DiGEM: Diabetes Glycaemic Education and Monitoring study
|Funding:||Department of Health, Research and Development Programme|
Department of Primary Care, University of Oxford;
Diabetes Trials Unit, University of Oxford;
Department of General Practice, University of Cambridge;
Database of Individual Patient Experience (DIPEX), University of Oxford
This randomised controlled trial investigated whether self monitoring, alone or with instruction in incorporating the results into self care, is more effective than usual care in improving glycaemic control in non-insulin treated patients with type 2 diabetes. Clinical results, which did not show a significant effect, were published in the BMJ in July 2007.
The health economic analysis collected comprehensive resource use data and investigated the costs and cost-effectiveness of two levels of patient education and training in the use of blood glucose self-monitoring, compared with standard delivery of usual care. The results of the economic evaluation were published in the BMJ in May 2008 and showed that 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 for this patient group. 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.
Farmer A J, Wade A N, French D P, Simon J, Yudkin P, Gray A, Craven A, Goyder L, Holman R R, Mant D, Kinmonth A-L, and Neil H AW (2009) Blood glucose self-monitoring in type 2 diabetes: a randomised controlled trial. Health Technol Assess, 13(15):iii-iv, ix-xi, 1-50.
Simon, J, Gray, A, Clarke, P, Wade, A, Neil, A, and Farmer, A (2008). 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, 336(7654):1177-80. Full text article available free through PubMed.