Most people with non-insulin-treated type 2 diabetes monitor their blood glucose levels regularly, even though the value of doing so is unclear. A pragmatic randomized trial was conducted in 15 primary care practices to evaluate whether this common practice improves glycated hemoglobin (HbA_1c) levels or health-related quality of life.

A total of 450 adults with non-insulin-treated type 2 diabetes were included. They had to be ages 30 or older, established patients at a participating practice, and have HbA_1c levels between 6.5% and 9.5% in the six months before the screening. Patients were randomized to one of three study arms: (1) no self-monitoring of blood glucose, (2) once-daily self-monitoring of blood glucose, and (3) enhanced once-daily self-monitoring of blood glucose with tailored messaging delivered to the patient. At baseline, 75% of patients were performing self-monitoring of blood glucose. At one-year follow-up, the researchers found no significant differences in glycemic control or health-related quality of life across the three groups. Secondary outcomes, such as reported symptoms and insulin initiation, were also similar in the three groups.

Self-monitoring of blood glucose shouldn't be routine for most patients with non-insulin-treated type 2 diabetes, the authors conclude. Instead, they recommend that clinicians and patients make decisions about monitoring based on individual circumstances.

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