World Diabetes Day 2012

To coincide with World Diabetes Day on 14 November, we highlight the latest evidence available on DARE that examines self-monitoring of blood glucose in people with type 2 diabetes who are not using insulin.

Self-monitoring of blood glucose level is an essential component of the effective management of type 1 diabetes and insulin treated type 2 diabetes. However, self-monitoring of blood glucose in people with type 2 diabetes who are not using insulin is less clear cut.

Over the last 15 years, a number of systematic reviews have examined the impact of self-monitoring on blood glucose levels and have varied in their estimates of effect (Faas,1997; Welschen, 2005; Sarol, 2005; Jansen, 2006; McGeoch, 2007; Allemann, 2009;Poolsup, 2009; Clar, 2010; St John, 2010; Malanda, 2012).

Recently, an individual participant data (IPD) meta-analysis has evaluated the effects of self-monitoring interventions in people with non-insulin treated type 2 diabetes (Farmer, 2012). IPD reviews differ from normal systematic reviews in that they collect and combine the original data from all relevant trials worldwide. Doing this can improve the quality of data, allow more detailed analyses and give more reliable results. In this review the authors found no clinically meaningful effect for reducing blood glucose levels. The authors concluded that there was no convincing evidence to support routine use of self-monitoring in people with non-insulin treated type 2 diabetes The review was well conducted and this conclusion seems reliable.

The CRD Databases provide access to other critically appraised systematic reviews and economic evaluations relevant to the management of diabetes. To search for these click here.

NIHR focus on diabetes research

To mark the 90th anniversary of the discovery of insulin, the National Institute for Health Research (NIHR) has launched an online resource, to showcase how the NIHR is supporting research into diabetes.

www.FocusOnDiabetes.nihr.ac.uk is launched on 14 November to coincide with World Diabetes Day.  It features interviews with NIHR-funded researchers, case-studies on activity taking place in NIHR-supported facilities, a list of studies funded by the NIHR in this area, and information for patients on how to get involved in diabetes clinical research.

Featured systematic reviews
(Most recent first)

1. Farmer AJ, Perera R, Ward A, Heneghan C, Oke J, Barnett AH, Davidson MB, Guerci B, Coates V, Schwedes U, O'Malley S. Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes. BMJ 2012; 344: doi:10.1136bmj.e486
2. Malanda UL, Welschen LMC, Riphagen II, Dekker JM, Nijpels G, Bot SDM. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database of Systematic Reviews: Reviews 2012; Issue 1.
3. Clar C, Barnard K, Cummins E, Royle P, Waugh N. Self monitoring of blood glucose in type 2 diabetes. Health Technology Assessment 2010; 14(12): 1-140
4. St John A, Davis WA, Price CP, Davis TM. The value of self-monitoring of blood glucose: a review of recent evidence. Journal of Diabetes and its Complications 2010; 24(2): 129-141.
5. Poolsup N, Suksomboon N, Rattanasookchit S. Meta-analysis of the benefits of self-monitoring of blood glucose on glycemic control in type 2 diabetes patients: an update. Diabetes Technology and Therapeutics 2009; 11(12): 775-784.
6. Allemann S, Houriet C, Diem P, Stettler C. Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis. Current Medical Research and Opinion 2009; 25(12): 2903-2913.
7. McGeoch G, Derry S, Moore RA. Self-monitoring of blood glucose in type-2 diabetes: what is the evidence? Diabetes/Metabolism Research and Reviews 2007; 23(6): 423-440.
8. Jansen JP. Self-monitoring of glucose in type 2 diabetes mellitus: a Bayesian meta-analysis of direct and indirect comparisons. Current Medical Research and Opinion 2006; 22(4): 671-681.
9. Sarol JN, Nicodemus NA, Tan KM, Grava MB. Self-monitoring of blood glucose as part of a multi-component therapy among non-insulin requiring type 2 diabetes patients: a meta-analysis (1966 - 2004). Current Medical Research and Opinion 2005; 21(2): 173-183.
10. Welschen LM, Bloemendal E, Nijpels G, Dekker JM, Heine RJ, Stalman WA, Bouter LM. Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabetes Care 2005; 28(6): 1510-1517
11. Faas A, Schellevis F G, Van Eijk J T. The efficacy of self-monitoring of blood glucose in NIDDM subjects: a criteria-based literature review. Diabetes Care 1997; 20(9): 1482-1486.