- Prescribing Advice for GPs - https://www.prescriber.org.uk -

SMBG not cost effective

The British Medical Journal has published the results of a study that aimed to assess the cost effectiveness of self monitoring of blood glucose (SMBG) in patients with non-insulin treated type 2 diabetes. This study has been covered by the general media (BBC).

Data from the diabetes glycaemic education and monitoring (DiGEM) study were analysed comparing standardised care with two levels of self monitoring. Data for clinic visits and drug usage were available for 12 months prior to study entry and for 12 months follow up. Quality of life was assessed at baseline and during follow up.

Overall there was a trend to more clinic visits and greater drug costs in the two groups where self monitoring was used although no statistical differences were found. There was a statistically higher cost in terms of the intervention and there was a reduction in quality of life in the intervention groups; this was statistically significant for the patients who were more intensively monitoring.

The authors conclude that, "self monitoring of blood glucose with or without additional training in incorporating the results into self care was associated with higher costs and lower quality of life in patients with non-insulin treated type 2 diabetes".

Action: Clinicians should be aware of this study; the wider reporting may generate patient queries. Self monitoring should be discouraged in patients with non-insulin treated type 2 diabetes.