| Summary: | BACKGROUND: Diabetes is a prevalent and costly disease in Veterans. Control of blood glucose is an important VA objective. Self-monitoring of blood glucose (SMBG) is advocated as a method to better achieve control. The Key Questions were: Key Question 1. Is regular SMBG effective in achieving target A1c levels for patients with type 2 diabetes? Key Question 2. Is regular SMBG effective in maintaining target A1c levels for patients with type 2 diabetes? Key Question 3. Does regular SMBG reduce the frequency of hypoglycemia in patients with type 2 diabetes? Key Question 4. Is there evidence that different frequencies of testing result in differences in improvements in A1c? METHODS: We searched PubMed from 2004-2006 using standard search terms. We performed an update search in July 2007. Titles, abstracts, and articles were reviewed in duplicate by physicians trained in the critical analysis of literature. Data were extracted by quantitative analysts. Pooled analyses were performed for trials with A1c outcomes at six months and 12 months or greater of follow-up. All other data were narratively summarized. RESULTS: We screened 52 titles, 14 were rejected, and we performed a more detailed review on 38 articles. From this, we identified 14 randomized controlled trials (RCTs) that measured the effect of SMBG compared to a group not receiving SMBG and monitored A1c levels with at least three months of follow-up. Four trials were excluded; one because it presented duplicate data and three because they evaluated SMBG in both the control and intervention groups, leaving 10 trials contributing to the efficacy analysis. We identified five observational studies assessing effectiveness in diabetic Veterans
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| Item Description: | Title from PDF cover. - "September 2007.". - "Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Greater Los Angeles Veterans Affairs Healthcare System/Southern California/RAND Evidence-based Practice Center, Los Angeles, CA.". - Mode of access: World Wide Web |
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