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Is Self-Monitoring of Blood Glucose Helpful in Type 2 Diabetes?

This practice does not appear to improve glycemic control for non–insulin-treated patients.

In the U.S., many type 2 diabetic patients self-monitor their blood glucose, even if their blood glucose levels are well controlled and they are not taking insulin. However, data conflict on whether self-monitoring improves glycemic control in such patients. In this observational Australian study, researchers analyzed the association between glycemic control and self-monitoring of blood glucose.

A cross-sectional study included 1286 patients (median glycosylated hemoglobin [HbA_1c] level, 7.4%) who were treated with diet only (32%), oral drugs only (56%), or insulin (12%). Frequency of self-monitoring was at least once daily in 20%, less than once daily in 49%, and never in 30%. Glycemic control (determined by HbA_1c level) was not associated with frequency of self-monitoring, after adjustment for potentially confounding variables. Moreover, in a 5-year longitudinal study that involved a subgroup of 531 patients, self-monitoring was not associated with glycemic control.

Comment: In this cohort of type 2 diabetic patients, self-monitoring of blood glucose did not improve glycemic control. The results are not surprising, given the small proportion of patients who used insulin and the fairly good level of glycemic control. Although I believe that self-monitoring adds little benefit for many non–insulin-treated patients, intermittent self-monitoring can be useful in selected cases to alert patients and clinicians that blood glucose levels are trending too high or too low.

— Allan S. Brett, MD

Published in Journal Watch General Medicine August 31, 2006

Citation(s):

Davis WA et al. Is self-monitoring of blood glucose appropriate for all type 2 diabetic patients? The Fremantle Diabetes Study. Diabetes Care 2006 Aug; 29:1764-70.

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