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Clinical Summary

T2D but not on insulin: how often should patients test blood glucose?

Takeaway

  • For noninsulin-treated patients with type 2 diabetes (T2D), performing self-monitoring of blood glucose (SMBG) 8-14 times/week is associated with improved glycemic control and reduced BMI.
  • SMBG ≤7 times/week made no difference.

Why this matters

  • SMBG informs patients of their glycemic levels, allowing them to adjust therapy to improve glycemic control.
  • International diabetes guidelines have not established optimal SMBG frequency in noninsulin-treated T2D.

Study design

  • Literature search yielded 12 randomized controlled trials of ≥6-month follow-up, including 3350 noninsulin-treated T2D patients, comparing effect of different SMBG frequencies on HbA1c.  
  • Funding:None.

Key results

  • Performing 8-14 SMBG measurements/week was associated with significant HbA1c reduction at 6 months (mean difference −0.46; P<.00001) and 12 months (−0.20; P<.0001).
  • SMBG performed ≤7x/week was not associated with significant HbA1c change at 6 months (−0.15; P=.23) or 12 months (0.07; P=.25).
  • Performing SMBG 8-14 times/week reduced BMI compared with controls (−0.46; 95% CI, −0.84 to −0.08).
  • Among 4 studies in which physicians applied SMBG results to diabetes medication adjustment, significant HbA1c reduction was seen in the intervention vs control arms (−0.23; P<.00001).

Limitations

  • SMBG benefits may be overestimated because of lack of blinding.
  • Only English-language published trials included.
  • SMBG timing not addressed.

References


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