Choosing Wisely:

Don’t recommend daily home finger glucose testing in patients with type 2 diabetes mellitus not using insulin.

Rationale and Comments: Self-monitoring of blood glucose (SMBG) is an integral part of patient self-management in maintaining safe and target-driven glucose control in type 1 diabetes. However, there is no benefit to daily finger glucose testing in patients with type 2 diabetes mellitus who are not on insulin or medications associated with hypoglycemia, and there is negative economic impact and potential negative clinical impact of daily glucose testing. SMBG should be reserved for patients during the titration of their medication doses or during periods of changes in patients’ diet and exercise routines.
Sponsoring Organizations:
  • Society of General Internal Medicine
  • Sources:
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Endocrinologic
  • References: • American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2013;36 Suppl 1:S11-66.
    • Karter AJ, Parker MM, Moffet HH, Spence MM, Chan J, Ettner SL, Selby JV. Longitudinal study of new and prevalent use of self-monitoring of blood glucose. Diabetes Care. 2006;29:1757-63.
    • Harris MI. Frequency of blood glucose monitoring in relation to glycemic control in patients with type 2 diabetes. Diabetes Care. 2001;24:979-82.
    • Malanda UL, Welschen LMC, Riphagen II, Dekker JM, Nijpels G, Bot SDM. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database of Systematic Reviews. 2012;1:1-88.
    • O'Kane MJ, Bunting B, Copeland M, Coates VE; ESMON study group. Efficacy of self-monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. 2008;336:1174-7.
    • Peel E, Douglas M, Lawton J. Self-monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients' perspectives. BMJ. 2007;335:493-8.
    • Cameron C, Coyle D, Ur E, Klarenback S. Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin. CMAJ. 2010;182(1):28-34.

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