Abstract
Although self monitoring of blood glucose is accepted to be effective in lowering Hb A1c levels in insulin-treated diabetic patients, any benefit in non-insulin-treated patients remains controversial. Observational studies cannot answer this question because of either patient self selection (individuals with healthier life styles chose to perform more SMBG) or physician self selection (patients in poorer control are asked to perform SMBG). Only randomized controlled trials (RCTs) can provide the answer. Of the 14 published bona fide RCTs, nine show no benefit in lowering Hb A1c levels. In four of the five positive ones, the SMBG group received more intensive education and/or treatment than the control group. In the one in which patients in both groups were followed similarly, over 500 patients were required to produce a statistically significant difference of 0.2% favoring SMBG, the clinical significance of which is debatable. Thus, there is scant evidence that very expensive SMBG in non-insulin-treated patients is effective in lowering Hb A1c levels. This lack of benefit argues for redirecting these resources into areas of diabetes care where strong evidence exists for improving diabetes outcomes.
Keywords: Self monitoring of blood glucose (SMBG), randomized controlled trials (RCTs), non-insulin-treated patients
Reviews on Recent Clinical Trials
Title: Evaluation of Self Monitoring of Blood Glucose in Non-Insulin-Treated Diabetic Patients by Randomized Controlled Trials: Little Bang for the Buck
Volume: 5 Issue: 3
Author(s): Mayer B. Davidson
Affiliation:
Keywords: Self monitoring of blood glucose (SMBG), randomized controlled trials (RCTs), non-insulin-treated patients
Abstract: Although self monitoring of blood glucose is accepted to be effective in lowering Hb A1c levels in insulin-treated diabetic patients, any benefit in non-insulin-treated patients remains controversial. Observational studies cannot answer this question because of either patient self selection (individuals with healthier life styles chose to perform more SMBG) or physician self selection (patients in poorer control are asked to perform SMBG). Only randomized controlled trials (RCTs) can provide the answer. Of the 14 published bona fide RCTs, nine show no benefit in lowering Hb A1c levels. In four of the five positive ones, the SMBG group received more intensive education and/or treatment than the control group. In the one in which patients in both groups were followed similarly, over 500 patients were required to produce a statistically significant difference of 0.2% favoring SMBG, the clinical significance of which is debatable. Thus, there is scant evidence that very expensive SMBG in non-insulin-treated patients is effective in lowering Hb A1c levels. This lack of benefit argues for redirecting these resources into areas of diabetes care where strong evidence exists for improving diabetes outcomes.
Export Options
About this article
Cite this article as:
B. Davidson Mayer, Evaluation of Self Monitoring of Blood Glucose in Non-Insulin-Treated Diabetic Patients by Randomized Controlled Trials: Little Bang for the Buck, Reviews on Recent Clinical Trials 2010; 5 (3) . https://dx.doi.org/10.2174/157488710792007248
DOI https://dx.doi.org/10.2174/157488710792007248 |
Print ISSN 1574-8871 |
Publisher Name Bentham Science Publisher |
Online ISSN 1876-1038 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Human Umbilical Cord Blood Cells and Diabetes Mellitus: Recent Advances
Current Stem Cell Research & Therapy The Significance of Oxidized Low-Density Lipoprotein in Body Fluids as a Marker Related to Diseased Conditions
Current Medicinal Chemistry Berberine as a Promising Safe Anti-Cancer Agent- Is there a Role for Mitochondria?
Current Drug Targets Naringenin and Atherosclerosis: A Review of Literature
Current Pharmaceutical Biotechnology Pharmacological Interactions of Paraoxonase 1 (PON1): A HDL-Bound Antiatherogenic Enzyme
Current Clinical Pharmacology NHE-1: A Promising Target for Novel Anti-cancer Therapeutics
Current Pharmaceutical Design The Role of Mediterranean Diet, CoQ10 and Conjugated-Melatonin in Osteoporosis Primary Prevention and Therapy
Current Nutrition & Food Science Chromium-Picolinate Therapy in Diabetes Care: Molecular and Subcellular Profiling Revealed a Necessity for Individual Outcome Prediction, Personalised Treatment Algorithms & New Guidelines
Infectious Disorders - Drug Targets Screening of Actinomycetes For α-amylase Inhibitors Production
Current Enzyme Inhibition Intracellular Location of KATP Channels and Sulphonylurea Receptors in the Pancreatic β-cell: New Targets for Oral Antidiabetic Agents
Current Medicinal Chemistry The Role of PTB in Insulin mRNA Stability Control
Current Diabetes Reviews Synthetic Cannabinoids: Psychopharmacology, Clinical Aspects, Psychotic Onset
CNS & Neurological Disorders - Drug Targets Therapeutic Angiogenesis: Recent and Future Prospects of Gene Therapy in Peripheral Artery Disease
Current Gene Therapy Editorial: Look for Changes in 2016
Current Molecular Medicine Functional Genomics- and Network-driven Systems Biology Approaches for Pharmacogenomics and Toxicogenomics
Current Drug Metabolism Glucose Transport Regulators
Current Medicinal Chemistry - Immunology, Endocrine & Metabolic Agents Diabetes Mellitus and Male Aging: Pharmacotherapeutics and Clinical Implications
Current Pharmaceutical Design Mitochondria-Mediated Oxidative Stress: Old Target for New Drugs
Current Medicinal Chemistry Re-Wiring the Circuit: Mitochondria as a Pharmacological Target in Liver Disease
Current Medicinal Chemistry Acetylome Regulation by Sirtuins in the Brain: From Normal Physiology to Aging and Pathology
Current Pharmaceutical Design