Breland Jessica Y, McAndrew Lisa M, Burns Edith, Leventhal Elaine A, Leventhal Howard
Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
Diabetes Educ. 2013 Jul-Aug;39(4):541-59. doi: 10.1177/0145721713490079. Epub 2013 Jun 7.
This systematic review examined the relationship between self-monitoring of blood glucose (SMBG) and glycemic control in patients with type 2 diabetes. The Common Sense Model of Self-Regulation (CSM) served as a theoretical framework for examining how, when (mediators), and for whom (moderators) SMBG improved glycemic control.
Five databases were searched: Medline, PsychInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health Literature.
Included studies had cross-sectional, longitudinal, or randomized controlled trial designs; were published between 2007 and 2011; and included patients with type 2 diabetes at least some of whom were not taking insulin; 1318 studies were screened, 119 were reviewed in detail, and 26 were included.
Data were collected on the relationship between SMBG and glycemic control, study design, mediators, moderators, participant characteristics, the CSM, and limitations.
Twenty-six studies met criteria for inclusion: 11 cross-sectional, 4 longitudinal, and 11 randomized controlled trials. The results of the cross-sectional studies were inconclusive. Results from the longitudinal studies and randomized control trials suggested that SMBG may improve glycemic control. The few studies investigating mediators or moderators reported mixed results. Few studies effectively measured the CSM.
Data suggested that SMBG may help improve glycemic control. Future trials must be designed to test hypotheses and improve our understanding of when, how, and for whom SMBG can enhance glycemic control. Rigorously controlled repetitions of current 2-arm trials will yield little new knowledge of theoretical or practical value.
本系统评价研究了2型糖尿病患者自我血糖监测（SMBG）与血糖控制之间的关系。自我调节常识模型（CSM）作为一个理论框架，用于研究SMBG如何、何时（中介因素）以及对谁（调节因素）改善血糖控制。
检索了五个数据库：医学索引数据库（Medline）、心理学文摘数据库（PsychInfo）、Cochrane系统评价数据库、Cochrane对照试验中心注册库以及护理与健康照护文献累积索引数据库。
纳入的研究采用横断面、纵向或随机对照试验设计；发表于2007年至2011年之间；纳入2型糖尿病患者，其中至少部分患者未使用胰岛素；共筛选了1318项研究，详细审查了119项，最终纳入26项。
收集了关于SMBG与血糖控制之间的关系、研究设计、中介因素、调节因素、参与者特征、CSM以及局限性的数据。
26项研究符合纳入标准：11项横断面研究、4项纵向研究和11项随机对照试验。横断面研究的结果尚无定论。纵向研究和随机对照试验的结果表明，SMBG可能改善血糖控制。少数研究中介因素或调节因素的结果不一。很少有研究有效测量了CSM。
数据表明，SMBG可能有助于改善血糖控制。未来的试验必须设计用于检验假设，并增进我们对SMBG何时、如何以及对谁能增强血糖控制的理解。严格控制的当前双臂试验的重复将产生很少具有理论或实践价值的新知识。
