[Lack of benefit of blood glucose autosurveillance in insulin-treated diabetics routinely followed up in a department specializing in diabetology].

Home blood glucose monitoring (HBGM) may be useful to achieve better metabolic control in type I diabetes. The aim of this study was to evaluate longterm results in a large population. A questionnaire was given to 282 routinely insulin-treated diabetics regularly attending our clinic. Home blood glucose testing was performed by 64.5% of the patients. Seventy nine percent of them continued to test urines. Mean HbA1 at the time of the visit was not statistically different in patients performing home blood glucose testing only (9.3 +/- 2.1%), in patients monitoring both blood and urines (9.2 +/- 2%), or urines only (9.3 +/- 1.7%) and in patients who did not practice self-monitoring (9.5 +/- 1.8%). The influence of HBGM on metabolic control as currently performed by diabetic patients in everyday life may be overemphasized. These disappointing results are mainly due to the fact that patients carry out passive home glucose testing and not home blood glucose monitoring which implies day-to-day adaptation of insulin dosage. Such an attitude seems to be due to incorrect selection of the patients, insufficient education and care and, for some patients, poor compliance with medical advice.