On what evidence-base do we recommend self-monitoring of blood glucose?
Self-monitoring of blood glucose (SMBG) has been considered one major breakthrough in diabetes therapy because, for the first time, patients were able to determine their blood glucose levels during daily life. It seems obvious that this must be of advantage to disease management and clinical outcome, but it has become a nightmare for those trying to provide evidence. Randomised controlled trials have yielded inconsistent results on a benefit of SMBG-based treatment strategies not only in type 2 but - surprisingly - also in type 1 and gestational diabetes. Despite this, SMBG is being considered indispensible in intensive insulin treatment, but is being debated for other clinical settings. When considering the non-RCT based reasons for recommending SMBG in type 1 and gestational diabetes it becomes apparent that the same reasons also apply to type 2 diabetes.
Kolb
Hubert
H
Hagedorn Research Institute, DK Gentofte, Denmark. hubert.kolb@gmx.com
Kempf
Kerstin
K
Martin
Stephan
S
Stumvoll
Michael
M
Landgraf
Rüdiger
R
D000203:Activities of Daily Living; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood; D019317:Evidence-Based Medicine; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
D006442:Glycated Hemoglobin