To determine the most effective way of monitoring glucose levels as an indicator of glycaemic control in people with type 2 diabetes in the community, we conducted a criteria-based review of randomized controlled trials and systematic reviews of randomized controlled trials that studied the efficacy of various glucose monitoring strategies. We searched the Cochrane Library, Medline, Embase, CINAHL and BNIPlus databases for relevant studies. The journals Diabetes, Diabetic Medicine, Diabetologia, Evidence-Based Medicine and Evidence-Based Nursing were hand searched. The outcome of interest was glycaemic control, as measured by glycated haemoglobin (HbA 1c ). A total of 642 titles were identified from the search; three studies answered the question criteria and only one study met all the quality criteria. The study that met the criteria was a systematic review of four trials measuring the efficacy of self-monitoring of glucose levels. The reduction in HbA 1c in those who monitored glucose levels was estimated to be −0.25% (95% CI −0.61−+0.10) this result shows a small improvement, but it is not statistically significant. A meta-analysis was also performed on three studies (n=278) comparing HbA1c in subjects who performed blood glucose monitoring with those who performed urine monitoring. The reduction in HbA1c when monitoring blood glucose rather than urine glucose was −0.03% (95% CI −0.52−+0.47). This result is not statistically significant. The efficacy of blood and urine glu

Capillary blood glucose (CBG) testing was developed to replace home urine glucose testing by patients or by the staff in physician offices. CBG testing can also be applied in the hospital laboratory as a cost-effective method to rapidly test blood glucose levels. The published accuracy of the various techniques was validated in the authors' laboratory. The phlebotomy team was trained in the technique, report formats (manual and computerized) were developed, and a schedule for monitoring diabetes four times daily was established. CBG testing provides several advantages: (1) rapid turnaround time facilitates adjusting insulin doses, (2) patient comfort is improved, and (3) capillary puncture is more convenient than venipuncture. If CBG tests are performed by laboratory personnel, the testing is standardized, the quality control is centralized and more regularly monitored, and quality assurance is better documented. This article outlines the establishment of a successful CBG testing program by a clinical laboratory.

The effects of blood glucose testing versus urine sugar testing on the metabolic control of insulin-dependent diabetic children. Glycosylated hemoglobin A1c was measured in 43 insulin-dependent diabetic children before and after training in blood glucose testing. These measurements were compared with those obtained from a group of matched controls who tested urine sugars for the same period. Mean HbA1c measurements for the blood glucose testing group were significantly improved at 6 mo after training in blood glucose testing, and were significantly lower than those measured in the urine sugar testing group. However, HbA1c levels in the blood glucose testing group were well above levels for nondiabetic persons, and were generally higher than those reported for adult insulin-dependent diabetic persons following training in blood glucose testing. Explanations for this difference were considered. It was noted that 81% of the trained children accepted and continued to use blood glucose testing for at least 9 mo after training. Published in Diabetes care

(35). Although urine glucose testing is no longer used, urine ketone testing is still the most … screening for diabetes and pre¬ diabetes may be an effective strategy for diabetes prevention … distasteful urine glucose testing methods pre¬ viously used. The Diabetes Control and Complications