Checking Your Own Blood Sugar

Type 2 diabetes patients not treated with insulin gain little from self monitoring of blood sugar

(RxWiki News) Self-monitoring of blood sugar levels is a key part of managing type 1 and type 2 diabetes in patients treated with insulin. Yet, it is unclear if self-monitoring works for those not treated with insulin.

Type 2 diabetes patients on non-insulin treatment who self-monitored blood sugar had larger reductions in levels of HbA1c (a measure of blood sugar over time), compared to those who did not self-monitor.

However, this difference was too small for the authors to conclude that self-monitoring should be used regularly for patients with non-insulin treated type 2 diabetes.

"Keep track of your blood sugar levels if you have diabetes."

Diabetes occurs when the body no longer produces or responds to insulin, a natural hormone that controls blood sugar levels. When it comes to treating diabetes, some patients need to take insulin while others can take other medications that improve their response to insulin.

Patients who use insulin usually need to draw blood and measure blood glucose on testing strips to ensure they are dosing themselves properly. The current research wanted to see if this type of blood test had any benefit for patients who do not use insulin.

In a recent analysis of past studies, Andrew Farmer, D.M., F.R.C.G.P., of the Department of Primary Health Care at the University of Oxford, and colleagues found that non-insulin treated type 2 diabetes patients who self-monitored blood sugar levels had a 0.25 percent reduction in levels of HbA1c (a measure of blood sugar over three months), compared to those who did not self-monitor.

Overall, those who self-monitored had about a 0.88 percent reduction in HbA1c levels, compared to a 0.69 percent reduction in those who did not self-monitor.

Previous research on this topic has had different results. That is, past studies have estimated different amounts of benefit from self-monitoring in non-insulin treated patients.

From this large analysis of data from 2552 patients, the researchers were still unable to conclude that self-monitoring leads to significantly better results.

While patients who self-monitored had better HbA1c levels than those who did not self-monitor, the difference was too small.

According to the authors, these small reductions in HbA1c might be important from a public health perspective, but only if these reductions are achieved on a wide scale and lower cost.

At the moment, self-monitoring costs remain high, with test strips costing as much as $3.11 in countries like India. While costs are generally lower in developed countries like the United States, the price of self-monitoring for non-insulin treated patients may not be worth the benefits gained.

The authors write that their analysis "lacked convincing evidence to support the routine use of self-monitoring of blood glucose in people with non-insulin treated type 2 diabetes."

"Better evidence that self-monitoring can provide feedback on treatment and behavior are needed before further large scale trials are carried out," they conclude.

More research is needed to determine those groups that may benefit from self-monitoring.

The researchers were supported by the United Kingdom's National Institute for Health Research.

Their study is published in the journal BMJ.