Blood Glucose Monitoring - Effectiveness

Effectiveness

For patients with diabetes mellitus type 2, the importance of monitoring and the optimal frequency of monitoring are not clear. There is no evidence that better HbA1c monitoring leads to better patient outcomes in actual practice. One randomized controlled trial found that self-monitoring of blood glucose did not improve the HbA1c among "reasonably well controlled non-insulin treated patients with type 2 diabetes".A recent meta-analysis of 47 randomized controlled trials encompassing 7677 patients showed that self-care management intervention improves glycemic control in Diabetics, with an estimated 0.36% (95% CI, 0.21-0.51) reduction in their glycosylated Hemoglobin values.Furthermore, a recent study showed that patients described as being “Uncontrolled Diabetics” (defined in this study by HbA1C levels >8%) showed a statistically significant decrease in the HbA1C levels after a 90-day period of seven-point Self-Monitoring of Blood Glucose (SMBG) with a Relative Risk Reduction (RRR) of 0.18% (95% CI, 0.86-2.64%, p<.001). Regardless of lab values or other numerical parameters, the purpose of the clinician is to improved quality of life and patient outcomes in diabetic patients. A recent study included 12 Randomized controlled trials and evaluated outcomes in 3259 patients. The authors concluded through a qualitative analysis that SMBG on quality of life showed no effect on patient satisfaction or the patients’ health-related quality of life. A recent study found that a treatment strategy of intensively lowering blood sugar levels (below 6%) in patients with additional cardiovascular disease risk factors poses more harm than benefit. For type 2 diabetics who are not on insulin, exercise and diet are the best tools. Blood glucose monitoring is, in that case, simply a tool to evaluate the success of diet and exercise. But those with type 2 who use insulin need to monitor their blood sugar just as frequently as those with type 1.