Clinical application guidelines for blood glucose monitoring in China (2022 edition)

Abstract

Glucose monitoring is an important component of diabetes management. The Chinese Diabetes Society (CDS) has been producing evidence-based guidelines on the optimal use of glucose monitoring since 2011. In recent years, new technologies in glucose monitoring and more clinical evidence, especially those derived from Chinese populations, have emerged. In this context, the CDS organised experts to revise the Clinical application guidelines for blood glucose monitoring in China in 2021. In this guideline, we focus on four methods of glucose monitoring that are commonly used in clinical practice, including capillary glucose monitoring, glycated haemoglobin A1c, glycated albumin, and continuous glucose monitoring. We describe the definitions and technical characteristics of these methods, the factor that may interfere with the measurement, the advantages and caveats in clinical practice, the interpretation of glucose metrics, and the relevant supporting evidence. The recommendations for the use of these methods are also provided. The various methods of glucose monitoring have their strengths and limitations and cannot be replaced by one another. We hope that these guidelines could aid in the optimal application of common methods of glucose monitoring in clinical practice for better diabetes care. K E Y W O R D S diabetes, glucose monitoring, guideline 1 | INTRODUCTION Glucose monitoring, as an important part of diabetes management, serves to evaluate the glucose status and the effectiveness of glucose lowering therapies. Common methods of glucose monitoring that are used in clinical practice include capillary glucose monitoring (which includes self-monitoring of blood glucose [SMBG] and the point-ofcare testing [POCT] in hospital), glycated haemoglobin A1c (HbA1c), glycated albumin (GA), and continuous glucose monitoring (CGM). In 2011, the Chinese Diabetes Society (CDS) issued the Clinical application guideline for blood glucose monitoring in China ( 2011Edition) (hereinafter referred to as the guideline), and further revision was made in 2015. In recent years, glucose monitoring technology is evolving in a more convenient, accurate, and minimally invasive or even noninvasive direction. In order to further standardise the use of various tools based on the recent advancements in technologies and evidence, the guideline is revised and updated again.The guideline lists the recommendations at the beginning of each chapter and marks the level of evidence (Table 1). Evidence level A is the evidence based on multiple randomised controlled trials or metaanalysis; evidence level B is the evidence based on a single randomised controlled trial or multiple non-randomised controlled trials;This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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