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Self-Monitoring Blood Glucose Associated With Improved Glucose Control

In the 8 studies, SMBG was most effective when done 8 times a week. Interestingly, the increased benefit associated with SMBG was much less when monitoring was conducted 6 days a week. Self-monitoring of blood glucose (SMBG), when done as part of a multi-faceted diabetes-management program, is associated with significantly better glycemic control in patients with type 2 diabetes mellitus, according to results reported here at the American Academy of Family Physicians.

Nemencio A. Nicodemus Jr. MD, endocrinologist, University of the Philippines College of Medicine, Manila, the Philippines, presented the results of a meta-analysis of 8 randomized controlled trials undertaken from 1966 through 2004, enrolling a total of 1307 patients. The studies all included treatment arms with and without SMBG. The studies reported hemoglobin A1c (HbA1c) levels at baseline.

Treatments that included SMBG as part of a multi-component treatment strategy such as diet and exercise interventions and oral antidiabetic agents (sulfonylurea, metformin and glitazone) were associated with a doubling of the mean reduction in HbA1c compared to treatment strategies that did not use SMBG, said Dr. Nicodemus in an interview. The mean HbA1c reduction in the treatments that included SMBG was 0.45%.

Dr. Nicodemus noted that "by itself, SMBG does not improve glycemic control. This is an effective strategy when used as part of a comprehensive management program. In our experience, SMBG is most effective when used to guide therapy."

Moreover, Dr. Nicodemus said that the efficacy of SMBG varies according to the self-monitoring strategy used. In the 8 studies, SMBG was most effective when done 8 times a week. Interestingly, the increased benefit associated with SMBG was much less when monitoring was conducted 6 days a week. There was no added HbA1c reduction when patients monitored glucose 9 times a week, Dr. Nicodemus added.

[Presentation title: "Self-monitoring of Blood Glucose in Multi-component Diabetes Management Therapies for Non-insulin Using Type 2 Diabetes Patients Leads to Better Glycemic Control: a Meta-analysis (1966-2004)."

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