Study casts doubt on benefits of glucose self-monitoring
- Self-monitoring of blood glucose (SMBG) is no better than traditional in-office monitoring for people with type 2 diabetes who don’t require insulin, a new study in JAMA Internal Medicine concludes.
- 450 patients in the North Carolina Chapel Hill health system were randomized to check their blood sugar using a Telcare connected blood glucose monitor, check their sugar via Telcare and receive “enhanced patient feedback” from their doctor or have their glucose monitored at the doctor’s office.
- During the one-year study, the researchers no significant differences in hemoglobin A1c levels and health-related quality of life among the three cohorts.
The study did, however, show a small — though not clinically significant — difference in outcomes between the two groups using Telcare: Those who received physician feedback had A1c reductions of about 0.5%, versus 0.2% in the group without enhanced feedback.
“This pattern suggests that, for SMBG to be an effective self-management tool in non-insulin-treated T2DM, the patient and physician must actively engage in performing, interpreting and acting on the SMBG values,” the University of North Carolina-Chapel Hill researchers write.
With U.S. spending on diabetes reaching $176 billion, it is among the most costly conditions to treat. Health IT has been touted as having potential to reduce those costs while improving health outcomes. For example, IBM Watson Health and the American Diabetes Association are applying cognitive computing to diabetes data to create personalized insights that reflect individual risk factors, treatment regimens and behavior. The tailored data can help to nudge patients toward healthier behaviors.
IBM is just one of the tech giant betting on diabetes. Verily, Alphabet’s life sciences unit, is working with French drugmaker Sanofi to create tools for diabetes management. And Samsung and WellDoc are partnering to bring WellDoc’s BlueStar mobile diabetes management app directly to consumers. There are reports that Apple also is eyeing the space and has hired biomedical engineers to develop noninvasive sensors to monitor blood sugar and help diabetics manage their disease.
In the case of the UNC study, more interaction between clinicians and patients may have improved outcomes, according to the researchers. “There is also a possibility that those participating might be generally good at self-care, so an automated system may add less than in other populations.”