Type 2 Diabetes: Blood Glucose Testing of Little Value

Many patients with type 2 diabetes consider finger-prick blood tests key for keeping blood glucose levels under control. But according to a new study, they are unlikely to be beneficial for patients who are not receiving insulin therapy.

Researchers found that self-monitoring of blood glucose (SMBG) for 1 year failed to improve blood glucose control or health-related quality of life (HRQOL) in patients with type 2 diabetes who were not treated with insulin.

Senior study author Dr. Katrina Donahue, of the School of Medicine at the University of North Carolina in Chapel Hill, and colleagues believe that their findings raise questions about the value of SMBG for many patients with type 2 diabetes, reports medicalnewstoday.com.

“Of course, patients and providers have to consider each unique situation as they determine whether home blood glucose monitoring is appropriate,” says Donahue.

“But the study results suggest that self-monitoring of blood glucose in non-insulin treated type 2 diabetes has limited utility. For the majority, the costs may outweigh the benefits.”

The team’s findings were recently reported in JAMA Internal Medicine.

 Type 2 Diabetes

In type 2 diabetes, the body is unable to effectively use insulin, which is a hormone that helps to regulate blood glucose levels. As a result, glucose accumulates in the blood.

Left untreated, high blood glucose levels can lead to severe complications, including kidney disease, stroke, and nerve damage.

While some patients with type 2 diabetes require insulin therapy, the majority of patients are able to manage their condition through diet, exercise, and medication, such as metformin.

Donahue and colleagues note that most patients with type 2 diabetes who do not receive insulin therapy perform SMBG, as it is often recommended by their doctor. SMBG usually involves an at-home finger-prick blood test that provides a blood glucose reading.

SMBG is generally accepted as essential for good blood glucose control, but some researchers have questioned its worth for type 2 diabetes patients in the absence of insulin therapy.

For this latest study, Donahue and colleagues sought to gain a better understanding of how SMBG affects hemoglobin A1c levels - an indicator of long-term blood glucose control - and HRQOL for patients with type 2 diabetes who are not treated with insulin.

The research included 450 patients with type 2 diabetes, who were an average age of 61 years.  For the study, patients were randomly allocated to one of three groups for 12 months: one group performed SMBG once daily; one group engaged in once-daily SMBG enhanced with automated, tailored messages of encouragement delivered via a Telcare meter; and one group did not engage in SMBG at all.

Researchers found that there were no significant differences in hemoglobin A1c levels and HRQOL between the groups that performed SMBG and those that did not.

What is more, there were no significant differences in incidences of low blood sugar, or hypoglycemia, hospitalizations, or emergency room visits between the three groups, nor was there any difference in the number of patients who needed to start insulin therapy during the study period.