AUTHOR=Holmes-Truscott Elizabeth , Baptista Shaira , Ling Mathew , Collins Eileen , Ekinci EIif I. , Furler John , Hagger Virginia , Manski-Nankervis Jo-Anne , Wells Caroline , Speight Jane 

TITLE=The impact of structured self-monitoring of blood glucose on clinical, behavioral, and psychosocial outcomes among adults with non-insulin-treated type 2 diabetes: a systematic review and meta-analysis

JOURNAL=Frontiers in Clinical Diabetes and Healthcare

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2023.1177030

DOI=10.3389/fcdhc.2023.1177030

ISSN=2673-6616

ABSTRACT=Background: Self-monitoring of blood glucose (SMBG) is considered of little clinical benefit for adults with non-insulin-treated type 2 diabetes, but no comprehensive review of a structured approach to SMBG has been published to date. 
Purpose: To conduct a systematic review and meta-analysis of the impact of sSMBG on HbA1c, treatment modifications, behavioural and psychosocial outcomes, and;  examine the moderating effects of sSMBG protocol characteristics on HbA1c.
Data sources: Four databases searched (November 2020; updated: February 2022). 
Study Selection: Inclusion criteria: non-randomised and randomised controlled trials (RCTs) and prospective observational studies; reporting effect of sSMBG on stated outcomes; among adults (18 years) with non-insulin-treated type 2 diabetes. Studies excluded if involving children or people with insulin-treated or other forms of diabetes. 
Data Extraction and Analysis: Outcome data extracted, and risk of bias/quality assessed independently by two researchers. Meta-analysis was conducted for RCTs, and moderators explored (HbA1c only). 
Data synthesis: From 2,078 abstracts, k=23 studies were included (N=5,372). Risk of bias was evident and study quality was low. Outcomes assessed included: HbA1c (k=23), treatment modification (k=16), psychosocial/behavioural outcomes (k=12). Meta-analysis revealed a significant mean difference favouring sSMBG in HbA1c (-0·29%, 95% CI: -0·46 to -0·11, k=13) and diabetes self-efficacy (0.17%, 95% CI: 0.01 to 0.33, k=2). Meta-analysis revealed no significant moderating effects by protocol characteristics. 
Limitations: Findings limited by heterogeneity in study designs, intervention characteristics, and psychosocial assessments.
Conclusions: A small positive effect of sSMBG on HbA1c and diabetes self-efficacy was observed. Narrative synthesis of sSMBG intervention characteristics may guide future implementation.