Self Monitoring of Glucose in Type 2 Diabetics Does Not Work
The Cochrane Review did an analysis of 9 studies of self monitoring of blood glucose. In these studies, There was no beneficial long term effect of self monitoring of blood sugars in Type 2 diabetics not on insulin. The authors say “We did not find good evidence for an effect on general health-related quality of life, general well-being, patient satisfaction, or on the decrease of the number of hypoglycaemic episodes. ”
I had run into this concept before. This study randomized Type 2 diabetics into two groups. The first group received glucometers and were encouraged to check their blood sugars as frequently as they wanted. The second group had no glucometer and could not check their own blood sugars. At one year, there was no significant benefit to self-monitoring of blood sugars. In fact, the only significant difference between the groups was that the self-monitoring group had more depression!
Of course, all patients on insulin, whether Type 1 or Type 2, need to have their blood sugars checked at least every time they get insulin.
However, the take home message from these studies for me is that doing a lot of glucometer checks in Type 2 diabetics who are not on insulin is probably a waste of time, despite the fact that it is heavily marketed on TV. The proper way to follow diabetic control in these patients is by using the HbA1C every 3-6 months.
If you do frequent blood sugar checks in these patients at your facility, bring up the Cochrane Study at your utilization review committee meetings and talk about it!
I know that this can be a controversial topic. Any feedback?
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“Merely having an open mind is nothing. The object of opening the mind, as of opening the mouth, is to shut it again on something solid.”
- G.K. Chesterton