Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes

Farmer, Andrew; Perera, Rafael; Ward, Alison; Heneghan, Carl; Oke, Jason; Barnett, Anthony; Davidson, Mayer B.; Guerci, Bruno; Coates, Vivien; Schwedes, U.; O'Malley, Simon

doi:10.1136/bmj.e486

Cited by 123 publications

(116 citation statements)

References 32 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At 12 months, a difference of 0.35% was found. 42 The difference in HbA1c levels was consistent across age, baseline HbA1c level, sex, and duration of diabetes.…”

Section: Meta-analysis Of Individual Patient Data In Randomised Trialmentioning

confidence: 71%

Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

Schnell

Alawi²,

Battelino

et al. 2013

J Diabetes Sci Technol

View full text Add to dashboard Cite

“…At 12 months, a difference of 0.35% was found. 42 The difference in HbA1c levels was consistent across age, baseline HbA1c level, sex, and duration of diabetes.…”

Section: Meta-analysis Of Individual Patient Data In Randomised Trialmentioning

confidence: 71%

Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

Schnell

Alawi²,

Battelino

et al. 2013

J Diabetes Sci Technol

View full text Add to dashboard Cite

“…On the other hand, no consensus on improvement of glycemic control by SMBG has been obtained in insulin-naïve patients, even though evidence of the general benefits of SMBG has been increasing in the last decade. Previous studies show that the effects of simply measuring blood glucose in insulin-naïve patients are minimal (St John et al, 2010;Farmer et al, 2012;Malanda et al, 2012). However, when individuals with insulin-naïve type 2 diabetes perform SMBG frequently, glycemic control has been shown to be improved (Harashima et al, 2013;Elgart et al, 2016) as also in type 1 (Miller et al, 2013) and insulin-treated type 2 diabetes (Elgart et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial

Nishimura

Harashima

Fujita

et al. 2017

Journal of Diabetes and its Complications

View full text Add to dashboard Cite

Aims:To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Methods:Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. Results:HbA1c levels were significantly decreased by 0.32% (3.50 mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94 kg and 6.8/4.7 mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Conclusions:Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions.

show abstract

“…Laboratory-measured clinic plasma glucose may be affected by the specific circumstances under which the blood samples are drawn (15). Although statistically significant differences in HbA 1c have been observed between noninsulintreated patients using SMBG or not, the potential clinically meaningful effect on management of noninsulin-treated type 2 diabetes remains to be further elucidated (16).…”

Section: Evidence For Smbgmentioning

confidence: 99%

Clinical Utility of SMBG: Recommendations on the Use and Reporting of SMBG in Clinical Research

et al. 2015

View full text Add to dashboard Cite

Quality glucose information is a core prerequisite for successful diabetes management. It enables professionals and people with diabetes to make medically relevant decisions on therapy. Details of glucose profile information beyond HbA 1c have been largely derived from self-monitoring of blood glucose (SMBG). Given the evidence base demonstrating the benefits of SMBG, its routine use is recommended for diabetes management and therapy by many international and regional guidelines (1-3). Today, SMBG is considered an important aspect of the management of glycemic control (3,4). Glucose information of high quality, considering the products used and the processes conducted, is also needed in clinical research in order to gain new evidence and insights on effective treatment strategies in diabetes. SMBG is widely and routinely applied in large clinical trials, where it is used to understand the glycemic state, to enhance awareness of the effects of lifestyle modification and the adaptation of treatment including insulin titration, and to enable documentation of intraday pre-and postprandial glucose excursions (glycemic variability) and the subsequent statistical analysis of this and the confirmation of hypoglycemic episodes. Examples of recent studies that used SMBG are Outcome Reduction With Initial Glargine Intervention (ORIGIN) trial, Action to Control Cardiovascular Risk in Diabetes (ACCORD), and, from earlier times, the Diabetes Control and Complications Trial (DCCT) (5-8). Indeed, SMBG is now applied in most studies of glucoselowering agents, including glucagon-like peptide 1 (GLP-1) receptor agonist and sodium-glucose cotransporter 2 (SGLT2) inhibitor studies.Reliable glucose information requires a clear definition as part of the study design and protocol, not least to ensure replication of the methodology. Interpretation and comparison of study results may be affected if SMBG methods and results are addressed inconsistently. With regard to the interpretation of outcomes of studies, reporting of SMBG in publications should be of the highest qualitydaccurate, precise, reliable, and reproducible. In many publications, however, relevant details of the SMBG measures are lacking or are incomplete. Therefore, the interpretation of study results may be hampered, reliability of study results may be compromised, and repetition of trials may become necessary.This consensus publication not only aims to summarize learnings from previous clinical studies about the use and reporting of SMBG but also proposes recommendations for the description of the performance and reporting of SMBG in future clinical study protocols and related publications.Clinical trials aim at expanding knowledge and evidence. One major principle of Good Clinical Practice is to conduct clinical studies at a quality standard that provides the highest level of safety for the study participants but also avoids a potentially unnecessary burden on participants by inefficient repetition of the experiments with "human beings" to answer a clinical/scientific qu...

show abstract

Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes

Cited by 123 publications

References 32 publications

Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial

Clinical Utility of SMBG: Recommendations on the Use and Reporting of SMBG in Clinical Research

Contact Info

Product

Resources

About