Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis
Abstract
Objective To assess the effect of self-monitoring of blood glucose (SMBG) on glycaemic control in non-insulin treated patients with type 2 diabetes by means of a systematic review and meta-analysis. Research design and methods MEDLINE and the Cochrane Controlled Trials Register were searched from inception to January 2009 for randomised controlled trials comparing SMBG with non-SMBG or more frequent SMBG with less intensive SMBG. Electronic searches were supplemented by manual searching of reference lists and reviews. The comparison of SMBG with non-SMBG was the primary, the comparison of more frequent SMBG with less intensive SMBG the secondary analysis. Stratified analyses were performed to evaluate modifying factors. Main outcome measures The primary endpoint was glycated haemoglobin A(1c) (HbA(1c)), secondary outcomes included fasting glucose and the occurrence of hypoglycaemia. Using random effects models a weighted mean difference (WMD) was calculated for HbA(1c) and a risk ratio (RR) was calculated for hypoglycaemia. Due to considerable heterogeneity, no combined estimate was computed for fasting glucose. Results Fifteen trials (3270 patients) were included in the analyses. SMBG was associated with a larger reduction in HbA(1c) compared with non-SMBG (WMD -0.31%, 95% confidence interval -0.44 to -0.17). The beneficial effect associated with SMBG was not attenuated over longer follow-up. SMBG significantly increased the probability of detecting a hypoglycaemia (RR 2.10,…
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Published reviews have concluded that SMBG is clinically ineffective.
“However, published reviews have concluded that SMBG is clinically ineffective (16–18)”
Two recent systematic reviews reported small but significantly greater decreases in HbA1c with SMBG than controls in type 2 diabetes not treated with insulin.
“Two recent systematic reviews of randomized controlled studies of SMBG in people with type 2 diabetes not treated with insulin reported small but significantly greater decreases in HbA 1c among patients using SMBG than in controls (110,111).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [110]
The effect of SMBG on HbA1c was limited to patients with HbA1c values ≥8% (64 mmol/mol).
“The effect of SMBG was limited to patients with HbA 1c values $8% (64 mmol/mol).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [110]
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“Regular blood glucose monitoring improves blood glucose level among people with T2DM [146] and its frequency varies from person to person depending on the patient’s needs and health care provider’s advice.”
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- Authors
- Allemann, S., Houriet, C., Diem, P., & Stettler, C.
- Affiliations
- University of Bern (CH)
- Corresponding author
- Allemann, Sabin
- Venue
- Current Medical Research and Opinion
- Publisher
- Informa Healthcare
- Published
- 2009-10-14
- Volume
- 25
- Issue
- 12
- Pages
- 2903-2913
- ISSN
- 0300-7995 (ISSN-L)
- 1473-4877
- OpenAlex
- W1974111768
- Cited by
- 115
- References
- 62
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 1 · 2019: 5 · 2018: 11 · 2017: 9 · 2016: 8 · 2015: 8 · 2014: 7 · 2013: 16 · 2012: 17
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Medical Research and Opinion (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Funders
- University of Texas at Austin
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- self-monitoring of blood glucose, type 2 diabetes, non-insulin-treated patients, glycemic control, HbA1c, hypoglycemia, fasting blood glucose
- MeSH terms
- Algorithms, Diabetes Mellitus, Type 2, Humans, Hypoglycemia, Hypoglycemic Agents, Blood Glucose Self-Monitoring, Incidence
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