The ACBRD reviews the evidence for the benefits of a structured approach to blood glucose monitoring
Checking blood glucose levels can be helpful if you have diabetes. But the current guidelines do not fully support its use for all people with diabetes. This is because there isn’t enough proof that it benefits people with type 2 diabetes who don’t use insulin. One reason could be that random checks of blood glucose don’t offer enough information, and the person doesn’t always know what to do with it or has barriers to acting on the information.
However, there is another way. ‘Structured’ monitoring involves checking glucose levels at specific times, or in a specific pattern, usually over a few days. This may be more useful than random or once-daily checks because it shows how glucose levels change and what might be influencing that. The benefits may be even greater when the person with diabetes and their health professional are trained to understand the glucose patterns. The information can be used to make changes to foods, physical activity or medications.
So, we conducted a review to understand the effects of structured monitoring. We reviewed 23 research studies. The studies were carried out in 30 countries; but none were in Australia. The studies reported on the effects on HbA1c (average glucose levels), changes in diabetes treatments, general well-being and how people feel about managing their diabetes. Overall, the findings show that structured monitoring has benefits for people with type 2 diabetes not using insulin. These include:
- reducing HbA1c
- feeling more confident about managing diabetes
However, the way that structured monitoring was done varied across studies. This makes it hard to say which approach works best overall. Still, it seems it can be helpful to:
- check glucose levels 4-7 times a day at regular intervals (e.g. three days in a row, once a month)
- keep track of meals, snacks, physical activity and medication taking
- learn how to understand the glucose patterns
It’s also helpful when health professionals are trained to understand structured monitoring, and discuss it during clinic appointments.
For practical guidance on how to do structured monitoring, see page 8 of the Diabetes Australia position statement on glucose monitoring.
This review was funded by the National Diabetes Services Scheme, an initiative of the Australian Government administered with assistance from Diabetes Australia.
Reference: Holmes-Truscott E, Baptista S, Ling M, Ekinci EI, Collins E, Furler F, Hagger V, Manski-Nankervis J, Wells C, Speight J. The impact of structured self-monitoring of blood glucose on clinical, behavioural, and psychosocial outcomes among adults with non-insulin-treated type 2 diabetes: A systematic review and meta-analysis. Frontiers in Clinical Diabetes and Healthcare, 2023, 4:1177030. DOI: https://10.3389/fcdhc.2023.1177030.