Highlights
- •Systematic review and meta-analysis to evaluate the Self-Monitoring of Blood Glucose (SMBG).
- •We randomized controlled trials conducted in patients with T2D comparing SMBG to a control group.
- •SMBG was associated with reduced HbA1c at 12 and 24 weeks, but no difference was found for 1-year.
- •Studies with HbA1c at baseline greater than HbA1c 8% showed a higher benefit in 12 and 24 weeks.
Abstract
Aims
Systematic review and meta-analysis to evaluate the effect of Self-Monitoring of Blood
Glucose (SMBG) on glycemic control in patients with type 2 Diabetes (T2D).
Methods
We searched the Medline, Embase, Cochrane Central, and ClinicalTrials.gov databases up to 20 July 2017. We also performed a manual search of abstracts from
recent meetings of the American Diabetes Association and the European Association
for the Study of Diabetes. Study selection: randomized controlled trials (RCTs) conducted
in patients with T2D comparing any kind of SMBG to a control group. Two independent
reviewers assessed the eligibility of references. Influence of SMBG in glycated hemoglobin
(HbA1c) was aggregated as weighted mean difference accessed by direct random effect
meta-analyses at 12, 24 weeks and 1 year. Sub-analyses were made to assess the effects
of previous glycemic control and number of tests performed.
Results
SMBG was associated with a reduction of HbA1c at 12 weeks (−0.31%; 95% CI: −0.57 to
−0.05) and 24 weeks (−0.34%; 95%CI: −0.52 to −0.17), but no difference was found for
1 year. Subgroup analysis including studies with baseline HbA1c greater than 8% showed
a higher reduction of HbA1c: −0.83% (95% CI: −1.55 to −0.11) at 12 weeks, and −0.48%
(95% CI: −0.77 to −0.19) at 24 weeks, with no difference for 1 year nor for the stratification
for number the tests.
Conclusion
SMBG seems to lead to a slightly better glycemic control in the short term in patients
with T2D. Patients decompensated at baseline appear to have the greatest benefit.
PROSPERO register: CRD42016033558.
Keywords
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Article info
Publication history
Published online: May 29, 2018
Accepted:
May 22,
2018
Received in revised form:
April 29,
2018
Received:
April 18,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
