NHS Diabetes Publishes Self-Monitoring of Blood Glucose Report

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A new report examines and makes recommendations about the issue of self-monitoring of blood glucose (SMBG) in people with Type 2 diabetes who are not treated with insulin. The report was commissioned by the National Clinical Director for Diabetes in England.
An NHS Diabetes working group was established with relevant stakeholders to undertake it, and they have now published their report. They requested a systematic review of the evidence from the Health Technology Assessment program (HTA) program, to inform their discussions.
Some of the main recommendations made in the NHS Diabetes working group report include:

• SMBG with appropriate structured education should be available to people receiving sulphonylurea treatment to identify hypoglycemic episodes.
• In keeping with existing NICE Clinical Guideline, SMBG should only be provided routinely to people with Type 2 diabetes not treated with insulin or sulphonylureas where there is an agreed purpose or goal to testing.
• SMBG should be used only within a care package, accompanied by structured education which should include clear instructions about the place of monitoring and how results can be used to reinforce lifestyle change, adjust therapy or alert healthcare professionals. This should include regular review to identify and support people who find it useful while discouraging people who gain no clinical benefit from continuing to test.
• Individuals with non-insulin treated diabetes who are motivated by SMBG activity and use the information to maximize the effect of lifestyle and medication should be encouraged to continue to monitor.
• Staff training in the use of SMBG to support changes in lifestyle and self-adjustment of medications is required.
• Savings from a reduction in SMBG in individuals with non-insulin treated diabetes should be used to provide both structured education and training of professionals.
• Future research should focus on how to identify those who will gain most from SMBG and establish how they integrate it successfully into their approach to self-management.

Commenting on the report, Stella Valerkou, Senior Policy Officer at Diabetes UK, said, “Diabetes UK welcomes the publication of this report and the evidence review which sought to clarify the issue of SMBG in people with non-insulin treated Type 2 diabetes.
“They identify that some people with Type 2 diabetes do derive benefit from SMBG, as it can support self-management, and impact on empowerment and motivation. SMBG should be made available to those who find it useful and have been provided with education in its use.
“The report also reflects the potentially damaging effect of the arbitrary removal of SMBG from individuals who view it as a key part of diabetes self management.
“The need for both staff and people with diabetes alike to be educated about SMBG, and to ensure this is integrated into overall diabetes care, is evident. This will enable people with Type 2 diabetes to maximize benefit from SMBG and assist professionals in their support of people with the condition.”
Diabetes UK