Evidence map›Paper›PMID 18420663›Full record

Trial reportBMJ (Clinical research ed.)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.

Judit Simon, Alastair Gray, Philip Clarke, Alisha Wade, Andrew Neil, Andrew Farmer, Diabetes Glycaemic Education and Monitoring Trial Group

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 11 pooled it
13.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 11 syntheses or guidelines pooled it, 207 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  8. Guideline
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  11. Standards of medical care in diabetes--2010.Diabetes care · 2010 · on this map
    Guideline
  12. Trial
  13. Electronic blood glucose monitoring impacts on provider and patient behavior.Journal of the American Medical Informatics Association : JAMIA · 2022
    Trial
  14. Trial
  15. Trial
  16. Self management and patient understanding of diabetes in the older person.Diabetic medicine : a journal of the British Diabetic Association · 2011
    Trial
  17. Trial
  18. Article
  19. Article
  20. Article

7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 4 countries.

Judit SimonHealth Economics Research Centre, Department of Public Health, University of Oxford, Oxford OX3 7LF. judit.simon@dphpc.ox.ac.uk
Alastair Gray
Philip Clarke
Alisha Wade
Andrew Neil
Andrew Farmer
Diabetes Glycaemic Education and Monitoring Trial Group
University of Oxford · GBJohns Hopkins University · USPrimary Health Care · QAUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo 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.

designIncremental 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.

settingPrimary care in the United Kingdom.

participants453 patients with non-insulin treated type 2 diabetes.

interventionsStandardised 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 measuresQuality adjusted life years and healthcare costs (sterling in 2005-6 prices).

resultsThe 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.

conclusionsSelf 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.

trial registrationCurrent Controlled Trials ISRCTN47464659.

Indexed as

AdultAgedBlood Glucose Self-MonitoringCost-Benefit AnalysisDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansHypoglycemiaMaleMiddle AgedPrognosisProspective StudiesQuality-Adjusted Life YearsQuality of LifeGlycated Hemoglobin

Identifiers

PMID18420663
PMCPMC2394644
OpenAlexW2021612182

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.