Self-monitoring of blood glucose did not improve glycemic control in patients with type 2 diabetes not treated with insulin.

M e t h o d s Design: Randomized controlled trial (Diabetes Glycemic Education and Monitoring [DiGEM] study). Allocation: Concealed.* Blinding: Blinded (laboratory staff).* Follow-up period: 12 months. Setting: 48 general practices in Oxfordshire and South Yorkshire, England, United Kingdom. Patients: 453 patients ≥ 25 years of age at diagnosis of type 2 diabetes (mean age 66 y at study entry, 57% men, median duration of diabetes 3 y) who were managed with diet or oral hypoglycemic agents alone, had hemoglobin A1c (HbA1c) level ≥ 6.2% (mean 7.5%), and were independent in activities of daily living. Exclusion criteria included serious disease and use of a blood glucose meter ≥ 2 times/wk in the previous 3 months. Intervention: Self-testing by use of a blood glucose meter 3 times daily 2 d/wk, with instructions to contact their physician if readings were consistently high or low (selftesting group, n = 150); self-testing (as above) plus training in timing, interpreting, and using the test results (self-monitoring group, n = 151); or quarterly blood glucose tests but no use of a blood glucose meter (control group, n = 152). All patients received usual care, including training in behavior-changing techniques and feedback on glycemic control. Outcomes: Change in HbA1c level, blood pressure, cholesterol, weight, and body mass index; and hypoglycemic episodes. Patient follow-up: 87% (intention-to-treat analysis).