Blood glucose self-monitoring in people with insulin-untreated type 2 diabetes mellitus

People with type 2 diabetes regularly check their blood glucose levels. This report investigates the question of whether this blood glucose self-monitoring makes medical and economic sense for type 2 diabetics.

A large number of clinical studies have shown that long-term blood glucose levels decline in people with insulin-untreated diabetes who regularly measure their blood glucose, and that these people experience fewer diabetes-related complications. They were also very likely to recognise hypoglycaemia. However, blood glucose levels declined by a greater amount overall in study participants who did not self-monitor. There were no differences between the groups in terms of satisfaction, quality of life or depressive moods, although the group who self-monitored felt more involved in the management of their condition. However, the totality of observed effects was small. In 2017, only a quarter of people with insulin-untreated type 2 diabetes mellitus measured their own blood glucose levels. Given the low medical benefit, the question arises of whether costs should no longer be reimbursed. According to health insurers, doing so would yield annual cost savings of around six million Swiss francs. In this case, however, civil law and ethical criteria would have to ensure that no one was disadvantaged, particularly the elderly or people who are limited by restricted vision or motor disorders.

The report concludes that blood glucose self-monitoring achieves only a modest reduction in long-term blood glucose values. According to modelled calculations for a 40-year period, survival is extended by 18 days. However, these mathematically modelled results for survival can be neither confirmed nor disproved since the issue has not been investigated in clinical studies.