The Effect of Self Monitoring of Blood Glucose (SMBG) on Improvement of Hemoglobin A1C and Glycemic Control in Diabetic Patients

Abstract

Background: It has been shown that improved glycemic control and lower hemoglobin A1C level in diabetic patients will reduce the frequency of microvascular complications. However there have been many debates on how to improve glycemic control and reduce hemoglobin A1C levels. The aim of this review was to assess available information that supports the use of Self Monitoring Blood Glucose (SMBG) in the care of either type 1 or type 2 diabetic patients. Materials and Methods: This review focuses on interventional and analytical studies that compared patients who performed SMBG with patients who did not. The data were derived from 35 interventional and observational studies published between 1983 and 2008, and also a cohort study between 1995 and 2003. All studies were obtained from searches of multiple electronic bibliographic databases supplemented with hand searches of references of retrieved articles. Results: The available scientific literature demonstrates that there is substantial evidence to support the use of SMBG in type 1 diabetes. Most studies do not show a benefit when patients with type 2 diabetes perform SMBG. Some studies demonstrated that SMBG as a part of educational program can be effective on reducing hemoglobin A1C levels. There was a relationship between the number of SMBG tests per unit time and hemoglobin A1C levels. Conclusion: The role of SMBG in reducing hemoglobin A1C level in type 1 diabetes is known, but most of the studies do not support the use of SMBG in type 2 diabetes currently. More rigorous studies should be carried out.