China: Self-Monitoring of Blood Glucose (SMBG) in Type 2 Diabetes (T2D) Patients

Self-monitoring of blood glucose (SMBG) is effective for controlling blood sugar in type 2 diabetes (T2D) patients who do not use insulin, a recent study published in the Journal of General Internal Medicine has shown. Better outcomes were seen with 8-11 times weekly SMBG accompanied by lifestyle adjustments.

SMBG is a valuable tool in diabetes management, but there is controversy about its efficacy and optimal application in T2D patients treated without insulin. Therefore, Chao Zhang, PhD, Capital Medical University, Beijing, China, and colleagues aimed to examine the efficacy of SMBG in controlling the blood sugar levels in T2D patients not treated with insulin and to find the optimal frequency and the most suitable population to benefit from SMBG.

Study Overview

The study included randomized controlled trials that compared self-monitoring of blood glucose with no SMBG or structured SMBG (with defined frequency and timing of glucose measurement, S-SMBG). For this purpose, the researchers retrieved eligible publications from the online databases between January 2000 to April 2022. The following parameters were assessed:

• Optimal frequency
• Efficacy
• Most suitable population for SMBG

For these parameters, the authors performed meta-analyses and sub-analyses.

Findings

• The authors identified twenty-two studies involving 6204 participants; 17 compared SMBG with no SMBG, and four compared SMBG with S-SMBG.
• Compared with no SMBG, SMBG reduced HbA1c (MD −0.30%), and S-SMBG performed better than SMBG (MD −0.23%).
• Subgroup analyses revealed that HbA1c control was better with 8–11 times weekly SMBG (MD −0.35%) versus other frequencies and with lifestyle modifications (MD −0.37%) than with no adjustments.
• The authors did not observe any significant differences in HbA1c between baseline HbA1c subgroups (≤ 8% and > 8%) and between diabetes duration subgroups (≤ 6 years and > 6 years), respectively.

"The results showed SMBG to be effective for HbA1c (glycated haemoglobin) control in non-insulin-treated T2D patients, although detailed monitoring design is lacking," the researchers wrote. "Better outcomes were observed with 8–11 times weekly SMBG and lifestyle adjustment based on the results of SMBG."

About Self-Monitoring of Blood Glucose

SMBG is an integral part of modern therapy for diabetes. SMBG's goal is to collect detailed information on blood glucose levels at many time points to maintain a more constant glucose level. It is recommended that diabetes patients and their healthcare professionals achieve a specific level of blood sugar control and prevent hypoglycemia.

Reference

Zou, Y., Zhao, S., Li, G. et al. The Efficacy and Frequency of Self-monitoring of Blood Glucose in Non-insulin-Treated T2D Patients: a Systematic Review and Meta-analysis. J GEN INTERN MED (2022). https://doi.org/10.1007/s11606-022-07864-z