Self-monitoring of blood glucose is an essential tool for diabetes management among insulin users, but no proof exists to support self-monitoring in non-insulin-dependent (type 2) diabetes.
This surprising conclusion comes from a report out of Germany’s Institute for Quality and Efficiency in Health Care, an independent scientific organization that investigates the benefits and harms of medical interventions.
A literature search ultimately yielded five comparative trials with and without self-monitoring. The trials lasted only six to 12 months and were not designed to investigate the long-term benefit of blood glucose self-monitoring. Overall, investigators found the quantity of data on hypoglycemia insufficient. But a clinically non-relevant yet statistically significant difference in hemoglobin (Hb) A1c value was noted between patients who engaged in self-monitoring and those who did not. On average, HbA1c was reduced by 0.23 percentage points more in the monitoring group than in the non-monitoring group.
The authors found no proof of harm from a self-monitoring intervention compared with a non-self-monitoring treatment approach. No major differences in weight loss, health-related quality of life, patient satisfaction, or morbidity or mortality were found in comparisons of self-monitoring and non-self-monitoring groups.
“There is no proof of benefit of either [self-monitoring of blood glucose] or [self-monitoring of urine glucose] in patients with diabetes mellitus type 2 who are not receiving insulin,” reported the authors.