RCTs: Three RCTs (1,000 patients) were included, all of which were of poor quality. Use of self-monitoring of blood glucose was associated with a statistically significant lower glycated haemoglobin in two studies, with mean reductions in glycated haemoglobin of about 1.0% and a decrease of 0.5% more in those who used self-monitoring of blood glucose compared with those who did not. There was no significant reduction in weight or changes in behaviour, but there was greater involvement with diabetes management.
Observational studies: Thirteen observational studies (60,082 patients) were included (range 115 to 31,438 patients), nine of which were retrospective.
A positive association between self-monitoring of blood glucose and a reduction in glycated haemoglobin measured clinically or by laboratory assessment was evident in larger studies (weighted mean HbA1c=8.4%; 10 comparisons; 43,905 patients) that had higher baseline glycated haemoglobin
levels; smaller studies (weighted mean HbA1c=7.1%; 10 comparisons; 10,963 patients) with lower baseline glycated haemoglobin levels reported no association between self-monitoring of blood glucose and clinical or laboratory measured glycated haemoglobin.