A Brief History of Self-Monitoring of Blood Glucose with Glucose Meters
Anton Hubert Clemens received the first patent for a blood glucose meter called the Ames Reflectance Meter on September 14, 1971. Richard K. Bernstein, an insulin dependent physician with diabetes, was one of the first patients to monitor his blood glucose at home using a glucose meter. He published a report on his experiences in an early volume of the medical journal, Diabetes Care. He has also written a book on this subject "Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars".
The first articles in the medical literature on the home blood glucose monitoring were published in 1978 (references 1-5). These demonstrated that patients could reliably measure their blood glucose levels at home and improve control of their glucose levels.
In November 1986, the American Diabetes Association, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health convened a Consensus Conference on Self-Monitoring of Blood Glucose. The results of that conference was that self-monitoring of blood glucose was an exciting and important tool for effective management of patients with diabetes (reference 6). It was recommended that SMBG be used by patients to accomplish the following goals:
(a) Keep track of their glucose levels over time,
(b) Help make day-to-day decisions for managing glucose,
(c) Recognize emergency situations, and
(d) Educate themselves on how to manage their blood glucose levels
SMBG was first used because health care providers and researchers believed that its use would help with glucose control and that better glucose control would reduce or prevent diabetes complications. In other words, if hyperglycemia (too much glucose in the blood) and hypoglycemia (too little glucose in the blood) could be controlled, people with diabetes would remain healthier.
This expectation was shown to be true in 1993, when the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) published results of a large and conclusive study called the Diabetes Control and Complications Trial (DCCT), which involved patients at 29 medical centers in the United States and Canada. In this study, SMBG was an important part of the glucose control strategy.
This study showed that for persons with type 1 diabetes, intensive treatment to keep blood glucose levels close to normal reduced the rate of diabetic complications. In fact, the risk reduction was 76% for eye disease, 50% for kidney disease, and 60% for nerve disease.
These benefits of tight control of glucose were not problem-free however. Patients in the intensive treatment group had an increased risk of hypoglycemia.
In September 1993 the American Diabetes Association held a second Development Conference on Self-Monitoring of Blood Glucose. This conference noted that SMBG was an important component of the treatment plan of patients with diabetes mellitus and four major reasons for using SMBG were discussed:
(a) Controlling glucose at a specific, healthy level,
(b) Detecting and preventing hypoglycemia, and severe hyperglycemia,
(c) Adjusting care in response to changes in life-style for individuals requiring medication, and
(d) Determining the need for starting insulin therapy in gestational diabetes mellitus (temporary diabetes that happens during pregnancy).
Currently, the market for blood glucose meters is several billions dollars per year worldwide and growth continues.
References
1. Danowski TS and Sunder JH: Jet injections of insulin during self-monitoring of blood glucose. Diabetes Care 1:27-33, 1978.
2. Skyler JS et al: Home blood glucose monitoring as an aid in diabetes management. Diabetes Care 1:150-157, 1978.
3.Sonksen PH, Judd Sl, and Lowy C: Home monitoring of blood glucose- method for improving diabetic control. Lancet 1: 729-732, 1978.
4. Walford S et al: Self-monitoring of blood glucose -- improvement of diabetic control: Lancet 1: 7320735, 1978.
5. Peterson et al: Feasibility of tight control of juvenile diabetics through patient-monitored glucose determinations. Diabetes 27(suppl 2): 437, 1978.
6. Ikeda Y et al: Pilot study of self-measurement of blood glucose using the Dextrostix-Eyetone system for juvenile-onset diabetes. Diabetologia 15:91-93, 1978.
