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Therapeutics
Cost-effectiveness analysis
Daily self-monitoring unlikely to be cost-effective in adults with type 2 diabetes not using insulin in Canada
  1. Mayer B Davidson
  1. Correspondence to Mayer B Davidson
    Charles R. Drew University, 1731 East 120th Street, Los Angeles, CA 90059, USA; mayerdavidson{at}cdrewu.edu

https://doi.org/10.1136/ebm1062

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    Commentary on:

    1. Cameron C,
    2. Coyle D,
    3. Ur E,
    4. et al
    . Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin. CMAJ 2010;182:28–34.
    OpenUrlAbstract/FREE Full Text

    Current status of self-monitoring of blood glucose

    Although there is little doubt that self-monitoring of blood glucose (SMBG) improves glycaemic outcomes in insulin-requiring diabetic patients, its use in non-insulin-treated patients is controversial. Observational studies cannot address this controversy because of either patient self-selection (people with healthier lifestyles are more likely to test) or physician self-selection (patients who are more out of control being asked to test). Only randomised control trials can provide the answer.

    Cost-effectiveness study in non-insulin-treated patients

    Cameron and colleagues evaluated the cost-effectiveness of SMBG in non-insulin-treated patients by analysing seven randomised control trials using the validated UK Prospective Diabetes Study Outcomes Model, drug costs from the Ontario Public Drug Program, and resource use and costs from the Ontario Ministry of Health and Long Term Care. They assumed 1.29 strips per day, at $0.73 per strip. They found a significant beneficial difference in the pooled HbA1c results of 0.25% for SMBG. However, of the …

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    Footnotes

    • Competing interests None.