Self-Monitoring of Blood Glucose: What Are Healthcare Professionals Recommending?

Authors: 
Celeste Latter, Pam McLean-Veysey, Peggy Dunbar, Dawn Frail, Ingrid Sketris, Wayne Putnam
Research Summary: 

Objective
The clinical benefit and cost-effectiveness of self monitoring of blood glucose (SMBG) in adults with type 2 diabetes not using insulin has been questioned. The objective of this study was to gain insight into healthcare professionals’ recommendations, practices and beliefs with respect to SMBG in well-controlled adults (glycated hemoglobin≤7.0%) with type 2 diabetes not using insulin.

Methods
Interviews were conducted with diabetes educators, pharmacists and family physicians in 3 district health authoritiesin Nova Scotia, Canada. Audiotaped interviews were transcribed and analyzed using a thematic analysis approach.

Results
All participants recommended SMBG for persons in this population. Recommendations varied both within and between professional groups and were noted to be highly individual. SMBG results were perceived to be valuable for both patients and healthcare professionals. Participants identified clinical practice guidelines as a trustworthy source of information about SMBG in this population.

Conclusion
Guidelines cite a lack of substantial evidence for SMBG in this population. Customized SMBG practices are important, but so are clarity and consistency in guideline rcommendations. Reducing the use of SMBG in patient populations where it is unlikely to be beneficial will allow reallocation of resources to interventions with proven benefit.