Self-Monitoring Not For All Beneficiary

Moreover, the report of the institute states, it remains unclear whether an additional benefit is displayed by the blood test compared to the urine test or vice versa, in other words, whether one or other of the tests might offer an advantage to patients. It is criticized that the current data are quantitatively and qualitatively inadequate: the few trials suitable for investigating these questions have not included or have insufficiently reported many outcomes important to patients.

Anyone who injects insulin should check their blood glucose level regularly, so that they can regulate the insulin dose according to need - this is an established procedure for patients with type 1 or type 2 diabetes. However, it is unclear whether people with type 2 diabetes who manage without insulin, also benefit from self-monitoring.

Experts assume that blood glucose self-monitoring helps these patients to lead a healthier life, because the measured values enable them to see the direct positive effect of diet and physical activity. The result should be that their blood glucose is better controlled and acute and long-term complications are reduced - this is the assumption.

In order to examine whether the above-mentioned assumptions can be scientifically proven, IQWiG searched for comparative trials with and without self-monitoring. Overall, six randomized controlled and suitable trials were found. All six trials investigated the benefit of blood glucose self-monitoring; no suitable clinical comparisons were identified on urine glucose self-monitoring. With duration of the included trials between six and twelve months, none of them were designed to investigate the long-term benefit of self-monitoring.

Data on criteria that were important for the patient-relevant benefit were not even collected in these six trials. This applies in particular to concomitant and late complications caused by diabetes, such as sight loss or cardiac disease. Other outcomes, such as quality of life and patient satisfaction, were in fact investigated in a few trials but inadequately reported, so that the results cannot be accepted as reliable. Yet even the few available data did not display any advantage for self-monitoring.; Source: Institute for Quality and Efficiency in Health Care