Self-monitoring of Blood Glucose in Diabetes Patients

Self-monitoring of blood glucose (SMBG) is an essential tool advocated for achieving improved glucose control. For patients taking insulin, this has long been accepted as instrumental in monitoring the effect their insulin is having on their blood glucose levels. The evidence for self-monitoring of blood glucose for patients not taking insulin however remains unclear. It is hypothesized that self-monitoring for these patients has a beneficial effect by encouraging dietary and lifestyle changes in response to continuous blood glucose feedback.

A recently published meta-analysis in the American Journal of Managed Care examines this.

“With an estimated cost of $466 million for Medicare alone, establishing the efficacy or lack of efficacy of SMBG represents an important goal for providers and payers interested in optimizing management of this condition” said the authors of the study from the Veterans Affairs of the Greater Los Angeles Healthcare System, and the RAND Corporation.

The researchers reviewed nine randomized controlled trials “measuring the effect of SMBG compared with no SMBG with A1C as an outcome.” They concluded that “at most, SMBG produces a statistically significant but clinically modest effect in controlling blood glucose levels in patients with DM not taking insulin. It is of questionable value in helping meeting target values of glucose control.”

For the full study, please visit: http://www.ajmc.com/files/articlefiles/AJMC_08jul_Towfigh468to475.pdf