The value of self-monitoring of blood glucose: a review of recent evidence.
OBJECTIVE
To review the recent literature relating to the role of self-monitoring of blood glucose (SMBG) and glycemic control.


METHODS
Medline and EMBASE databases were searched between 1996 and June 2008 using terms that included diabetes mellitus, self-care, and blood glucose self monitoring. Both experimental and nonexperimental studies with HbA(1c) as an outcome measure were included. A meta-analysis was performed on randomized controlled trials (RCTs) in type 2 diabetes which met the inclusion criteria.


RESULTS
From 1102 relevant papers, 34 original containing 38 separate studies were identified as being published between 2000 and June 2008. There were 23 studies of type 2 diabetes and, of these, 13 were nonexperimental and 10 experimental, including six RCTs. The results of five of these RCTs in non-insulin-treated type 2 diabetic patients were combined in a meta-analysis with two earlier RCTs which yielded a significant pooled SMBG-related decrease in HbA(1c) of -0.22 (95% CI -0.34% to -0.11%).


CONCLUSIONS
The present meta-analysis showed an SMBG-related HbA(1c) reduction in non-insulin-treated type 2 diabetes patients that was similar to that in previous systematic reviews but in a substantially larger patient sample. This finding is consistent with most observational studies of similarly treated patients.
St John
Andrew
A
ARC Consulting, Perth, W Australia 6050, Australia. andrew.stjohn2@bigpond.com <andrew.stjohn2@bigpond.com>
Davis
Wendy A
WA
Price
Christopher P
CP
Davis
Tim M E
TM
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy; D015444:Exercise / Q000502:physiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human