Self-monitoring in Type 2 diabetes mellitus: a meta-analysis
Self-monitoring in Type 2 diabetes mellitus: a meta-analysis
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DOI：
10.1046/j.1464-5491.2000.00390.x
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发表时间：
2000-11-01
影响因子：
3.5
通讯作者：
Swaminathan, R
中科院分区：
文献类型：
--
作者：
Coster, S;Gulliford, MC;Swaminathan, R
目的自我监测血糖或尿糖在2型糖尿病患者中广泛应用。本研究通过系统回顾和荟萃分析评估了该技术在改善血糖控制方面的有效性。方法采用随机对照试验，比较2型糖尿病患者进行血糖或尿糖监测与不进行自我监测，或进行血糖自我监测与尿糖自我监测对糖化血红蛋白的影响。结果共鉴定出8份报告。对这些内容进行了质量评定，并对数据进行了摘要。在0到28的范围内，平均（sd）质量评分为15.0（1.69）。没有研究有足够的能力来检测糖化血红蛋白（GHb）的差异小于0.5%。一项研究被排除，因为它是一个复杂干预的集群随机试验，另一项研究因为果糖胺被用作结果测量。荟萃分析使用了四项研究的数据，将血液或尿液监测与不定期监测进行比较。从监测中估计GHb减少为-0.25%（95%置信区间-0.61至0.10%）。三个比较血糖监测和尿糖监测的研究也被结合起来。通过监测血糖而不是尿糖，估计GHb的减少量为-0.03%（-0.52至0.47%）。结论本研究结果并不能为具有可观成本的护理项目的临床有效性提供证据。需要进一步的工作来评估自我监测，以便更有效地利用糖尿病护理资源。
Aims Self-monitoring of blood or urine glucose is widely used by subjects with Type 2 diabetes mellitus. This study evaluated the effectiveness of the technique at improving blood glucose control through a systematic review and meta-analysis.Methods Randomized controlled trials were identified that compared the effects of blood or urine glucose monitoring with no self-monitoring, or blood glucose self-monitoring with urine glucose self-monitoring, on glycated haemoglobin as primary outcome in Type 2 diabetes.Results Eight reports were identified. These were rated for quality and data were abstracted. The mean (sd) quality score was 15.0 (1.69) on a scale ranging from 0 to 28. No study had sufficient power to detect differences in glycated haemoglobin (GHb) of less than 0.5%. One study was excluded because it was a cluster randomized trial of a complex intervention and one because fructosamine was used as the outcome measure. A meta-analysis was performed using data from four studies that compared blood or urine monitoring with no regular monitoring. The estimated reduction in GHb from monitoring was -0.25% (95% confidence interval -0.61 to 0.10%). Three studies that compared blood glucose monitoring with urine glucose monitoring were also combined. The estimated reduction in GHb from monitoring blood glucose rather than urine glucose was -0.03% (-0.52 to 0.47%).Conclusions The results do not provide evidence for clinical effectiveness of an item of care with appreciable costs. Further work is needed to evaluate self-monitoring so that resources for diabetes care can be used more efficiently.