Question-mark over diabetes self-monitoring

Both doctors and patients are uncertain about the benefits of self-monitoring among sufferers of type two diabetes, a study shows.

Research published online at bmj.com today reveals that the practice of home blood glucose monitoring may be less useful than was initially intended.

Dr Elizabeth Peel and colleagues at Birmingham’s Aston University found that many of the 18 patients they interviewed decreased or abandoned the self-monitoring process.

Many reported little, declining or no interest from doctors in their activities, while many reported encountering difficulties about whether they were using their equipment correctly. Some continued despite these problems, however.

Dr Peel suggests the patients’ experiences reflect a clinical divide over the value of the practice. She says some believe the process helps keep blood glucose levels under control, while others say it “can lead to feelings of frustration and guilty”.

“Patients find results difficult to interpret and act on, and few patients use self monitoring to guide and maintain changes to their behaviour or lifestyle,” the report notes.

“Education about blood glucose self-monitoring should be explicit, goal-oriented, tailored to individual needs and on a continuous basis,” it concludes, recommending that the personality of patients should be tested to establish whether the practice is “problematic or beneficial” on a case-by-case basis.