New Articles on Self-Monitoring of Blood Glucose

June 07, 2010

The Canadian Agency for Drugs and Technologies in Health (CADTH) is pleased to announce the publication of new articles exploring the utilization, expenditure, and efficacy of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes not using insulin.

Canadian Journal of Diabetes

The first article, entitled “Utilization and Expenditure on Blood Glucose Test Strips in Canada” and published as an original research article in the March 2010 issue of the Canadian Journal of Diabetes, reveals that the current utilization and expenditure in Canada on blood glucose test strips is considerable ― with almost half of total expenditures being for patients not using insulin ― despite a lack of convincing evidence that routine SMBG is beneficial for these patients.

Chris Cameron and co-authors suggest that there may be more cost-effective strategies for improving the health of this particular population.

The same issue of the Canadian Journal of Diabetes includes an “Editor’s Note” and two invited commentaries to debate the use of SMBG in patients with type 2 diabetes not using insulin:

• “The Cost of Diabetes: A Game Changer” (Editor’s Note)
• “Self-monitoring of Blood Glucose in Individuals with Type 2 Diabetes Not Using Insulin” (Commentary)
• “Self-monitoring of Blood Glucose in Individuals with Type 2 Diabetes Not Using Insulin: Leaving No Cornerstone Unturned” (Commentary).

Open Medicine

CADTH’s second article, “Efficacy of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin: a systematic review and meta-analysis,” is published in Open Medicine.

Interpreting the available literature, Brendan McIntosh et al. affirm that SMBG was associated with a clinically modest, although statistically significant, reduction in hemoglobin A1C concentrations, whether patients were educated on how to interpret and use the test results or not. More studies are needed, however, to determine if SMBG reduces the risk of long-term complications of diabetes and other clinically important outcomes, and which patients are most likely to benefit from self-monitoring.

A related commentary also appears in the same issue:

• “To test or not to test? Self-monitoring of blood glucose in patients with type 2 diabetes managed without insulin” (Commentary).

Both articles are based on CADTH’s extensive research on the practice of SMBG by people living with diabetes, which has generated significant national interest and discussion.

Supporting the Optimal Practice of SMBG — CADTH Resources

To access CADTH’s recommendations, the supporting evidence, and a wealth of user-friendly tools designed to help consumers, health care professionals, and policy- and decision-makers put evidence about SMBG into daily practice, visit us at www.cadth.ca/smbg.

If you have any questions or comments, please contact us at compusinfo@cadth.ca.