necessary for effective implementation. The Diabetes Canada Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada; Blood Glucose Monitoring in Adults and Children with Diabetes: Update 2021 state that “glucose monitoring remains a cornerstone of diabetes management. Most people with diabetes will benefit from self-monitoring of their blood glucose for a variety of reasons” (1). It also notes that patient empowerment and behaviour- change theories may be used to develop effective strategies to support the incorporation of CBG, rtCGM and isCGM into diabetes self-management (1). As diabetes educators we can have a significant impact in assisting patients to develop the confidence and competence to use these monitoring tools and to assist the patient with the interpretation of the data. Technological advances in diabetes management, including the ability to download and interpret the data, have led to user-friendly devices that provide easily accessible information about glucose levels. This information can help to identify factors that may pose challenges to achieving optimal control, and provide feedback to facilitate adjustments to the self-care regimen. Effective use of information provided by CBG, rtCGM and/or isCGM requires initial and ongoing education with clearly defined glycemic goals. An empowering approach to self care will facilitate decision making and adjustments based on interpretation of trends in glucose levels. Ongoing education and support is vital, both for maintaining accuracy of technique via return demonstration and for ensuring accuracy of equipment via laboratory/meter comparisons if concerned(3). With the rapidly evolving advancements in the area of blood glucose monitoring this chapter has been updated to reflect the changes in Diabetes Canada Clinical Practice Guidelines for the Prevention and Management of Diabetes : Blood Glucose Monitoring in Adults and Children with “Diabetes Educators may play a pivotal role in helping patients incorporate blood glucose monitoring into their self-management and care” (2).