Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes Who Are Not Using Insulin
Open accessAbstract
BACKGROUND: Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not using insulin. OBJECTIVES: The objective of this review was to assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Date of last search: September 2004. SELECTION CRITERIA: We included randomised controlled trails investigating the effects of SMBG compared with usual care and/or with self-monitoring of urine glucose in patients with type 2 diabetes who where not using insulin. Included studies should have used at least one of the following outcome measures: glycaemic control, quality of life, well-being, patient satisfaction, or hypoglycaemic episodes. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data from included studies and assessed study quality. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta-analysis. MAIN RESULTS: Six randomised controlled trials were included in the review. Four trials compared SMBG with usual care, one trial compared SMBG with self-monitoring of urine glucose and there was one three-armed trial comparing SMBG with self-monitoring of urine glucose and usual care. Because of the differences in patient characteristics, interventions and outcomes between the studies, it was not possible to perform a meta-analysis. The methodological quality of studies was low. Two of the six studies reported a significant lowering effect of self-monitoring of blood glucose on HbA1c. However, one of these studies had a co-intervention with education on diet and lifestyle. There were few data on the effects of other outcomes and these effects were not statistically significant. AUTHORS' CONCLUSIONS: From this review we concluded that self-monitoring of blood glucose might be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. To assess the potential beneficial effects of SMBG in these patients a large and well-designed randomised controlled trial is required. This long-term trial should also investigate patient-related outcomes like quality of life, well-being and patient satisfaction, and provide adequate education to the patient to allow SMBG to be effective.
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A 2005 Cochrane review concluded that SMBG might be effective in improving glucose control in type 2 diabetes not using insulin.
“A 2005 Cochrane review (105,106) of self-monitoring in individuals with type 2 diabetes not using insulin concluded that SMBG might be effective in improving glucose control.”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [106]
There was insufficient evidence to evaluate whether SMBG improves quality of life, well-being, patient satisfaction, or decreases hypoglycemic episodes.
“There was insufficient evidence to evaluate whether it was beneficial in improving quality of life, improving well-being or patient satisfaction, or decreasing the number of hypoglycemic episodes.”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [106]
The need for and number of required self-monitoring of blood glucose measurements are not clear and depend on the medications used.
“The need for and number of required SMBG measurements are not clear (85) and are dependent on the medications used.”
From Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy (2009) · cites this paper as [85]
A meta-analysis of SMBG in non-insulin-treated patients with type 2 diabetes concluded that some regimen of SMBG was associated with a reduction in A1C of ≥0.4%.
“A meta-analysis of SMBG in non–insulin-treated patients with type 2 diabetes concluded that some regimen of SMBG was associated with a reduction in A1C of ≥0.4%.”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [33]
In the meta-analysis of SMBG in non-insulin-treated type 2 diabetes, many studies also included patient education with diet and exercise counseling and, in some cases, pharmacologic intervention, making it difficult to assess the contribution of SMBG alone to improved control.
“However, many of the studies in this analysis also included patient education with diet and exercise counseling and, in some cases, pharmacologic intervention, making it difficult to assess the contribution of SMBG alone to improved control (33).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [33]
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References 43 · Cited by 374
Research works printed but not linked: 2
- Alderson P, Green S, Higgins JPT (Eds.): Locating and selecting studies for reviews: Cochrane Reviewers' Handbook 4.2.2: section 5 [updated March 2004]. Avail- able from http://www.cochrane.org/ resources/handbook/hbook.htm. Ac- cessed 31 January 2004
- Deeks JJ, Higgins JPT, Altman DG (Eds.): Analysing and presenting results: Co- chrane Reviewers' Handbook 4.2.2: sec- tion 8 [updated March 2004]. Available from http://www.cochrane.org/resources/ handbook/hbook.htm. Accessed 31 Janu- ary 2004
- Authors
- Welschen, L. M. C., Bloemendal, E., Nijpels, G., Dekker, J. M., Heine, R. J., Stalman, W. A. B., & Bouter, L. M.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-06-01
- Volume
- 28
- Issue
- 6
- Pages
- 1510-1517
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2004717077
- Cited by
- 374
- References
- 43
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 12 · 2016: 9 · 2015: 9 · 2014: 17 · 2013: 14 · 2012: 26
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- self-monitoring of blood glucose, type 2 diabetes, non-insulin-treated diabetes, glycemic control, HbA1c, diabetes self-management, hypoglycemia, quality of life, patient satisfaction
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Self Care, Blood Glucose Self-Monitoring, Randomized Controlled Trials as Topic, Databases, Factual
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