Monitoring Your Glucose Level May Be a Waste of Time & $$$

When someone is diagnosed with type 2 diabetes, they are given plenty of advice of the importance of keeping good control of their blood sugar levels, and are usually taught how to self-monitor their blood glucose. Frequent regular finger sampling, use of a home monitor, and careful recording of results all cost time and money, not to mention inconvenience and discomfort; a report of a cost-effectiveness study of self-monitoring is therefore very interesting.

The study in question was done in Ireland, and reported in the British Medical Journal. People under 70 with newly-diagnosed type-2 diabetes were eligible. The 184 participants (111 were men) were allocated at random to self-monitoring or no-monitoring of blood glucose levels for one year, with follow-up at 3-monthly intervals. The self-monitoring requirement was to make 4 fasting and four post-prandial blood glucose measurements a week. The factors used to compare the two groups were HbA1c levels, use of antidiabetic meds, body mass index (BMI), and reported hypoglycemic episodes.

At baseline, the average age was about 59, and the average HbA1c was 8.7. The BMIs were slightly higher in the monitoring group (34 vs. 32). After one year the average HbA1c was the same in both groups (6.9), the BMIs were very similar in both groups (33 vs. 32), and the use of antidiabetic meds and hypoglycemic episodes were virtually the same in both groups. The only statistically significant difference was that the self-monitoring patients scored higher on a test for depressive symptoms.

The results of this study show that fairly frequent self-monitoring had no significant influence on the control of their blood sugar metabolism over the first year of their management. This finding is contrary to some other studies that have found support for self-monitoring and tight glucose control; however, the drop-out rates in these were relatively high (over 40%). The difference from earlier studies is that here the diabetics were newly-diagnosed, and a ‘quality-of-life’ measure (depressive symptoms) was included. The results are enough to elevate the controversy.