Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there is a trade off between benefits and harms of the intervention.
Population: Adults with type 2 diabetes
Intervention: Self-monitoring blood glucose
Comparison: No self-monitoring blood glucose (including usual care and self-monitoring of urine glucose)
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Hemoglobin A1c (HbA1c) (follow up: 24-52 weeks) | Favors intervention | Low |
Fasting blood glucose (mmol/L) (follow up: 26-52 weeks) | Favors intervention | Low |
Postprandial blood glucose (mg/dL) at 26 weeks for adults with type 2 diabetes on diet, antidiabetic, and/or insulin medicines (follow up: 6 months) | Favors intervention | Low |
Any hypoglycemia from 26-52 weeks (follow up: 6-12 months) | Favors comparison | Low |
Severe hypoglycemia from 26-52 weeks (follow up: 6-12 months) | No statistically significant difference | Low |
Adverse events at 6 months for adults with type 2 diabetes on oral antidiabetes medicines (follow up: 6 months) | No statistically significant difference | Moderate |
Recommendations as stated in the source guideline The guideline development group states: do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless: the person is on insulin or there is evidence of hypoglycemic episodes or the person is on oral medication that may increase their risk of hypoglycemia while driving or operating machinery or the person is pregnant, or is planning to become pregnant.
Note The guideline development group noted that self-monitoring of blood glucose provides the potential for tight glycemic control which reduces the risk of diabetes-related complications. However, the impact on hypoglycemic events is important in determining the safety and acceptability in patients.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- What are the effects of diet, physical activity, or both in people at increased risk of developing type 2 diabetes mellitus?
- Can glucagon‐like peptide (GLP)‐1 analogs prevent or delay the development of type 2 diabetes?
- In people with increased risk of developing type 2 diabetes mellitus, what are the preventative effects of alpha‐glucosidase inhibitors compared with exercise/diet or placebo or metformin?
- For people at risk for developing type 2 diabetes mellitus, how does metformin compare with diet and exercise?
- For adults with inadequately controlled type 2 diabetes (T2DM), how does metformin‐sulfonylurea compare with alternative metformin combinations?
- In people with type 2 diabetes mellitus, what are the effects of adding colesevelam to other antidiabetic agents?
- How do short‐acting insulin analogues compare with regular human insulin for adults with type 2 diabetes mellitus?
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