Self‐monitoring in Type 2 diabetes mellitus: a meta‐analysis

Coster, Samantha; Gulliford, Martin; Seed, Paul; Powrie, Jake; Swaminathan, R.

doi:10.1046/j.1464-5491.2000.00390.x

Cited by 164 publications

(116 citation statements)

References 22 publications

(28 reference statements)

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“…This equates to an absolute reduction in HbA 1c from 9.0% to 8.7% over 18 months, consistent with systematic reviews which have estimated that SMBG reduces HbA 1c by 0.4% [23]. This improvement in glycaemic control was also reflected at 18 months in clinically important reductions in HbA 1c from baseline of 12.5% in almost one-quarter of participants.…”

Section: Discussionsupporting

confidence: 84%

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)

et al. 2009

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Aims To determine whether continuous glucose information provided through use of either the GlucoWatch G2 Biographer or the MiniMed continuous glucose monitoring system (CGMS) results in improved glycated haemoglobin (HbA 1c ) for insulintreated adults with diabetes mellitus, relative to an attention control and standard care group.Methods Four hundred and four adults taking at least two daily insulin injections and with two consecutive HbA 1c values ‡ 7.5% were recruited to this randomized controlled trial (RCT). All were trained at baseline to use the same monitor for traditional capillary glucose testing throughout the 18-month study. The CGMS group were asked to wear the device three times during the first 3 months of the trial and on another three occasions thereafter. The GlucoWatch group wore the device a minimum of four times per month and a maximum of four times per week during the first 3 months and as desired for the remainder of the trial. Trained diabetes research nurses used downloaded data to guide therapy adjustments. Proportional reduction in HbA 1c from baseline to 18 months was the primary outcome measure.Results Neither an intention-to-treat nor per-protocol analysis showed improvement in HbA 1c in the device groups compared with standard care. For the intention-to-treat analysis, when the standard care group was compared with each of the other groups, this equated to differences in mean relative HbA 1c reduction (95% confidence interval) from baseline to 18 months of 3.5% ()1.3 to 8.3; GlucoWatch), 0.7% ()4.1 to 5.5; CGMS), and )0.1% ()4.6 to 4.3; attention control).Conclusions The additional information provided by these devices did not result in improvements in HbA 1c in this population.

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Section: Discussionsupporting

confidence: 84%

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)

et al. 2009

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“…This association too, did not change considerably when adjusted for disease severity and the personal objectives of selfmonitoring. The observed importance of clinical status and personal objectives is confirmed by previous studies [6][7][8][9]15,16].…”

Section: Discussionsupporting

confidence: 82%

Perceived diabetes status is independently associated with glucose monitoring behaviour among type 2 diabetes mellitus patients

Klungel

Storimans

Floor-Schreudering

et al. 2008

Primary Care Diabetes

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were excluded. We used logistic regression to calculate odds ratios (OR) and their 95% confidence intervals (CI).Results: About 54% of the patients (n = 841) returned evaluable questionnaires. After exclusion of 97 type 1 diabetes mellitus patients, 744 type 2 diabetes mellitus patients were included.Practising SMBG was more common among patients who rated their diabetes status as poorly or moderately controlled compared to those who rated it (very) well-controlled (OR 1.93; 95% CI: 1.20-3.12). A better perceived diabetes status was more likely in those who performed SMBG infrequently compared to those who performed SMBG frequently (p-value for trend = 0.001). Self-reported factors of disease severity and personalised objectives did not affect these associations considerably.Conclusions: Among type 2 diabetes mellitus patients, SMBG behaviour is associated with patients' perceptions of diabetes status, irrespective of the self-reported disease severity.

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“…b ↔ indicates no difference in health outcomes; + indicates improvements in health outcomes; and -indicates decline in health outcomes. c Downs and Black score ranges were given corresponding quality levels: excellent (26)(27)(28) and good (20)(21)(22)(23)(24)(25). Studies that scored either in the fair (15)(16)(17)(18)(19) of a wireless personal digital assistant (PDA) with diabetes management software and an integrated motivational game (DiaBetNet) may assist youth 8-18 years with diabetes (type 1 and type 2) in managing their blood glucose levels.…”

Section: Cell Phones and Wireless Devicesmentioning

confidence: 99%

Health Technologies for Monitoring and Managing Diabetes: A Systematic Review

Russell-Minda

Jutai

Speechley

et al. 2009

J Diabetes Sci Technol

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Background: The primary objective of this review was to determine the strength of evidence for the effectiveness of self-monitoring devices and technologies for individuals with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) based on specific health-related outcome measures. Self-monitoring devices included those that assist patients with managing diabetes and preventing cardiovascular complications (CVCs). A secondary objective was to explore issues of feasibility, usability, and compliance among patients and providers. Methods: Study criteria included individuals ≥14 years and youth (7–14 years) with T1DM or T2DM, intervention with a self-monitoring device, assessment of clinical outcomes with the device, literature in English, and ≥10 participants. Relevant published literature was searched from 1985 to 2008. Randomized controlled trials and observational studies were included. Data were extracted for clinical outcomes, feasibility and compliance methods, and results. Selected studies were independently evaluated with a validated instrument for assessing methodological quality. Results: Eighteen trials were selected. Predominant types of device interventions included self-monitoring of blood glucose, pedometers, and cell phone or wireless technologies. Feasibility and compliance were measured in the majority of studies. Conclusions: Self-monitoring of blood glucose continues to be an effective tool for the management of diabetes. Wireless technologies can improve diabetes self-care, and pedometers are effective lifestyle modification tools. The results of this review indicate a need for additional controlled trial research on existing and novel technologies for diabetes self-monitoring, on health outcomes associated with diabetes and CVCs, and device feasibility and compliance.

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Self‐monitoring in Type 2 diabetes mellitus: a meta‐analysis

Abstract: The results do not provide evidence for clinical effectiveness of an item of care with appreciable costs. Further work is needed to evaluate self-monitoring so that resources for diabetes care can be used more efficiently.

Cited by 164 publications

References 22 publications

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)

Perceived diabetes status is independently associated with glucose monitoring behaviour among type 2 diabetes mellitus patients

Health Technologies for Monitoring and Managing Diabetes: A Systematic Review

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Self‐monitoring in Type 2 diabetes mellitus: a meta‐analysis

Abstract: The results do not provide evidence for clinical effectiveness of an item of care with appreciable costs. Further work is needed to evaluate self-monitoring so that resources for diabetes care can be used more efficiently.

Cited by 164 publications

References 22 publications

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA1c in insulin‐treated diabetes (MITRE Study)

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA1c in insulin‐treated diabetes (MITRE Study)

Perceived diabetes status is independently associated with glucose monitoring behaviour among type 2 diabetes mellitus patients

Health Technologies for Monitoring and Managing Diabetes: A Systematic Review

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Product

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Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)

Randomized controlled trial to assess the impact of continuous glucose monitoring on HbA_1c in insulin‐treated diabetes (MITRE Study)