Monitoring module

Evidence to support unilateral SBGM in non-insulin treated type 2 diabetes is equivocal. While various views have concluded that SBGM in this population may be effective in improving blood glucose control, the absence of well designed studies has resulted in this being a contentious area with an absence of definitive recommendations.

High level evidence supports SBGM in people with insulin treated diabetes where SBGM provides a feedback loop and the basis for adjustment of insulin doses and self regulation of other self management behaviours. One review has suggested that SBGM for people with non-insulin treated diabetes can only be effective if a systems approach to SBGM is applied and that studies to assess the evidence for SBGM should be designed and evaluated within a complete control system (referred to as common sense framework) where the person with diabetes: knows how to take a reading; understands when the reading is above or below target values; can make the connection between the readings and prior behaviour; can implement an action plan to change behaviours that are leading to out of target readings; relies on SBGM readings rather than subjective feelings; and can evaluate blood glucose readings in a non-judgmental and non-blaming environment.¹

Other mediators that may be linked to the efficacy of SBGM include shorter duration of diabetes (i.e., SBGM may be more beneficial early in diabetes) and higher HbA1c levels.¹ In addition, SBGM schedules must be such that they enable people to make the connection between behaviour (eating, activity and medication taking) and blood glucose results. Fixed time schedules are of little value in a volitional self management system.¹