Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin.

L. M. Welschen, E. Bloemendal, G. Nijpels, J. M. Dekker, R. J. Heine, W. A. Stalman, L. M. Bouter

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

BACKGROUND: Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not using insulin. OBJECTIVES: The objective of this review was to assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Date of last search: September 2004. SELECTION CRITERIA: We included randomised controlled trails investigating the effects of SMBG compared with usual care and/or with self-monitoring of urine glucose in patients with type 2 diabetes who where not using insulin. Included studies should have used at least one of the following outcome measures: glycaemic control, quality of life, well-being, patient satisfaction, or hypoglycaemic episodes. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data from included studies and assessed study quality. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta-analysis. MAIN RESULTS: Six randomised controlled trials were included in the review. Four trials compared SMBG with usual care, one trial compared SMBG with self-monitoring of urine glucose and there was one three-armed trial comparing SMBG with self-monitoring of urine glucose and usual care. Because of the differences in patient characteristics, interventions and outcomes between the studies, it was not possible to perform a meta-analysis. The methodological quality of studies was low. Two of the six studies reported a significant lowering effect of self-monitoring of blood glucose on HbA1c. However, one of these studies had a co-intervention with education on diet and lifestyle. There were few data on the effects of other outcomes and these effects were not statistically significant. AUTHORS' CONCLUSIONS: From this review we concluded that self-monitoring of blood glucose might be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. To assess the potential beneficial effects of SMBG in these patients a large and well-designed randomised controlled trial is required. This long-term trial should also investigate patient-related outcomes like quality of life, well-being and patient satisfaction, and provide adequate education to the patient to allow SMBG to be effective.

Original languageEnglish
JournalCochrane database of systematic reviews (Online)
Issue number2
Publication statusPublished - 2005

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Blood Glucose Self-Monitoring
Type 2 Diabetes Mellitus
Insulin
Urine
Patient Satisfaction
Glucose
Meta-Analysis
Randomized Controlled Trials
Quality of Life
Outcome Assessment (Health Care)
Bibliographic Databases
Patient Education
Self Care
Type 1 Diabetes Mellitus
Hypoglycemic Agents
Life Style

Cite this

Welschen, L. M., Bloemendal, E., Nijpels, G., Dekker, J. M., Heine, R. J., Stalman, W. A., & Bouter, L. M. (2005). Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin. Cochrane database of systematic reviews (Online), (2).
Welschen, L. M. ; Bloemendal, E. ; Nijpels, G. ; Dekker, J. M. ; Heine, R. J. ; Stalman, W. A. ; Bouter, L. M. / Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin. In: Cochrane database of systematic reviews (Online). 2005 ; No. 2.
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Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin. / Welschen, L. M.; Bloemendal, E.; Nijpels, G.; Dekker, J. M.; Heine, R. J.; Stalman, W. A.; Bouter, L. M.

In: Cochrane database of systematic reviews (Online), No. 2, 2005.

Research output: Contribution to JournalReview articleAcademicpeer-review

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T1 - Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin.

AU - Welschen, L. M.

AU - Bloemendal, E.

AU - Nijpels, G.

AU - Dekker, J. M.

AU - Heine, R. J.

AU - Stalman, W. A.

AU - Bouter, L. M.

PY - 2005

Y1 - 2005

N2 - BACKGROUND: Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not using insulin. OBJECTIVES: The objective of this review was to assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Date of last search: September 2004. SELECTION CRITERIA: We included randomised controlled trails investigating the effects of SMBG compared with usual care and/or with self-monitoring of urine glucose in patients with type 2 diabetes who where not using insulin. Included studies should have used at least one of the following outcome measures: glycaemic control, quality of life, well-being, patient satisfaction, or hypoglycaemic episodes. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data from included studies and assessed study quality. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta-analysis. MAIN RESULTS: Six randomised controlled trials were included in the review. Four trials compared SMBG with usual care, one trial compared SMBG with self-monitoring of urine glucose and there was one three-armed trial comparing SMBG with self-monitoring of urine glucose and usual care. Because of the differences in patient characteristics, interventions and outcomes between the studies, it was not possible to perform a meta-analysis. The methodological quality of studies was low. Two of the six studies reported a significant lowering effect of self-monitoring of blood glucose on HbA1c. However, one of these studies had a co-intervention with education on diet and lifestyle. There were few data on the effects of other outcomes and these effects were not statistically significant. AUTHORS' CONCLUSIONS: From this review we concluded that self-monitoring of blood glucose might be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. To assess the potential beneficial effects of SMBG in these patients a large and well-designed randomised controlled trial is required. This long-term trial should also investigate patient-related outcomes like quality of life, well-being and patient satisfaction, and provide adequate education to the patient to allow SMBG to be effective.

AB - BACKGROUND: Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not using insulin. OBJECTIVES: The objective of this review was to assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Date of last search: September 2004. SELECTION CRITERIA: We included randomised controlled trails investigating the effects of SMBG compared with usual care and/or with self-monitoring of urine glucose in patients with type 2 diabetes who where not using insulin. Included studies should have used at least one of the following outcome measures: glycaemic control, quality of life, well-being, patient satisfaction, or hypoglycaemic episodes. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data from included studies and assessed study quality. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta-analysis. MAIN RESULTS: Six randomised controlled trials were included in the review. Four trials compared SMBG with usual care, one trial compared SMBG with self-monitoring of urine glucose and there was one three-armed trial comparing SMBG with self-monitoring of urine glucose and usual care. Because of the differences in patient characteristics, interventions and outcomes between the studies, it was not possible to perform a meta-analysis. The methodological quality of studies was low. Two of the six studies reported a significant lowering effect of self-monitoring of blood glucose on HbA1c. However, one of these studies had a co-intervention with education on diet and lifestyle. There were few data on the effects of other outcomes and these effects were not statistically significant. AUTHORS' CONCLUSIONS: From this review we concluded that self-monitoring of blood glucose might be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. To assess the potential beneficial effects of SMBG in these patients a large and well-designed randomised controlled trial is required. This long-term trial should also investigate patient-related outcomes like quality of life, well-being and patient satisfaction, and provide adequate education to the patient to allow SMBG to be effective.

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