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Comment & Response
December 2017

Concerns About Conclusions of Self-monitoring of Blood Glucose

Author Affiliations
  • 1Diabetes Education and Control Group, Federal University of Sao Paulo, Rua Leandro Dupret, 365 Sao Paulo, Brazil
  • 2Biomedical Informatics Consultants, LLC, Potomac, Maryland
JAMA Intern Med. 2017;177(12):1873-1874. doi:10.1001/jamainternmed.2017.6142

To the Editor In a recent issue of JAMA Internal Medicine, an Original Investigation by Young et al1 reports the results of a randomized clinical study wherein use of daily self-monitoring of blood glucose failed to improve glycated hemoglobin (HbA1c) levels compared with the study’s control participants. Young et al1 conclude that glucose monitoring in patients with non–insulin-treated type 2 diabetes should not be routine, and Figure 1 shows a reduction of HbA1c by 0.35% in patients using self-monitoring of blood glucose after 6 months. Glycated hemoglobin levels gradually returned to baseline levels by 1 year, but 33% of study participants had stopped monitoring after 6 months while 40% to 60% stopped monitoring after 1 year.1 If half the participants did not adhere to the intervention, a sustained response should not have been expected, especially with the well-known progression of glucose intolerance in type 2 diabetes.