June 13, 2017

Is the Finger-Stick Blood Test Necessary for Type 2 Diabetes Treatment?

CHAPEL HILL, NC -- June 13, 2017 -- Blood glucose testing does not offer a significant advantage in blood sugar control or quality of life for patients with type 2 diabetes who are not treated with insulin, according to a study published online by JAMA Internal Medicine.

“Our study results have the potential to transform current clinical practice for patients and their providers by placing a spotlight on the perennial question, ‘to test or not to test?’” said senior author Katrina Donahue, MD, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

In the MONITOR trial, 450 patients were assigned to no blood sugar monitoring, once daily glucose monitoring, or enhanced once-daily glucose monitoring with an internet-delivered tailored message of encouragement or instruction for 1 year.

Results showed no significant differences in blood glucose control across the 3 groups. There were no significant differences in health-related quality of life or for hypoglycaemia, hospitalisations, and emergency room visits.

There was also no difference in the number of individuals who had to start using insulin treatment to better control blood glucose levels.

“Of course, patients and providers have to consider each unique situation as they determine whether home blood glucose monitoring is appropriate,” said Dr. Donahue. “But the study’s null results suggest that self-monitoring of blood glucose in non-insulin treated type 2 diabetes has limited utility. For the majority, the costs may outweigh the benefits.”

Proponents of blood glucose testing argue that daily testing promotes better awareness of glucose levels, leading to improvements in diet and lifestyle. In the past, a number of smaller clinical trials have shown mixed results in attempting to verify this. Several studies suggested a benefit for testing, while others found no evidence of benefit, or found that testing could even be harmful. Daily testing imposes not only a financial cost, but can also take a mental toll, increasing the rate of depression or anxiety in some patients.

“There was no difference between either type of testing,” said first author Laura Young, MD, University of North Carolina at Chapel Hill. “Enhanced self-monitoring blood glucose, in the pragmatic setting of regular daily life, offered no additional health benefits.”

“There has been a lack of consensus, not just in the United States, but worldwide,” she added. “The lack of standard guidelines makes it all the more difficult for patients, who are already struggling to manage a chronic condition. And at the end of the day, patients have to make a choice.”

SOURCE: University of North Carolina Health Care System
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