Home Blood Sugar Monitoring Questioned

For many patients with type 2 diabetes it may not help with glucose control, study finds

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By
HealthDay Reporter

TUESDAY, June 26, 2007 (HealthDay News) -- Home monitoring of blood sugar levels may not be as essential to the effective care of type 2 diabetes as previously thought, a new British study suggests.

The researchers found that having patients monitor their own glucose levels at home had no effect on their overall blood sugar levels. The findings do not apply to type 2 diabetics who must take insulin.

"We wanted to investigate a current controversy, which is whether monitoring blood sugar for people with type 2 diabetes, who are not using insulin, is helpful or not," explained lead researcher Dr. Andrew Farmer, a lecturer in the Department of Primary Health Care at the University of Oxford.

The study appears in the current online edition of the British Medical Journal, and Farmer planned to report on the findings Tuesday at the American Diabetes Association conference, in Chicago.

Farmer noted that some patient groups and doctors are in favor of having patients monitor their own blood sugar, but it is expensive and so some insurance companies discourage it.

"We found no conclusive evidence that home monitoring improved glucose control," Farmer said.

In the study, Farmer's team randomly assigned 453 patients with type 2 diabetes to one of three groups.

One group had their blood sugar level checked three times a month. The second group was given a meter to test their blood sugar at home and told to have their doctor interpret the results. The third group was given meters and taught how to interpret the findings.

At one year, Farmer's group found no difference in blood sugar levels between the groups. In addition, there was no evidence that having patients monitor their blood sugar improved their glucose control.

Moreover, half of the people who had been given glucose monitors stopped using them before the end of the study, Farmer said.

Home glucose monitoring is supposed to work by helping patients adjust their medications and give them a new attitude toward their diabetes, so they might take their condition more seriously and change their behavior, Farmer said.

"But in either case, if there is an effect it is relatively small, at best," Farmer said. His conclusion: "People shouldn't be hassled into using these meters."

Farmer believes that, given these findings, the current guidelines for monitoring blood sugar may need to be revised. The value of home monitoring remains necessary and worthwhile for people with type 1 diabetes, and for people with type 2 diabetes who are taking insulin, Farmer said.

"These patients can adjust their insulin much more carefully and make the necessary changes," Farmer said. "Studies have found improved outcomes from that. It's just in this situation [patients with type 2 diabetes who are not using insulin] that this technology's place is limited and should not be recommended."

More information

For more information on diabetes, visit the American Diabetes Association.

SOURCES: Andrew Farmer, M.D., lecturer, Department of Primary Health Care, University of Oxford, U.K.; June 26, 2007, British Medical Journal online

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