A contrarian view.
3-16 SELF MONITORING OF GLUCOSE BY PEOPLE WITH DIABETES: EVIDENCE BASED PRACTICE
"There is no convincing evidence that glycemic control is consistently influenced by self monitoring of blood or urine." "Recent studies have suggested that self monitoring of blood glucose may be a waste of time for many patients receiving insulin."
Studies comparing patients with insulin-dependent diabetes who performed home monitoring with those who did not have shown no differences in glycemic control. Even less evidence links monitoring with improved glycemic control in non-insulin-dependent diabetes.
"Existing evidence suggests that self monitoring does not improve glycemic control, that blood testing is not necessarily better than urine testing, and that it may be appropriate for some patients to perform no self testing at all." Some patients give up self monitoring if they cannot see its purpose, while others feel guilty if they do not comply with the recommended regimen. Others experience anxiety, frustration, and helplessness in the face of unsatisfactory results which they feel powerless to improve.
Self monitoring tests are often inaccurate and unreliable. Inappropriate and unhelpful testing is widespread. Costs over time are high. Psychological well being may be compared.

BMJ March 29, 1997; 314: 964-66 Commentary, "Education and Debate" from East Cornwall Hospital, Bedminster, Cornwall, UK

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