Addressing Schemes of Self-Monitoring of Blood Glucose in Type 2 Diabetes: A European Perspective and Expert Recommendation

Abstract

Self-monitoring of blood glucose (SMBG) in type 2 diabetes has increasingly been shown to display beneficial effects on glycemic control. SMBG is not only associated with a reduction of hemoglobin A1c but has also been demonstrated to increase patients' awareness of the disease. SMBG has also the potential to visualize and predict hypoglycemic episodes. International guidelines by the International Diabetes Federation, the European Society of Cardiology, and the European Association for the Study of Diabetes and also the International Society for Pediatric and Adolescent Diabetes emphasize that SMBG is an integral part of self-management. More recently, two European consensus documents have been published to give recommendations for frequency and timing of SMBG also for various clinical scenarios. Recently, a European expert panel was held to further facilitate and enhance standardized approaches to SMBG. The aim was to present simple, clinically meaningful, and standardized SMBG strategies for type 2 diabetes. The panel recommended a less intensive and an intensive scheme for SMBG across the type 2 diabetes continuum. The length and frequency of SMBG performance depend on the clinical circumstances and the quality of glycemic control. The expert panel also recommended further evaluation of various schemes for SMBG in type 2 diabetes in clinical studies.

Higher Accuracy of Self-Monitoring of Blood Glucose in Insulin-Treated Patients in Germany: Clinical and Economical Aspects

“…55 The evidence for the clinical benefit of SMBG in diabetes is increasing. 9,11,[56][57][58] The current study supports the view that SMBG is cost-effective and contrasts with some previous observations. [12][13][14]59,60 These studies, however, were criticized for not having included a structured educational and therapeutic component in response to BG values.…”

“…1 It also supports preventive strategies of acute and chronic complications of diabetes. 2 Self-monitoring of blood glucose (BG) increases the patient's awareness of hypoglycemic symptoms 3,4 and facilitates self-regulatory prevention of significant hypoglycemic episodes. 4,5 The need for prevention of hypoglycemic episodes has also been underlined in clinical trials, e.g., Action to Control Cardiovascular Risk in Diabetes; Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; and Veterans Affairs Diabetes Trial.…”

Consensus Report: The Current Role of Self-Monitoring of Blood Glucose in Non-Insulin-Treated Type 2 Diabetes

“…For assessing the potential benefits of SMBG in NIT T2DM, these studies help inform policy decisions, provide insights into the use of test strips, and contribute to the creation of studies of this practice. 8 Large-scale epidemiological studies have generated conflicting outcomes. Some of them do not show that the use of SMBG is associated with improved glycemic control or survival in NIT T2DM.…”

Telehealth Remote Monitoring Systematic Review

“…Guidelines recommend individualized analysis and behavioral treatment based on SMBG profiles. Interventions with structured SMBG for people with type 2 diabetes must include the following features: [10][11][12] 1. Educational intervention (including self-management, SMBG, and/or behavior change) described for participants (Education) 2.…”