Blonde Lawrence, Karter Andrew J
Ochsner Diabetes Clinical Research Unit, Section on Endocrinology, Diabetes and Metabolic Diseases, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA.
Am J Med. 2005 Sep;118(Suppl 9A):20S-26S. doi: 10.1016/j.amjmed.2005.07.053.
Many people with diabetes are falling short of attaining or maintaining glycemic goals. Self-monitoring of blood glucose (SMBG) is among the many strategies proposed to address the problem. SMBG complements hemoglobin A1c (HbA1c) testing by providing specific information regarding the effects of diet, exercise, and medications on glycemia. Although the importance of self-monitoring is appreciated for insulin-using patients, evidence is still emerging in support of self-monitoring for patients with type 2 diabetes managed with oral agents or diet. Evaluating the available evidence requires a good understanding of the study design and methodology. Although several clinical trials involving SMBG have been insufficiently powered to detect clinically meaningful differences in HbA1c, recent meta-analyses have reproducibly supported the benefit of self-monitoring in non-insulin-treated patients. Although additional work is needed to establish optimal frequency and timing of SMBG, these studies can serve as a basis for conservative recommendations to guide patients and their healthcare providers.
许多糖尿病患者未能达到或维持血糖目标。自我血糖监测（SMBG）是为解决该问题而提出的众多策略之一。SMBG通过提供有关饮食、运动和药物对血糖影响的具体信息，对糖化血红蛋白（HbA1c）检测起到补充作用。尽管自我监测对使用胰岛素的患者的重要性已得到认可，但对于使用口服药物或饮食控制的2型糖尿病患者，支持自我监测的证据仍在不断涌现。评估现有证据需要对研究设计和方法有很好的理解。尽管几项涉及SMBG的临床试验在检测HbA1c方面的临床意义差异时样本量不足，但最近的荟萃分析反复支持了自我监测对非胰岛素治疗患者的益处。尽管还需要更多工作来确定SMBG的最佳频率和时间，但这些研究可作为为患者及其医疗服务提供者提供保守建议的基础。
