Effects of Structured Versus Unstructured Self-Monitoring of Blood Glucose on Glucose Control in Patients With Non-insulin-treated Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials

Mannucci, Edoardo; Antenore, Alessandro; Giorgino, Francesco; Scavini, Marina

doi:10.1177/1932296817719290

Cited by 70 publications

(67 citation statements)

References 32 publications

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“…In a clinical trial with type 2 diabetes patients without insulin treatment, structured SMBG reduced the HbA 1c level by 0.32% . Mannucci E et al performed a meta‐analysis of the effect of structured SMBG on type 2 diabetes patients without insulin treatment and found that structured SMBG effectively reduced the HbA 1c level . However, no study has reported the sustained contribution of structured SMBG to diabetes self‐efficacy.…”

Section: Discussionmentioning

confidence: 99%

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Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Shen

Zhu

et al. 2018

Diabetes Metabolism Res

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Section: Discussionmentioning

confidence: 99%

“…patients without insulin treatment and found that structured SMBG effectively reduced the HbA 1c level. 13 However, no study has reported the sustained contribution of structured SMBG to diabetes self-efficacy.…”

Section: Discussionmentioning

confidence: 99%

Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Shen

Zhu

et al. 2018

Diabetes Metabolism Res

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“…For instance, experts from UK requested once daily testing at different times of the day, while Lu et al recommended performing at least two preprandial SMBG per day, and Bonomo et al and Chidum et al suggested distributing three tests through the week. A recent systematic review highlighted the benefits of structured SMBG over unstructured SMBG on glucose control in patients with non‐insulin‐treated T2D . However, the timing and frequencies of performing SMBG in the three RCTs included in this systematic review were also inconsistent.…”

Section: Introductionmentioning

confidence: 98%

“…A recent systematic review highlighted the benefits of structured SMBG over unstructured SMBG on glucose control in patients with noninsulin-treated T2D. 22 However, the timing and frequencies of performing SMBG in the three RCTs included in this systematic review were also inconsistent.…”

mentioning

confidence: 99%

Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Tan

Lee

2019

Int J Clin Pract

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Aims International diabetes guidelines have not established the frequencies of self‐monitoring of blood glucose in patients with type 2 diabetes (T2D) who do not use insulin. The present study aimed to assess the impact of self‐monitoring of blood glucose (SMBG) frequencies on the glucose control and other outcomes in non‐insulin‐treated patients with T2D. Methods A literature search was performed in four databases. Randomised controlled trials with ≥6‐month follow‐up duration that compared the impact of different frequencies of SMBG on glycated haemoglobin A1c (HbA1c) were included. Studies with abstract only or reported effects of SMBG as a secondary outcome were excluded. Results Of the 1557 studies identified, 12 RCTs with a total of 3350 patients were analysed. Overall, performing SMBG for 8 to 14 times per week was correlated with a better HbA1c control at 6 months (MD −0.46%, 95% CI −0.54 to −0.39) and 12 months (MD −0.20%, 95% CI −0.29 to −0.11). However, up to seven measurements of SMBG per week did not significantly affect glycaemic control. In addition, performing SMBG between 8 and 14 times per week was also associated with improved BMI (MD −0.46, 95% CI −0.84 to −0.08). When the results of SMBG were applied to adjust diabetes medication, a significant reduction in HbA1c levels was observed in the intervention arm compared to the control arm. Conclusions Eight to 14 measurements of SMBG per week were associated with an improved glycaemic control and a reduced BMI in patients with T2D not using insulin.

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“…It is recognized that self-monitoring of blood glucose (SMBG) helps to improve glycaemic control and identify hypoglycaemia in people with Type 1 and Type 2 diabetes treated with insulin, whilst there is ongoing debate regarding the clinical benefits of using SMBG in those with Type 2 diabetes who are not on insulin therapy [1]. Many studies and meta-analyses have been conducted since the first evaluation of SMBG in 1983 [2], with little consensus on the benefit, in part because of the variation in intervention regimens and study populations [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In 2009, the International Diabetes Federation guidelines on SMBG use in non-insulin-treated Type 2 diabetes presented evidence supporting structured blood glucose (BG) monitoring combined with appropriate action [19].…”

Section: Introductionmentioning

confidence: 99%

Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial

et al. 2019

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Aim To examine the impact of structured self‐monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub‐optimally controlled Type 2 diabetes. Methods We conducted a 12‐month, multicentre, randomized controlled trial in people with established (>1 year) Type 2 diabetes not on insulin therapy, with sub‐optimal glycaemic control [HbA1c ≥58 to ≤119 mmol/mol (≥7.5% to ≤13%)]. A total of 446 participants were randomized to a control group (n =151) receiving usual diabetes care, a group using structured self‐monitoring of blood glucose alone (n =147) or a group using structured self‐monitoring of blood glucose with additional monthly ‘TeleCare’ support (n =148). The primary outcome was HbA1c at 12 months. Results A total of 323 participants (72%) completed the study; 116 (77%) in the control group, 99 (67%) in the self‐monitoring of blood glucose alone group and 108 (73%) in the self‐monitoring of blood glucose plus TeleCare group. Compared to baseline, the mean HbA1c was lower in all groups at 12 months, with reductions of 3.3 mmol/mol (95% CI –5.71 to –0.78) or 0.3% (95% CI –0.52 to –0.07; P=0.01) in the control group, 11.4 mmol/mol (95% CI –14.11 to –8.76) or 1.1% (–1.29 to –0.81; P<0.0001) in the group using self‐monitoring of blood glucose alone and 12.8 mmol/mol (95% CI –15.34 to –10.31) or 1.2% (95% CI –1.40 to ‐0.94; P<0.0001) in the group using self‐monitoring of blood glucose plus TeleCare. This represents a reduction in HbA1c of 8.9 mmol/mol (95% CI –11.97 to –5.84) or 0.8% (95% CI –1.10 to ‐0.54; P≤0.0001) with structured self‐monitoring of blood glucose compared to the control group. Participants with lower baseline HbA1c, shorter duration of diabetes and higher educational achievement were more likely to achieve HbA1c ≤53 mmol/mol (7.0%). Conclusions Structured self‐monitoring of blood glucose provides clinical and statistical improvements in glycaemic control in Type 2 diabetes. No additional benefit, over and above the use of structured self‐monitoring of blood glucose, was observed in glycaemic control with the addition of once‐monthly TeleCare support. (Clinical trial registration no.: ISRCTN21390608)

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Effects of Structured Versus Unstructured Self-Monitoring of Blood Glucose on Glucose Control in Patients With Non-insulin-treated Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials

Abstract: In RCTs performed in non-insulin-treated patients with type 2 diabetes, SMBG is associated with a significant, although small, reduction in HbA1c. HbA1c reduction was greater with structured SMBG and when structured SMBG data were used to adjust diabetes therapy.

Cited by 70 publications

References 32 publications

Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial

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