Value of self-monitoring of blood glucose in non-insulin-using patients with type 2 diabetes

Abstract

Design. A randomized controlled trial. Subjects. Participants included 184 adults with newly diagnosed type 2 diabetes who were not taking insulin. Methods. Participants were randomized to receive either a structured educational program alone or a structured educational program plus additional training and advice about self-monitoring of blood glucose (SMBG). All participants received follow-up visits every 3 months with predefined treatment algorithms based on A1C level. Patients in the SMBG group were asked to complete four fasting and four postprandial measures per week and were given advice about what to do in response to high SMBG readings. Results. Adherence to SMBG was good: 66% of participants in the SMBG group completed > 80% of requested measures. No differences between groups were observed in A1C at 12 months (6.9% in each group; mean difference 0.07%; 95% confidence interval -0.25 to 0.38) or in the incidence of hypoglycemia. Those in the SMBG group had somewhat higher scores on the depression subscale of a well-being questionnaire. Conclusions. The addition of SMBG did not appear to provide additional benefit for newly diagnosed, non-insulin-using patients with type 2 diabetes who were receiving care in an organized program with a strong educational component.