The Pharmaceutical Journal
Vol 269 No 7211 p208
17 August 2002

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MeReC Bulletin article (PDF 55K)

Patient self-testing of blood glucose levels lacks evidence, says NPC

There is little evidence to support self-monitoring of blood glucose levels in all people with diabetes, according to the National Prescribing Centre's MeReC Bulletin.

The bulletin recommends that for self-monitoring to be useful, it should form part of a wider management programme, and that patients should be adequately trained in self-monitoring techniques. In addition, the bulletin suggests that health care professionals should be clear about what they hope to achieve through self-monitoring by patients.

"Although self-monitoring is common practice and a consensus view encourages it, evidence for its effect on control of blood glucose is unclear, particularly in patients with type 2 diabetes. In addition, the effects of self-monitoring of blood glucose on patient outcomes have not been adequately documented," the bulletin states.

It adds that there is no evidence that blood testing is more effective than urine testing at improving blood glucose control in people with type 2 diabetes. Because of this and because of the higher cost of blood testing, the bulletin suggests urine testing could be considered for some patients, including those that find blood testing difficult. The MeReC Bulletin concludes that patients using insulin for either type 1 or type 2 diabetes who adjust their dose according to the results of the tests are most likely to benefit from self-monitoring. However, it points out that measuring glycosylated haemoglobin (HbA_1c) levels is likely to provide more helpful information about glycaemic control than day-to-day monitoring of blood glucose.

The value of self-monitoring blood glucose was also investigated in an article (PDF 50K), published in The Journal recently (PJ, 15 June, p847). It concludes there is confusion around whether patients should self-monitor and suggests national guidance would help clarify matters.

A copy of the MeReC Bulletin (PDF 55K), "When and how should patients with diabetes mellitus test blood glucose?" (2002;13 No. 1), is included with this week's issue of The Journal sent to community and hospital pharmacists in England and Wales.

The publication is also available on the National Prescribing Centre websites (www.npc.co.uk and nww.npc.ppa.nhs.uk).

  * PDF files on PJ Online require Acrobat Reader 4 or later.