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Type-2 diabetes: self-monitoring of blood glucose levels not a key factor in reducing complications

Self-monitoring of blood glucose levels does not play a big part in preventing complications associated with type-2 diabetes, but it does increase anxiety and mood disorders.

The available evidence at the start of the 2000s showed no improvement in the control of blood glucose levels through self-monitoring of type-2 diabetes patients, but it did reveal increased symptoms of anxiety and depression. Two reviews of trials provide robust new evidence.

A report published in 2010 analysed 10 trials involving nearly 2300 patients, including those receiving hypoglycaemic drugs and those not. It showed a statistically significant reduction in the level of glycohaemoglobin (HbA1C, the standard blood glucose test in the treatment of diabetes) in self-monitoring patients compared with those who do not self-monitor. But in practice, this reduction of around 0.2% in absolute terms is of uncertain clinical relevance.

The 2010 review of the results of six studies showed that self-monitoring improves understanding of diabetes and empowers patients. But patients who self-monitor their blood glucose levels showed more signs of mood disorders and anxiety than those who did not.

Another report, published in 2012, analysed the personal data of around 2500 patients. Self-monitoring patients would adjust their treatment according to the readings. This analysis also revealed a decrease of around 0.2% of glycohaemoglobin levels in patients who self-monitored compared with those who did not.

In practice, self-monitoring of blood glucose levels in diabetic patients receiving an anti-diabetic treatment other than insulin does not play an important part in reducing complications associated with type-2 diabetes.

©Prescrire 1 September 2012

Source : "Autosurveillance glycémique et diabète de type 2. Non décisive pour réduire les complications du diabète" Rev Prescrire 2012; 32 (344): 448.