Self-monitoring in doubt for type-2 diabetes

Self-monitoring of blood glucose levels does not improve blood glucose control in non-insulin using type-2 diabetics, claim UK researchers.

The findings, presented at the American Diabetes Association Conference in Chicago last week, suggest that the current guidelines for self-monitoring among these patients should be reviewed.

Self-monitoring for non-insulin treated type-2 diabetes is commonly recommended, but evidence of effectiveness is inconclusive.The researchers id-entified 453 type-2 diabetes patients aged 25 and over, who managed their diabetes with diet or hypoglycaemic agents alone.

Patients were randomly assigned to one of three groups. The control group received standard care with three monthly HbA1c measurements.

The second group was given a meter with advice to contact their GP for interpretation of results, while the third group was given a meter and trained to interpret the readings and apply the results (intensive self-monitoring).

After one year, no difference in HbA1c was found between the three groups.

The researchers concluded that the cost, effort and time involved in self-monitoring of blood glucose for patients with non-insulin-treated type-2 diabetes may be better directed to supporting other health-related behaviours.

BMJ Online 2007; Live links at http://www.healthcarerepublic.com

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