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Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

机译：Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

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Background: The benefit of self-monitoring of blood glucose in reducing HbA_1c in non-insulin-treated participants remains unclear. HbA_1c may be improved in this population with said self-monitoring. Objective: The aim of this study was to conduct meta-analyses of glycemic control in non-insu lin-treated participants with Type 2 diabetes: self-monitoring of blood glucose versus usual care, structured versus unstructured self-monitoring of blood glucose, and use of self-monitoring of blood glucose readings by clinicians to adjust (or modify) therapy versus usual care. Methods: MEDLINE, Embase, and Cochrane Central were electronically searched to identify articles published from January 1, 2000, to June 30, 2020. Trials investigating changes in HbA_1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA_1c at baseline and follow-up for each trial. Results: Nineteen trials involving 4,965 participants were included. Overall, self-monitoring of blood glucose reduced HbA_1c. Preplanned subgroup analysis showed that using self-monitoring of blood glucose readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA_1c was shown in self-monitoring of blood glucose without therapy adjustment. The same difference was observed in structured versus unstructured self-monitoring of blood glucose. Discussion: HbA_1c is improved with clinician therapy modification based on structured self-monitoring of blood glucose readings. Implications are for clinicians to prescribe structured self-monitoring of blood glucose to modify therapy based on the readings and not prescribe unstructured self-monitoring of blood glucose. Participants with suboptimal glycemic control may benefit most. A self-monitoring of blood glucose regimen that improves clinical and cost-effectiveness is presented. Future studies can investigate this regimen specifically.

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