An updated Cochrane systematic review found inconsistent evidence of benefit for self-monitoring of blood glucose (SMBG) in people with type 2 diabetes who do not use insulin.
In type 2 diabetes not on insulin, does SMBG, as compared with usual care, reduce HbA1c?
The reviewers also looked at adverse events (including hypoglycemia), quality of life and cost outcomes.
The review included 12 studies, comprising 3,259 patients. The reviewers found that for most of the analyses they planned, there was insufficient or inconsistent data.
However, they did find some statistically significant evidence of benefit for SMBG in:
- newly-diagnosed patients at 12 months of follow-up,
- patients with a duration of more than a year, a 6 months of follow-up,
- greater detection of asymptomatic hypoglycaemia
Users of this research should consider:
- The large amount of important heterogeneity between the studies. Different studies use different definitions of SMBG, with different target populations and differently defined outcomes. You may be better to seek out a good quality individual trial that is more directly relevant to your patient and setting.
- The inconsistency between analyses undertaken at 6 months and 12 months of follow-up.
- Is the reported benefit clinically important?
- Any testing regime can only have benefit if it is accompanied by appropriate changes in treatment.
The full text of this review is available at:
Malanda UL, Welschen LMC, Riphagen II, Dekker JM, Nijpels G, Bot SDM. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD005060. DOI: 10.1002/14651858.CD005060.pub3.