Self-monitoring in Type 2 diabetes mellitus: a meta-analysis
Article first published online: 7 JUL 2008
Volume 17, Issue 11, pages 755–761, November 2000
How to Cite
Coster, S., Gulliford, M. C., Seed, P. T., Powrie, J. K. and Swaminathan, R. (2000), Self-monitoring in Type 2 diabetes mellitus: a meta-analysis. Diabetic Medicine, 17: 755–761. doi: 10.1046/j.1464-5491.2000.00390.x
- Issue published online: 7 JUL 2008
- Article first published online: 7 JUL 2008
- Accepted 6 September 2000
- blood glucose self-monitoring;
- systematic review;
- Type 2 diabetes mellitus
Aims Self-monitoring of blood or urine glucose is widely used by subjects with Type 2 diabetes mellitus. This study evaluated the effectiveness of the technique at improving blood glucose control through a systematic review and meta-analysis.
Methods Randomized controlled trials were identified that compared the effects of blood or urine glucose monitoring with no self-monitoring, or blood glucose self-monitoring with urine glucose self-monitoring, on glycated haemoglobin as primary outcome in Type 2 diabetes.
Results Eight reports were identified. These were rated for quality and data were abstracted. The mean (sd) quality score was 15.0 (1.69) on a scale ranging from 0 to 28. No study had sufficient power to detect differences in glycated haemoglobin (GHb) of less than 0.5%. One study was excluded because it was a cluster randomized trial of a complex intervention and one because fructosamine was used as the outcome measure. A meta-analysis was performed using data from four studies that compared blood or urine monitoring with no regular monitoring. The estimated reduction in GHb from monitoring was −0.25% (95% confidence interval −0.61 to 0.10%). Three studies that compared blood glucose monitoring with urine glucose monitoring were also combined. The estimated reduction in GHb from monitoring blood glucose rather than urine glucose was −0.03% (−0.52 to 0.47%).
Conclusions 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.