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© 2005 by the American Diabetes Association, Inc.
Reviews/Commentaries/ADA Statements |
Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes Who Are Not Using Insulin
A systematic review
1 Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, the Netherlands
2 Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
3 Department of Endocrinology, Diabetes Center, VU University Medical Center, Amsterdam, the Netherlands
Address correspondence and reprint requests to Laura M.C. Welschen, MSc, Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. E-mail: l.welschen@vumc.nl or www.emgo.nl
Abbreviations: SMBG, self-monitoring of blood glucose • SMUG, self-monitoring of urine glucose
| The first 300 words of the full text of this article appear below. |
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INTRODUCTION |
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A strict glycemic control reduces the risk of the development of micro- and macrovascular complications (1–3). In the U.K. Prospective Diabetes Study, each 1% reduction in HbA1c was associated with a 37% decrease in risk for microvascular complications and a 21% decrease in risk for any end point or death related to diabetes (3). In clinical practice, a 3-monthly visit to the general practitioner is recommended for the assessment of glycemic control (4). There is now much debate on the effectiveness of self-monitoring of blood glucose (SMBG) as a tool in the self-management of diabetic patients (1,5,6).
SMBG aims at collecting information on blood glucose levels at different time points during the day and allows for the timely identification of high levels. SMBG has proven effective for patients with type 1 diabetes (7–9) and patients with type 2 diabetes who are using insulin (10–12) because the information about a patient’s glucose level is useful to refine and adjust insulin dosages, resulting in an improved glycemic control. It has been suggested that patients with type 2 diabetes who are not using insulin might also benefit from SMBG (13). These patients might cope more independently with their disease when using SMBG, and they might achieve a better understanding about the factors that affect their disease and potentially a better perceived quality of life. SMBG might also improve adherence to pharmacological treatment and motivate patients to make appropriate lifestyle changes (10,14).
Until 2001, several reviews investigated the literature on the effectiveness of SMBG in patients with type 2 diabetes who are not using insulin and reported no clear effects of SMBG on HbA1c (1
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RESEARCH DESIGN AND METHODS |
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Identification of studies
Study selection
Methodological quality assessment
Data extraction
Data analysis
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RESULTS |
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Methodological quality of included studies
Outcomes
HbA1c.
Fasting plasma glucose.
Hypoglycemic episodes.
Quality of life, well-being, and patient satisfaction.
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CONCLUSIONS |
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Nonrandomized controlled trials
Methodological issues
Implications for practice and research
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