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Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: A meta-analysis of randomised controlled trials
Zhu H.1; Zhu Y.1; Leung S.-W.2
2016-09-01
Source PublicationBMJ Open
ISSN2044-6055
Volume6Issue:9
Abstract

effectiveness of self-monitoring of blood glucose (SMBG) in patients with non-insulin-treated type 2 diabetes (T2D). Methods: A comprehensive literature search was conducted in PubMed, Cochrane Library, Web of Science, ScienceDirect and ClinicalTrials.gov from their respective inception dates to 26 October 2015. Eligible randomised controlled trials (RCTs) were included according to prespecified criteria. The quality of the included RCTs was evaluated according to the Cochrane Risk of Bias Tool, and the evidence quality of meta-analyses was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria. A meta-analysis of primary and secondary outcome measures was performed. Sensitivity and subgroup analyses were carried out to evaluate the robustness and heterogeneity of the findings. Beggfs and Eggerfs tests were used to quantify publication biases. Results: A total of 15 RCTs, comprising 3383 patients with non-insulin-treated T2D, met the inclusion criteria. The SMBG intervention improved glycated haemoglobin (HbA1c) (mean difference .0.33; 95% CI .0.45 to .0.22; p=3.0730e.8; n=18), body mass index (BMI; .0.65; .1.18 to .0.12; p=0.0164; n=9) and total cholesterol (TC; .0.12; .0.20 to .0.04; p=0.0034; n=8) more effectively than the control in overall effect. The sensitivity analysis revealed little difference in overall effect, indicating the robustness of the results. SMBG moderated HbA1c levels better than the control in all subgroup analyses. Most of the RCTs had high risk of bias in blinding, while the overall quality of evidence for HbA1c was moderate according to the GRADE criteria. Publication bias was moderate for BMI. Conclusions: SMBG improved HbA1c levels in the short term (.6-month follow-up) and long term (.12-month follow-up) in patients with T2D who were not using insulin. Trial registration number: CRD42015019099.

DOI10.1136/bmjopen-2015-010524
URLView the original
Indexed BySSCI
Language英語English
WOS Research AreaGeneral & Internal Medicine
WOS SubjectMedicine, General & Internal
WOS IDWOS:000391302900209
Scopus ID2-s2.0-84985946872
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Document TypeJournal article
CollectionInstitute of Chinese Medical Sciences
Affiliation1.State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
2.State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China School of Informatics, University of Edinburgh, Edinburgh, UK.
First Author AffilicationInstitute of Chinese Medical Sciences
Recommended Citation
GB/T 7714
Zhu H.,Zhu Y.,Leung S.-W.. Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: A meta-analysis of randomised controlled trials[J]. BMJ Open, 2016, 6(9).
APA Zhu H.., Zhu Y.., & Leung S.-W. (2016). Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: A meta-analysis of randomised controlled trials. BMJ Open, 6(9).
MLA Zhu H.,et al."Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: A meta-analysis of randomised controlled trials".BMJ Open 6.9(2016).
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