Glucose Self-Monitoring Improves A1C in People With Type 2 Who Don’t Use Insulin

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Glucose Self-Monitoring Improves A1C in People With Type 2 Who Don’t Use Insulin

Monitoring blood glucose levels throughout the day can help people with type 2 diabetes who don’t use insulin improve their long-term blood glucose control, according to a new analysis published in the Journal of General Internal Medicine.

There has long been debate about how useful blood glucose self-monitoring is for people with type 2 diabetes who don’t use insulin or take another drug, such as a sulfonylurea, that can cause hypoglycemia (low blood glucose). Some diabetes experts believe that if there isn’t anything meaningful you can do to change your blood glucose level — such as take a higher dose of insulin if your level is high, or take a glucose tablet if your level is low — then there’s no point in monitoring your glucose level on a routine basis. On the other side of the debate, many people believe that tracking blood glucose regularly can help people with type 2 decide things like what to eat, how much and when to exercise, or when to contact or visit their doctor.

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For the latest analysis, researchers were interested in whether glucose self-monitoring had any effect on A1C — a measure of long-term blood glucose control — in people with type 2 diabetes who didn’t use insulin. They combined data from 22 different studies on this topic, which included a total of 6,204 participants. Most of these studies — 17 — compared self-monitoring with no self-monitoring, while a handful compared self-guided self-monitorng — checking your glucose when you think it’s needed — with structured self-monitoring, at set times during the day.

Glucose self-monitoring linked to lower A1C

Overall, the researchers found that compared with no self-monitoring, glucose self-monitoring was linked to a lower A1C level by a median of 0.30%. Compared with self-guided self-monitoring, structured self-monitoring was linked to a lower A1C level by a median of 0.23%. Diving deeper into the data, the researchers found that checking blood glucose levels eight to 11 times a week was linked to the lowest A1C levels compared with checking more often or less often — with a median A1C level 0.35% lower compared with no self-monitoring. When participants made lifestyle adjustments based on their glucose results — such as changing their eating or physical activity habits — glucose self-monitoring was linked to a lower A1C level by a median of 0.37%.

The researchers concluded that among people with type 2 diabetes who don’t use insulin, glucose self-monitoring is still a potentially useful tool for blood glucose control — especially when it’s structured, rather than used at will or haphazardly, and when people make lifestyle adjustments based on their glucose readings. These results lend support to proponents of making blood glucose self-monitoring a normal part of recommended diabetes care for people with type 2 diabetes, regardless of whether they use insulin.

Want to learn more about A1C? Read “How to Lower A1C Levels Naturally,” “How to Lower Your A1C Levels: More Steps You Can Take” and “Getting Your A1C to Target.”

Living with type 2 diabetes? Check out our free type 2 e-course!

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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