Intended for healthcare professionals


Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial

BMJ 2008; 336 doi: (Published 22 May 2008) Cite this as: BMJ 2008;336:1174

Merely proves there is no point in home monitoring if you ignore the results

The paper itself shows that the home BG readings were totally ignored
in deciding the therapy for each individual. So even if home BG readings
were elevated, they were not used to change therapy, as the treatments
were solely determined by HbA1c readings. The patients might as well have
done daily iridology. These authors might get the Nobel prize for the
bleeding obvious. The only real conclusion that can be made from this data
is "We have proven that there is no point in home monitoring if your
doctor ignores the results, just as we have done".
Indignantly yours
Ben Balzer

We used an identical treatment algorithm for dietary and
pharmacological management of glycaemia for both groups based on HbA1c
targets (figure 1)Go. Blood concentrations of HbA1c, lipids, and
electrolytes were measured at or before each clinic and results were
discussed with patients in the context of the treatment targets.
Measurement of HbA1c was performed in the local hospital laboratory with a
diabetes control and complications trial (DCCT) aligned HbA1c assay.2 All
laboratories participated in HbA1c external quality assurance, which was
satisfactory for the duration of the study. All other laboratory tests
were also performed in the local hospital laboratory, where staff were
blinded to treatment allocation.

Competing interests:
None declared

Competing interests: No competing interests

26 April 2008
Ben L Balzer
General Practitioner
Beverly Hills 2209 NSW Australia