The value of self-monitoring of blood glucose: a review of recent evidence

Aims: 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. (C) 2010 Elsevier Inc. All rights reserved.