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A friend of mine sent me this abstract. Thought it may be of some use to those of us with T2 DM who are monitoring BG every day.
Simon J, Gray A, Clarke P, Wade A, Neil A, Farmer A; Diabetes Glycaemic Education
and Monitoring Trial Group. Cost effectiveness of self monitoring of blood glucose in patients with
non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM
trial. BMJ. 2008 May 24;336(7654):1177-80.
OBJECTIVE: To assess the cost effectiveness of self monitoring of blood glucose
alone or with additional training in incorporating the results into self care, in
addition to standardised usual care for patients with non-insulin treated type 2
diabetes. DESIGN: Incremental cost utility analysis from a healthcare
perspective. Data on resource use from the randomised controlled diabetes
glycaemic education and monitoring (DiGEM) trial covered 12 months before
baseline and 12 months of trial follow-up. Quality of life was measured at
baseline and 12 months using the EuroQol EQ-5D questionnaire. SETTING: Primary
care in the United Kingdom. PARTICIPANTS: 453 patients with non-insulin treated
type 2 diabetes. INTERVENTIONS: Standardised usual care (control) compared with
additional self monitoring of blood glucose alone (less intensive self
monitoring) or with training in self interpretation of the results (more
intensive self monitoring). MAIN OUTCOME MEASURES: Quality adjusted life years
and healthcare costs (sterling in 2005-6 prices). RESULTS: The average costs of
intervention were pound89 (euro113; $179) for standardised usual care, pound181
for less intensive self monitoring, and pound173 for more intensive self
monitoring, showing an additional cost per patient of pound92 (95% confidence
interval pound80 to pound103) in the less intensive group and pound84 ( pound73
to pound96) in the more intensive group. No other significant cost difference was
detected between the groups. An initial negative impact of self monitoring on
quality of life occurred, averaging -0.027 (95% confidence interval-0.069 to
0.015) for the less intensive self monitoring group and -0.075 (-0.119 to -0.031)
for the more intensive group. CONCLUSIONS: Self monitoring of blood glucose with
or without additional training in incorporating the results into self care was
associated with higher costs and lower quality of life in patients with
non-insulin treated type 2 diabetes. In light of this, and no clinically
significant differences in other outcomes, self monitoring of blood glucose is
unlikely to be cost effective in addition to standardised usual care.
Simon J, Gray A, Clarke P, Wade A, Neil A, Farmer A; Diabetes Glycaemic Education
and Monitoring Trial Group. Cost effectiveness of self monitoring of blood glucose in patients with
non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM
trial. BMJ. 2008 May 24;336(7654):1177-80.
OBJECTIVE: To assess the cost effectiveness of self monitoring of blood glucose
alone or with additional training in incorporating the results into self care, in
addition to standardised usual care for patients with non-insulin treated type 2
diabetes. DESIGN: Incremental cost utility analysis from a healthcare
perspective. Data on resource use from the randomised controlled diabetes
glycaemic education and monitoring (DiGEM) trial covered 12 months before
baseline and 12 months of trial follow-up. Quality of life was measured at
baseline and 12 months using the EuroQol EQ-5D questionnaire. SETTING: Primary
care in the United Kingdom. PARTICIPANTS: 453 patients with non-insulin treated
type 2 diabetes. INTERVENTIONS: Standardised usual care (control) compared with
additional self monitoring of blood glucose alone (less intensive self
monitoring) or with training in self interpretation of the results (more
intensive self monitoring). MAIN OUTCOME MEASURES: Quality adjusted life years
and healthcare costs (sterling in 2005-6 prices). RESULTS: The average costs of
intervention were pound89 (euro113; $179) for standardised usual care, pound181
for less intensive self monitoring, and pound173 for more intensive self
monitoring, showing an additional cost per patient of pound92 (95% confidence
interval pound80 to pound103) in the less intensive group and pound84 ( pound73
to pound96) in the more intensive group. No other significant cost difference was
detected between the groups. An initial negative impact of self monitoring on
quality of life occurred, averaging -0.027 (95% confidence interval-0.069 to
0.015) for the less intensive self monitoring group and -0.075 (-0.119 to -0.031)
for the more intensive group. CONCLUSIONS: Self monitoring of blood glucose with
or without additional training in incorporating the results into self care was
associated with higher costs and lower quality of life in patients with
non-insulin treated type 2 diabetes. In light of this, and no clinically
significant differences in other outcomes, self monitoring of blood glucose is
unlikely to be cost effective in addition to standardised usual care.