The dilemma of self-monitoring of blood glucose

Excerpt

In a paper published in Diabetologia last year, Martin et al. [1] reported that self-monitoring of blood glucose (SMBG) in the observational retrospective cohort Retrolective Study ‘Self-monitoring of Blood Glucose and Outcome in Patients with Type 2 Diabetes’ (ROSSO) was associated with significantly decreased diabetes-related morbidity and all-cause mortality even after adjusting for age, sex, comorbidities at diagnosis of diabetes (hypertension, CHD and history of stroke), fasting plasma glucose concentrations, triacylglycerol levels and treatment. These findings remained true for patients not taking insulin. In contrast, in the present issue of Diabetologia, Davis et al. [2] report that, in the observational, prospective Fremantle study, SMBG was not associated with improved outcomes of diabetes-related morbidity, cardiac death or all-cause mortality after adjustment for confounders. The confounders adjusted for in the Fremantle study were age, sex, duration of diabetes, prior CHD, prior peripheral arterial disease, neuropathy, retinopathy, microalbuminuria, systolic blood pressure, total serum cholesterol and current smoking. Surprisingly, there was a significant 79% increased risk of cardiovascular mortality in those patients who were not taking insulin but were performing SMBG. …