Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes.
Journal
Nursing research
ISSN: 1538-9847
Titre abrégé: Nurs Res
Pays: United States
ID NLM: 0376404
Informations de publication
Date de publication:
Historique:
pubmed:
23
7
2021
medline:
19
11
2021
entrez:
22
7
2021
Statut:
ppublish
Résumé
The benefit of self-monitoring of blood glucose in reducing HbA1c in non-insulin-treated participants remains unclear. HbA1c may be improved in this population with said self-monitoring. The aim of this study was to conduct meta-analyses of glycemic control in non-insulin-treated participants with Type 2 diabetes: self-monitoring of blood glucose versus usual care, structured versus unstructured self-monitoring of blood glucose, and use of self-monitoring of blood glucose readings by clinicians to adjust (or modify) therapy versus usual care. MEDLINE, Embase, and Cochrane Central were electronically searched to identify articles published from January 1, 2000, to June 30, 2020. Trials investigating changes in HbA1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA1c at baseline and follow-up for each trial. Nineteen trials involving 4,965 participants were included. Overall, self-monitoring of blood glucose reduced HbA1c. Preplanned subgroup analysis showed that using self-monitoring of blood glucose readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA1c was shown in self-monitoring of blood glucose without therapy adjustment. The same difference was observed in structured versus unstructured self-monitoring of blood glucose. HbA1c is improved with clinician therapy modification based on structured self-monitoring of blood glucose readings. Implications are for clinicians to prescribe structured self-monitoring of blood glucose to modify therapy based on the readings and not prescribe unstructured self-monitoring of blood glucose. Participants with suboptimal glycemic control may benefit most. A self-monitoring of blood glucose regimen that improves clinical and cost-effectiveness is presented. Future studies can investigate this regimen specifically.
Sections du résumé
BACKGROUND
The benefit of self-monitoring of blood glucose in reducing HbA1c in non-insulin-treated participants remains unclear. HbA1c may be improved in this population with said self-monitoring.
OBJECTIVE
The aim of this study was to conduct meta-analyses of glycemic control in non-insulin-treated participants with Type 2 diabetes: self-monitoring of blood glucose versus usual care, structured versus unstructured self-monitoring of blood glucose, and use of self-monitoring of blood glucose readings by clinicians to adjust (or modify) therapy versus usual care.
METHODS
MEDLINE, Embase, and Cochrane Central were electronically searched to identify articles published from January 1, 2000, to June 30, 2020. Trials investigating changes in HbA1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA1c at baseline and follow-up for each trial.
RESULTS
Nineteen trials involving 4,965 participants were included. Overall, self-monitoring of blood glucose reduced HbA1c. Preplanned subgroup analysis showed that using self-monitoring of blood glucose readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA1c was shown in self-monitoring of blood glucose without therapy adjustment. The same difference was observed in structured versus unstructured self-monitoring of blood glucose.
DISCUSSION
HbA1c is improved with clinician therapy modification based on structured self-monitoring of blood glucose readings. Implications are for clinicians to prescribe structured self-monitoring of blood glucose to modify therapy based on the readings and not prescribe unstructured self-monitoring of blood glucose. Participants with suboptimal glycemic control may benefit most. A self-monitoring of blood glucose regimen that improves clinical and cost-effectiveness is presented. Future studies can investigate this regimen specifically.
Identifiants
pubmed: 34292228
doi: 10.1097/NNR.0000000000000542
pii: 00006199-900000000-99647
doi:
Substances chimiques
Blood Glucose
0
Glycated Hemoglobin A
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
487-497Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to report.
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