In a new study, researchers from UNC School of Medicine find that blood glucose testing may not offer a big advantage in blood sugar control for people with type 2 diabetes
The research is published in JAMA Internal Medicine. The paper introduces findings from a randomized trial called “The MONITOR Trial.”
This is the first large pragmatic study examining glucose monitoring in the United States.
Type 2 diabetes is an epidemic disease afflicting one in 11 people in the United States. For those treated with insulin, checking blood sugar with a finger stick at home is a common practice for monitoring the effects of insulin therapy.
However, most of the 25 million people with type 2 diabetes do not take insulin. They control their blood sugar with exercise, diet, and sometimes medications such as metformin.
Currently, 75 percent of these patients also perform regular blood glucose testing at home, generally at the recommendation of a provider.
But there is an ongoing debate about its effectiveness in controlling diabetes or improving how patients feel.
During the study, 450 patients were divided into three groups: no blood sugar monitoring, once daily glucose monitoring, or enhanced once-daily glucose monitoring with an internet-delivered tailored message of encouragement or instruction.
The researchers found that there were no significant differences in blood glucose control across the three groups.
In addition, there were no significant differences found in health-related quality of life among the groups.
The team also noticed that there were no notable differences in hypoglycemia (low blood sugar), hospitalizations, emergency room visits.
Between programs, there was also no difference in the number of people who had to start using insulin treatment to better control blood sugar levels.
One senior author said: “Our study results have the potential to transform current clinical practice for patients and their providers by placing a spotlight on the perennial question, ‘to test or not to test?'”
“Of course, patients and providers need to consider each unique situation as they determine whether home blood glucose monitoring is appropriate,” she said.
“But the study’s null results suggest that self-monitoring of blood glucose in non-insulin treated type 2 diabetes has limited utility. For the majority, the costs may outweigh the benefits.”
The authors suggest that patients living with diabetes should discuss the need for blood sugar monitoring with their health care providers.
If together a patient and their provider decide that blood sugar monitoring is not necessary, patients could be spared hundreds of finger sticks and save hundreds of dollars every year, at least until insulin treatment is required.