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Letter: self-monitoring of blood glucose—caution warranted
University of Alabama; Tuscaloosa, Alabama, USA
| The first 150 words of the full text of this article appear below. |
The DiGEM trial results1—abstracted in Evidence-Based Medicine 2008;13:7 (Self-monitoring of blood glucose did not improve glycaemic control in patients with type 2 diabetes not treated with insulin)—are indeed important on several levels. Yet it remains difficult to translate these findings into clinical practice. I have found myself even more ambivalent about suggesting self-monitoring of blood glucose (SMBG) to patients who are reasonably well-controlled on oral antidiabetes medications.
To translate the trial findings, I propose the following practical suggestions: (1) For patients struggling to comply with healthcare recommendations, we now know that SMBG does not need to be as high a priority in our counselling. (2) For patients struggling to afford all of the components necessary to actually perform SMBG (eg, glucometer, strips, lancets), this now becomes an area of potential cost savings. Freeing up limited discretionary income might allow patients to afford a nutrition consultation, important medications,
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