Review of Tests Used by Patients in Monitoring Diabetes Mellitus

Abstract

Tests used in monitoring diabetes by patients have been reviewed to enable patients make the right choice of tests. Most diabetic patients who take insulin injections or are treated with sulphonylureas should follow intensive treatment programmes that include frequent selfmonitoring of blood glucose (SMBG) at home. This is aimed at achieving preprandial plasma glucose levels of 5.0 – 7.2 mmol l^-l and peak postprandial plasma glucose levels of < 10.0 mmol,sup>-1. Glycated haemoglobin (HbA_1C) should be tested by patients at home or by a doctor every 3 months to access glycaemic control and quality of diabetic care. Management plan should achieve normal or near-normal glycaemia of < 7.0 per cent to reduce diabetic complications. Routine laboratory blood glucose testing by laboratory personnel should be used to test the accuracy of SMBG and all portable capillary blood testing devices, and not access glycaemic control, except when adjusting oral medications in a patient not taking insulin. Home tests for blood â-hydroxybutyrate for diagnosing and monitoring ketoacidosis are available for use by diabetic patients. Urine glucose and ketone tests used by patients are unreliable. Government, non-governmental organizations and individuals should strive to make SMBG and HbA_1C testing accessible and affordable to diabetics to improve diabetic care in Ghana.