Post Graduate Program in Medical Sciences - Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Department of Internal Medicine, Medical School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
Post Graduate Program in Medical Sciences - Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Division of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Diabetes Res Clin Pract. 2018 Aug;142:173-187. doi: 10.1016/j.diabres.2018.05.037. Epub 2018 May 30.
Systematic review and meta-analysis to evaluate the effect of Self-Monitoring of Blood Glucose (SMBG) on glycemic control in patients with type 2 Diabetes (T2D).
We searched the Medline, Embase, Cochrane Central, and ClinicalTrials.gov databases up to 20 July 2017. We also performed a manual search of abstracts from recent meetings of the American Diabetes Association and the European Association for the Study of Diabetes.
randomized controlled trials (RCTs) conducted in patients with T2D comparing any kind of SMBG to a control group. Two independent reviewers assessed the eligibility of references. Influence of SMBG in glycated hemoglobin (HbA1c) was aggregated as weighted mean difference accessed by direct random effect meta-analyses at 12, 24 weeks and 1 year. Sub-analyses were made to assess the effects of previous glycemic control and number of tests performed.
SMBG was associated with a reduction of HbA1c at 12 weeks (-0.31%; 95% CI: -0.57 to -0.05) and 24 weeks (-0.34%; 95%CI: -0.52 to -0.17), but no difference was found for 1 year. Subgroup analysis including studies with baseline HbA1c greater than 8% showed a higher reduction of HbA1c: -0.83% (95% CI: -1.55 to -0.11) at 12 weeks, and -0.48% (95% CI: -0.77 to -0.19) at 24 weeks, with no difference for 1 year nor for the stratification for number the tests.
SMBG seems to lead to a slightly better glycemic control in the short term in patients with T2D. Patients decompensated at baseline appear to have the greatest benefit. PROSPERO register: CRD42016033558.
系统评价和荟萃分析评估自我血糖监测（SMBG）对 2 型糖尿病（T2D）患者血糖控制的影响。
我们检索了 Medline、Embase、Cochrane 中央和 ClinicalTrials.gov 数据库，截至 2017 年 7 月 20 日。我们还对美国糖尿病协会和欧洲糖尿病研究协会最近会议的摘要进行了手动搜索。
在 T2D 患者中进行的比较任何类型的 SMBG 与对照组的随机对照试验（RCT）。两名独立的评审员评估参考文献的合格性。通过直接随机效应荟萃分析，以 12、24 周和 1 年为时间点，将 SMBG 对糖化血红蛋白（HbA1c）的影响综合为加权均数差值。进行了亚分析以评估先前血糖控制和测试次数的影响。
SMBG 与 12 周时的 HbA1c 降低（-0.31%；95%置信区间：-0.57 至 -0.05）和 24 周时的 HbA1c 降低（-0.34%；95%置信区间：-0.52 至 -0.17）相关，但 1 年后无差异。包括基线 HbA1c 大于 8%的研究的亚组分析显示 HbA1c 降低更高：12 周时降低 0.83%（95%置信区间：-1.55 至 -0.11），24 周时降低 0.48%（95%置信区间：-0.77 至 -0.19），但 1 年后和测试次数分层无差异。
SMBG 似乎在短期内导致 T2D 患者的血糖控制略有改善。基线失代偿的患者似乎获益最大。PROSPERO 注册号：CRD42016033558。
