Home glucose meters: how accurate should they be to avoid dysglycemia in patients using carbohydrate counting?

Abstract

Accurate self-monitoring of blood glucose is the key to an effective and safe intensive insulin therapy. Indeed, most insulin dosing decisions are made based on the blood glucose values obtained from home glucose meters, in particular for those using diet planning and carbohydrate counting. Patients on that therapeutic regimen depend not only on their ability to accurately estimate the carbohydrate content of each meal but also on the accuracy of the glucose meter being used. Therefore, in order to avoid postprandial hypoglycemia and hyperglycemia, it is of great importance to realize how important is the accuracy of blood glucose meters according to the particular characteristics of each patient. In this regard, we propose an analytic method to find the limits of the blood glucose meters accuracy according to the insulin-to-carb ratio, the insulin sensitivity factor and the ability of each patient to estimate the carbohydrate content of each meal.