Despite the availability of robust evidence demonstrating that lowering glycaemic levels reduces the risks of diabetes-related complications, there has been little improvement in recent years in glycaemic control among individuals with diabetes in Europe and the US. Although widely used, there has been considerable controversy surrounding the role of self-monitoring of blood glucose (SMBG) as a means of achieving glycaemic control. This has resulted in a re-consideration of the prescription of blood glucose strips especially in the current climate of health care cost-containment. Existing clinical recommendations lack specific guidance to patients and health professionals regarding SMBG practice intensity and frequency, particularly for those not treated with insulin. Previous studies of the association between SMBG and glycaemic control found often weak, and sometimes conflicting, evidence. More rigorous longitudinal studies are needed to examine the role of SMBG with special attention to the unique needs of patients using different diabetes treatments, within special clinical sub-populations, and during initiation of SMBG versus its ongoing use. Further understanding of the intensity and frequency of SMBG are also needed to capture variability in glycaemic patterns in order to facilitate more specific guideline development.