Choosing Wisely:

Avoid routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.

Rationale and Comments: Once target control is achieved and the results of self-monitoring become quite predictable, there is little gained in most individuals from repeatedly confirming. There are many exceptions, such as for acute illness, when new medications are added, when weight fluctuates significantly, when A1C targets drift off course and in individuals who need monitoring to maintain targets. Self-monitoring is beneficial as long as one is learning and adjusting therapy based on the result of the monitoring.
Sponsoring Organizations:
  • The Endocrine Society/American Association of Clinical Endocrinologists
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Endocrinologic
  • References: • Davidson MB, Castellanos M, Kain D, Duran P. The effect of self monitoring of blood glucose concentrations on glycated hemoglobin levels in diabetic patients not taking insulin: a blinded, randomized trial. Am J Med. 2005;118:422-5.
    • Farmer A, Wade A, Goyder E, Yudkin P, French D, Craven A, Holman Rury, Kinmonth AL, Neil A. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomized trial. BMJ. 2007;335:132-40.
    • 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): randomized controlled trial. BMJ. 2008;336:1174-7.

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