Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials

Zhu, Hongmei; Zhu, Yanan; Leung, Siu-wai

doi:10.1136/bmjopen-2015-010524

Cited by 71 publications

(72 citation statements)

References 29 publications

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“…Within primary care, POCT have been incorporated into chronic disease self-management programs to improve glycemic control in type-2 diabetes mellitus and therapeutic anticoagulation for those on warfarin (Heneghan et al, 2016, Zhu et al, 2016). However, its role in promoting guideline-recommended CVD preventive therapies among an asymptomatic, but at-risk, general population is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study

Karmali

Brown

Sanchez

et al. 2017

Preventive Medicine Reports

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Updated cholesterol guidelines emphasize multivariable cardiovascular disease (CVD) risk estimation to guide treatment decision-making in primary prevention. This study tested the preliminary feasibility, acceptability and efficacy of point-of-care testing (POCT) and quantitative CVD risk assessment in high-risk adults to increase guideline-recommended statin use in primary prevention. Participants were aged 40–75 years, without CVD or diabetes mellitus, and potentially-eligible for consideration of statins based on estimated 10-year CVD risk from last-measured risk factor levels in the electronic health record. We performed POCT to facilitate quantitative CVD risk assessment with the Pooled Cohort Equations immediately before a scheduled primary care provider (PCP) visit. Outcomes were: physician documentation of a CVD risk discussion and statin prescription on the study date. We also assessed acceptability of the intervention through structured questionnaire. We recruited 18 participants (8 from an academic practice and 10 from a federally-qualified health clinic). After the intervention, 83% of participants discussed CVD risk with their PCP, 47% received a statin recommendation from their PCP, and 29% received a new statin prescription during the PCP visit. Participants reported high levels of satisfaction with the intervention. This study demonstrates that in initial testing pre-visit POCT and quantitative CVD risk assessment appears to be a feasible and acceptable intervention that may promote guideline-recommended statin initiation in primary prevention. Future research with an adequately powered trial is warranted to determine the effectiveness of this approach in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study

Karmali

Brown

Sanchez

et al. 2017

Preventive Medicine Reports

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“…A sensitivity analysis was carried out on sample size, which is a dominant factor determining the robustness of the results. The meta‐analysis was thus repeated after excluding studies with sample size less than 100 . All analyses were performed using Review Manager (RevMan) 5.3 software.…”

Section: Methodsmentioning

confidence: 99%

“…Several systematic reviews and meta‐analyses have explored the effects of SMBG on glycaemic control in non‐insulin‐treated T2D patients, showing a reduction of glycated haemoglobin A1c (HbA1c) from 0.21% to 0.34% and a slight improvement in body mass index (BMI) . Despite the improvement in glycaemic control and BMI, finger pricking‐associated pain remains a burden of diabetes management .…”

Section: Introductionmentioning

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 reflects in a much better way intra-and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications (28). Additionally and beyond the effects of the meta-analysis of Zhu et al (29), Rodbard (30) reported that CGM has been demonstrated to be useful in reducing the risks of hypo-and hyperglycemia too, improving glycemic variability and increasing patients' quality of life in both type 1 and type 2 diabetes (30). Additionally and beyond the effects of the meta-analysis of Zhu et al (29), Rodbard (30) reported that CGM has been demonstrated to be useful in reducing the risks of hypo-and hyperglycemia too, improving glycemic variability and increasing patients' quality of life in both type 1 and type 2 diabetes (30).…”

Section: Glucose Monitoringmentioning

confidence: 99%

Technology in Diabetes Treatment: Update and Future

Schiel¹,

Bambauer²,

Steveling

2018

Artificial Organs

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Worldwide the number of people with diabetes mellitus is increasing. There are estimations that diabetes is one of the leading causes of death. The most important goals for the treatment of diabetes are self‐management of the disease and an optimal quality of diabetes control. In the therapy new technologies, like real‐time continuous interstitial glucose monitoring, continuous subcutaneous insulin infusion (CSII), electronic tools for the monitoring of therapeutic approaches, automated bolus calculators for insulin and electronic tools for education and information of patients, have become widespread and play important roles. All these efforts are related to the interaction between patients, caregivers, scientists or researchers and industry. The presentation of different aspects of new technological approaches in the present article should give more information about different technologies. However, because of the rather quickly appearance of new technologies, the presentation can only be a spotlight. Further studies are mandatory to analyze the effects and long‐term benefits of each technology and electronic device.

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Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials

Cited by 71 publications

References 29 publications

Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study

Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study

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

Technology in Diabetes Treatment: Update and Future

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