"Of course, patients and providers have to consider each unique situation as they determine whether home blood glucose monitoring is appropriate", Donahue says. It has been seen that simple lifestyle measures such as a good diet, eating frequently and regular exercise can help in managing type 2 diabetes.
"There has been a lack of consensus, not just in the United States, but worldwide".
Many patients with type 2 diabetes not treated with insulin regularly perform self-monitoring of blood glucose (SMBG), although the value of that practice has been debated. These patients, too, are often recommended glucose monitoring.Treatment plans don't change based on blood sugar test results.
Type 2 diabetes results from cells becoming resistant to insulin, with the pancreas still able to produce insulin in most cases.
After one year, the researchers found no evidence that self-monitoring led to improved glycemic control and no significant differences found in health-related quality of life between patients who performed once-daily self-monitoring with those who did not self-monitor. The paper, published in JAMA Internal Medicine, details findings from a trial called "The MONITOR Trial".
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Incorporating technology into self-management activities has been touted as potentially transformative for patients, yet one recent study found that diabetic patients who self-monitored their blood glucose levels at home did not control their conditions any better than patients who did not self-monitor. There were no notable differences in hypoglycemia (low blood sugar), hospitalizations, emergency room visits.
For this latest study, Donahue and colleagues sought to gain a better understanding of how SMBG affects hemoglobin A1c levels - an indicator of long-term blood glucose control - and HRQOL for patients with type 2 diabetes who are not treated with insulin. "For majority, the costs may outweigh the benefits", she added.
Most of the 25 million people with type 2 diabetes in USA today do not take insulin but control their blood sugar with exercise, diet, and sometimes medications such as metformin. Hemoglobin A1c is a blood test (usually done at the doctor's office) that provides an average of about two to three months of blood sugar levels.
A number of smaller trials have previously shown mixed results in attempting to verify this. "We did not find harms, nor did we find benefits". Patients had an average age of 61 and had had diabetes for an average of eight years. Daily testing imposes not only a financial cost, but can also take a mental toll, increasing the rate of depression or anxiety in some patients. All in all, home finger stick blood tests did not prove any health advantage, even when the monitoring process was enhanced by technology. "The lack of standard guidelines makes it all the more hard for patients, who are already struggling to manage a chronic condition".
The study that involved 450 patients suggested that patients living with diabetes should discuss the need for blood sugar monitoring with their health care providers. If together a patient and their provider decide that blood sugar monitoring is not necessary, patients could be spared hundreds of finger sticks and save hundreds of dollars every year, at least until insulin treatment is required.
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