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Position Statement and Paper
Role of Self Monitoring of Blood Glucose: Recommendations from the Canadian Agency for Drugs and Technologies in Health (CADTH) and the Canadian Diabetes Association
Vincent Woo MD, FRCPC and Arlene Kuntz BSP, CDE on behalf of the Canadian Diabetes Association’s Clinical and Scientific Section
The Canadian Agency for Drugs and Technologies in Health (CADTH) released a report prepared by the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS) entitled “Optimal Therapy Recommendations for the Prescribing and Use of Blood Glucose Test Strips.” This report has been reviewed by the Canadian Diabetes Association.
One of the main findings indicated in the report for adults with type 2 diabetes who do not use insulin states that:
- Routine self-monitoring of blood glucose by most adults with type 2 diabetes using oral anti-diabetes drugs is not recommended / suggested by the COMPUS Expert Review Committee (CERC).
It is also noted by CERC that the primary consideration for this finding was cost-effectiveness.
There are a number of recommendations that the Canadian Diabetes Association 2008 Clinical Practice Guidelines state that significantly differ from the findings in this report.
Upon review of the report findings, the Canadian Diabetes Association holds the following positions:
- The frequency of self-monitoring of blood glucose should be individualized depending on glycemic control and type of therapy and should include both pre- and postprandial measurements of blood glucose levels.
- There is clear evidence for reduced episodes of hypoglycemia in patients with type 2 diabetes who practice frequent self-monitoring of blood glucose.
In the time made available for consultation, the Canadian Diabetes Association reviewed some of the studies cited by CERC and concluded the following:
- There are significant limitations in the studies cited by CERC. The studies therefore do not provide conclusive evidence for the recommendation.
- The Association does not agree with the economic analysis from this report as it significantly undervalues safety and clinical considerations including hypoglycemia and diabetes complications.
For further details, see the 2008 Clinical Practice Guidelines.
View entire Position Paper.
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