Self-monitoring doesn't help type 2 diabetics

For patients with type 2 diabetes, control of blood sugar (glycemic control) does not appear to be improved if they self-monitor their blood glucose levels, according to researchers at the University of Western Australia, Fremantle.

Dr. Wendy A. Davis and colleagues examined data from 1,286 patients enrolled in the Fremantle Diabetes Study. A total of 531 subjects completed annual reviews over five years. The results of the study are published in the journal Diabetes Care.

Seventy percent of patients reported performing self-monitoring of blood glucose at study entry, with an average of four tests per week. Predictors of blood glucose monitoring included shorter diabetes duration; attending diabetes education sessions or diabetes-related clinics; seeing medical specialists; taking insulin with or without glucose-lowering oral drugs; and self-reporting episodes of low blood sugar.

The data findings revealed no significant differences in blood glucose levels or in frequency of testing between those who self-monitored blood glucose and those who did not. This was true overall and within diabetes treatment groups.

"Current American Diabetes Association recommendations are that self-monitoring of blood glucose should be performed three or more times per day for type 2 diabetic patients using multiple insulin injections, but that for patients using once-daily insulin, oral (glucose-lowering) agents, or diet alone, there is low-level evidence of benefit," Davis and colleagues note.

"Our data," they conclude, "add to the evidence relating to diet- and (glucose-lowering drug)-treated patients, but we did not sub-divide our insulin-treated patients by injection frequency because of relatively low numbers."

They suggest that blood glucose monitoring may still be useful for type 2 diabetic patients who require insulin, for dose adjustments" and for preventing low blood sugar.

SOURCE: Diabetes Care, August 2006.