Diabetes News Roundup: New Thoughts on Standard Thinking

Type 2 DM Patients May Not Need Routine Home Blood Glucose Monitoring.

Routine self-monitoring of blood glucose levels

does not significantly improve hemoglobin A1c (A1c) levels or health-related quality of life for most patients with non–insulin-treated T2DM.

Clinical Implications:

Clinicians should consider the specifics of each patient’s clinical situation when deciding whether to test or not to test for blood glucose levels and whether the costs, including disposable glucose testing strips, outweigh the benefits.

Cardiovascular and Metabolic Effects of Metformin in Type 1 Diabetes

The use of metformin in T1DM

does not significantly reduce insulin requirements and improve glycemia, but can reduce body weight in those with increased BMI and insulin resistance, and appears to have metabolic effects.

Clinical Implications:

Metformin may not improve glycemic control in adults with long-standing T1DM, as suggested by current guidelines, but it appears to have a wider role in cardiovascular risk management.

Racial Differences in Hemoglobin A1c Levels

A1c levels overestimate the mean glucose concentration

in blacks as compared with whites, possibly owing to racial differences in the glycation of hemoglobin.

Clinical Implication:

Race only partially explains the differences in HbA1c between blacks and whites. Future research needs to focus on identifying and modifying barriers impeding improved glycemic control in blacks with diabetes.