Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis
Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis
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DOI：
10.1185/03007990903364665
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发表时间：
2009-12-01
影响因子：
2.3
通讯作者：
Stettler, Christoph
中科院分区：
文献类型：
--
作者：
Allemann, Sabin;Houriet, Carine;Stettler, Christoph
目的：通过系统评价和荟萃分析，评估自我血糖监测（SMBG）对非胰岛素治疗的 2 型糖尿病患者血糖控制的影响。 研究设计和方法：从 MEDLINE 和 Cochrane 对照试验注册库中检索了从成立到 2009 年 1 月的随机对照试验，比较 SMBG 与非 SMBG 或更频繁的 SMBG 与较少的情况。 密集SMBG。电子检索以参考文献列表和评论的手动检索为补充。 SMBG 与非 SMBG 的比较是主要分析，较频繁的 SMBG 与较少强度的 SMBG 的比较是次要分析。进行分层分析以评估修改因素。主要结局指标：主要终点是糖化血红蛋白A(1c) (HbA(1c))，次要终点包括空腹血糖和低血糖的发生。使用随机效应模型计算 HbA1c 的加权平均差 (WMD)，并计算低血糖的风险比 (RR)。由于相当大的异质性，没有计算空腹血糖的综合估计值。结果：分析中纳入了 15 项试验（3270 名患者）。与非 SMBG 相比，SMBG 与 HbA1c 的大幅降低相关（WMD -0.31%，95% 置信区间 -0.44 至 -0.17）。与 SMBG 相关的有益效果并没有随着较长时间的随访而减弱。 SMBG 显着增加了检测低血糖的可能性（RR 2.10、1.37 至 3.22）。与强度较低的 SMBG 相比，频繁的 SMBG 并未导致 HbA(1c) 发生显着变化（WMD -0.21%，95% CI -0.57 至 0.15）。结论：与非 SMBG 相比，SMBG 与未接受胰岛素治疗的 2 型糖尿病患者的血糖控制显着改善相关。与较少强度的 SMBG 相比，更频繁的 SMBG 的附加价值仍不确定。
Objective:To assess the effect of self-monitoring of blood glucose (SMBG) on glycaemic control in non-insulin treated patients with type 2 diabetes by means of a systematic review and meta-analysis.Research design and methods:MEDLINE and the Cochrane Controlled Trials Register were searched from inception to January 2009 for randomised controlled trials comparing SMBG with non-SMBG or more frequent SMBG with less intensive SMBG. Electronic searches were supplemented by manual searching of reference lists and reviews. The comparison of SMBG with non-SMBG was the primary, the comparison of more frequent SMBG with less intensive SMBG the secondary analysis. Stratified analyses were performed to evaluate modifying factors.Main outcome measures:The primary endpoint was glycated haemoglobin A(1c) (HbA(1c)), secondary outcomes included fasting glucose and the occurrence of hypoglycaemia. Using random effects models a weighted mean difference (WMD) was calculated for HbA1c and a risk ratio (RR) was calculated for hypoglycaemia. Due to considerable heterogeneity, no combined estimate was computed for fasting glucose.Results:Fifteen trials (3270 patients) were included in the analyses. SMBG was associated with a larger reduction in HbA1c compared with non-SMBG (WMD -0.31%, 95% confidence interval -0.44 to -0.17). The beneficial effect associated with SMBG was not attenuated over longer follow-up. SMBG significantly increased the probability of detecting a hypoglycaemia (RR 2.10, 1.37 to 3.22). More frequent SMBG did not result in significant changes of HbA(1c) compared with less intensive SMBG (WMD -0.21%, 95% CI -0.57 to 0.15).Conclusions:SMBG compared with non-SMBG is associated with a significantly improved glycaemic control in non-insulin treated patients with type 2 diabetes. The added value of more frequent SMBG compared with less intensive SMBG remains uncertain.