A misunderstanding in self-management centers on the role of self-monitoring. Many view it as an intervention, although the data does not support this premise. Rather, it is simply a way of measuring some event. Still, as noted in other entries, research on self-monitoring as an intervention continues to occur. The most recent example was a study by Farmer and coworkers. They wished to determine whether self monitoring, alone or with instruction in incorporating the results into self care, is more effective than usual care in improving blood glucose control in non-insulin treated patients with type 2 diabetes. The participants all had non-insulin treated type 2 diabetes for a median duration of three years. They were assigned to three groups: (a) usual care with blood glucose measurements every three months; (b) blood glucose self monitoring with advice for patients to contact their doctor for interpretation of results, in addition to usual care; and (c) and blood glucose self monitoring with additional training of patients in interpretation and application of the results to enhance motivation and maintain adherence to a healthy lifestyle. Results showed that at 12 months the differences in blood glucose level between the three groups were not statistically significant.

VALUE OF STUDY TO READER: Farmer and his coworkers concluded that there is no convincing evidence that self-monitoring, alone or together with instruction, improved blood glucose control in patients. Sadly enough, these results could have been predicted before the study was designed and carried out. It has been widely accepted that self-monitoring, in and of itself, rarely changes behavior. When it does, it is referred to as reactivity. Self-monitoring is nothing more than measuring a particular event. That’s all it is. Suggesting that the process changes behavior is incorrect.

A. Farmer et al. Impact of self-monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomized trial. British Medical Journal, 2007; 335:132.