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Self-monitoring reduces blood-sugar levels in patients with non-insulin-treated Type 2 diabetes

Mannucci E, Antenore A, Giorgino F, Scavini M.  Effects of structured versus unstructured self-monitoring of blood glucose on glucose control in patients with non-insulin-treated type 2 diabetes: A meta-analysis of randomized controlled trials Journalof Diabetes Technology and Science. 2018; 12(1): 183-189.

Review question

• Is self-monitoring of blood-sugar levels effective for patients with Type 2 diabetes who are not treated with insulin?

Background

• Regularly measuring blood-sugar levels may increase awareness of the effect of lifestyle factors, such as food choices and levels of exercise, on health. However, many patients with Type 2 diabetes who are not treated with insulin do not regularly monitor their blood-sugar levels.
• Currently, physicians use blood-sugar charts recorded by patients to adjust treatment plans.
• While self-monitoring of blood sugar is a good way to engage patients in their own care and tailor treatment, is it effective at reducing blood-sugar levels among patients with Type 2 diabetes who are not treated with insulin?

How the review was done

• A detailed search of a number of electronic databases was conducted to identify studies published from 2000 to 2015. Studies that focused on adults with non-insulin-treated Type 2 diabetes who self-monitored their blood-sugar levels were included in the review.
• A total of 151 studies were identified in searches, and 11 were included in the review after assessments for eligibility.
• This review was funded by an unconditional educational grant from Roche Diagnostics.

What the researchers found

• The researchers found that self-monitoring blood-sugar levels effectively reduced blood-sugar levels over the long term in non-insulin-treated Type 2 diabetes. This was particularly the case when self-monitoring was done in a structured way, meaning that the timing and frequency of measurements were specified, and when self-monitoring data was used to adjust medications based on clinical recommendations.
• The researchers suggested that while the reduction in blood-sugar levels was small, the resulting health benefits are significant and difficult to achieve without self-monitoring.

Conclusion

• The review found that self-monitoring blood-sugar levels effectively reduced blood-sugar levels over the long term among patients with Type 2 diabetes who are not treated with insulin, particularly when self-monitoring was done in a structured way.
• While the reduction in blood-sugar levels was small, this can still lead to significant long-term health improvements for patients with Type 2 diabetes who are not treated with insulin.