People with diabetes are often advised to check their blood sugar levels at home by pricking a finger and testing the blood with a glucose meter. They can review the results with their doctors over the phone, online, or at the next office appointment. The value of this for people with type 2 diabetes is uncertain.
In a study published in JAMA Internal Medicine, researchers enrolled 450 people with Type 2 diabetes, none of whom were taking insulin. They were randomly assigned to one of three groups:
no self-monitoring of blood sugar
once daily self-monitoring of blood sugar
once-daily self-monitoring of blood sugar with “enhanced feedback” from their blood glucose meters with messages intended to educate and motivate the study volunteers.
After one year these researchers found that, compared with those not self-monitoring blood sugar, those who self-monitored had no improvement in the control of their blood sugar, and had no improvement in measures of quality of life.
The impact of this study could be enormous. Of the enrolled study subjects, three-quarters routinely checked blood sugar at home. If that’s typical of people with type 2 diabetes, these findings could allow thousands of people to stop sticking themselves and save money on monitoring equipment, with no ill effects on their health.
But even if these findings are confirmed, there may be situations when home monitoring is still useful and important. For example, home monitoring might be a good idea when people like those in this study:
develop an infection
change the dose of their diabetes medications
add or stop taking one of their medications
gain or lose a significant amount of weight
begin taking insulin.
This study did not examine these situations and so could not draw conclusions about them. It’s also worth noting this study lasted only one year. It may take longer to see a benefit from home monitoring. Finally, this study did not include individuals with type 1 diabetes, so the results do not apply to them.
The bottom line
This new study suggests that doctors treating people with type 2 diabetes may not need to recommend routine self-monitoring of blood sugar. However, while that may be true for the average person with type 2 diabetes who is not taking insulin, we’ll need more studies and longer-term studies to identify which people with type 2 diabetes will benefit most from home monitoring and when it’s just not worth the effort.
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications
Follow me on Twitter @RobShmerling
First published on www.health.havard.edu