Self-monitoring of Blood Glucose Levels and Intensified Insulin Therapy

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Abstract
Prospective studies have shown that children and adolescents with diabetes have a high prevalence of serious complications and a sharp reduction in life expectancy. Recently, self-monitoring of blood glucose levels has become available and, for the first time, provides a method for determining the concentration of blood glucose with considerable accuracy. We have introduced this method of control assessment to our pediatric diabetic patient population in conjunction with a program of intensified insulin administration (two or more injections per day). This is a report of the ready acceptance of these methods by children and adolescents and their parents (53/63, or 84%). The effectiveness of this program is evidenced by a progressive and significant reduction in the percentage of glycosylated hemoglobin during a period of 18 months in a majority of the subjects. These observations suggest that improved glycemic control can be achieved in young diabetics by using multiple insulin injections and self-monitoring of blood glucose levels. Whether such control can lead to a better long-term outlook for diabetics remains to be seen. (JAMA1983;249:2913-2916)