The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia - Vic, Melbourne, Australia.
Curr Med Res Opin. 2013 Mar;29(3):161-8. doi: 10.1185/03007995.2012.761957. Epub 2013 Jan 11.
There is debate in the literature about the effectiveness of self-monitoring of blood glucose (SMBG) for people with type 2 diabetes (T2DM) who do not use insulin. Several recent systematic reviews and meta-analyses conclude that SMBG does not have any clinical benefit for this group.
We critically appraise the available evidence, and argue whether SMBG is warranted for people with non-insulin-treated T2DM.
Considerable heterogeneity exists amongst the literature, and aspects of the methodology of some of these studies confound interpretation of results. Recent evidence demonstrates that when SMBG is 'structured', incorporated as part of a complex intervention, and embedded within education and collaborative care, improvements in average blood glucose levels result. In contrast, studies that do not apply SMBG systematically, or that assess a low frequency SMBG regimen that precludes identification and interpretation of SMBG patterns, are not clinically effective. Psychosocial outcomes, such as self-efficacy and diabetes-related distress, and other clinical outcomes, such as hypoglycaemia detection, should also be considered as important clinical endpoints.
This is not a systematic literature review. The literature is limited by a lack of studies evaluating a 'structured' approach to SMBG.
It is the quality, not quantity, of SMBG that makes a difference to outcomes for people with non-insulin-treated T2DM. The benefits of 'structured' SMBG should be considered as part of a complex intervention when making decisions about policy and practice, and assumptions about the benefits of SMBG for people with non-insulin-treated T2DM should be challenged.
对于未使用胰岛素的 2 型糖尿病（T2DM）患者，文献中存在关于自我血糖监测（SMBG）有效性的争议。最近的几项系统评价和荟萃分析得出结论，SMBG 对该人群没有任何临床获益。
我们批判性地评估现有证据，并论证 SMBG 是否适用于未经胰岛素治疗的 T2DM 患者。
文献中存在相当大的异质性，并且这些研究的某些方法学方面使结果的解释变得复杂。最近的证据表明，当 SMBG 被“结构化”，作为复杂干预的一部分，并嵌入教育和协作护理中时，平均血糖水平会得到改善。相比之下，那些没有系统地应用 SMBG 的研究，或者评估频率较低的 SMBG 方案，无法识别和解释 SMBG 模式，则没有临床效果。心理社会结局，如自我效能和与糖尿病相关的困扰，以及其他临床结局，如低血糖检测，也应被视为重要的临床终点。
这不是系统的文献综述。由于缺乏评估 SMBG 结构化方法的研究，文献受到限制。
对未经胰岛素治疗的 T2DM 患者而言，SMBG 的质量而非数量对结局产生影响。在制定政策和实践决策时，应将“结构化”SMBG 的益处视为复杂干预的一部分，并对 SMBG 对未经胰岛素治疗的 T2DM 患者的益处提出质疑。
