In October, 2008, the International Diabetes Federation (IDF) Clinical Guidelines Taskforce, in conjunction with the SMBG International Working Group, convened a workshop in Amsterdam to address the issue of SMBG utilization in people with type 2 diabetes (T2DM) that is not treated with insulin. Workshop participants included clinical investigators actively engaged in self-monitoring of blood glucose (SMBG) research and research translation activities. The purpose of the workshop was to: 

     Review the findings of selected key studies that describe the clinical and metabolic impact and the cost implica?tions of SMBG. 

     Identify additional studies and study designs that are needed to further define the role of SMBG in non-insulin-treated people with T2DM. 

     Propose recommendations for the use of SMBG in non-insulin-treated people with T2DM.

     

     The following report presents a summary of the findings and recommendations related to the use of SMBG in people with non-insulin-treated type 2 diabetes. 

 

      Diabetes is a significant and growing worldwide concern with potentially devastating consequences (1). Numerous studies have demonstrated that optimal management of glycaemia and other cardiovascular risk factors can reduce the risk of development and progression of both microvascular and macrovascular complications (3-6;8-12;16).

     

      Results from studies of SMBG use in non-insulin-treated T2DM have been mixed, due to differences in study design, populations, outcome indicators, and inherent limitations of the traditional RCT models used. However, current evidence suggests that using SMBG in this population has the potential to improve glycaemic control, especially when incorporated into a comprehensive and ongoing educa?tion programme that promotes management adjustments according to the ensuing blood glucose values (22;67;68).

     

      SMBG use should be based on shared decision making between people with diabetes and their healthcare provid?ers and linked to a clear set of instructions on actions to be taken based upon SMBG results. SMBG prescription is discouraged in the absence of relevant education and/or ability to modify behaviour or therapy modalities. 

     

      In summary, the appropriate use of SMBG by people with non-insulin-treated diabetes has the potential to optimize diabetes management through timely treatment adjustments based on SMBG results and improve both clinical outcomes and quality of life. However, the value and utility of SMBG may evolve within a preventive care model that is based on ongoing monitoring and the ability to adjust management as the diabetes progresses over time. In the meantime, more effective patient and provider training around the use of SMBG is needed. Because skilled healthcare professionals are needed now and in the future to address the growing diabetes epidemic, it is hoped that this report will encourage the development and systematic introduction of more effective diabetes self-management education/training and the value-based models of clinical decision making and care delivery.