Daily Times

ISLAMABAD: Many patients with type 2 diabetes consider finger-prick blood tests key for keeping blood glucose levels under control. But according to a new study, they are unlikely to be beneficial for patients who are not receiving insulin therapy.

Researchers found that self-monitoring of blood glucose (SMBG) for 1 year failed to improve blood glucose control or health-related quality of life (HRQOL) in patients with type 2 diabetes who were not treated with insulin.

Senior study author Dr Katrina Donahue, of the School of Medicine at the University of North Carolina in Chapel Hill, and colleagues believe that their findings raise questions about the value of SMBG for many patients with type 2 diabetes.

“Of course, patients and providers have to consider each unique situation as they determine whether home blood glucose monitoring is appropriate,” says Dr Donahue.

“But the study’s null results suggest that self-monitoring of blood glucose in non-insulin treated type 2 diabetes has limited utility. For the majority, the costs may outweigh the benefits.”

Dr Donahue and colleagues note that most patients with type 2 diabetes who do not receive insulin therapy perform SMBG, as it is often recommended by their doctor. SMBG usually involves an at-home finger-prick blood test that provides a blood glucose reading.

SMBG is generally accepted as essential for good blood glucose control, but some researchers have questioned its worth for type 2 diabetes patients in the absence of insulin therapy.

For this latest study, Dr Donahue and colleagues sought to gain a better understanding of how SMBG affects hemoglobin A1c levels – an indicator of long-term blood glucose control – and HRQOL for patients with type 2 diabetes who are not treated with insulin.

For the study, patients were randomly allocated to one of three groups for 12 months: one group performed SMBG once daily; one group engaged in once-daily SMBG, enhanced with automated, tailored messages of encouragement delivered via a Telcare meter; and one group did not engage in SBMG at all.

The hemoglobin A1c levels of each patient were measured at study baseline and 1 year after, and their HRQOL was assessed at both time points using a series of questionnaires.

The researchers found that there were no significant differences in hemoglobin A1c levels and HRQOL between the groups that performed SMBG and those that did not.

What is more, there were no significant differences in incidences of low blood sugar, or hypoglycemia, hospitalisations, or emergency room visits between the three groups, nor was there any difference in the number of patients who needed to start insulin therapy during the study period.

Based on their results, the researchers suggest that healthcare professionals might want to reconsider recommending routine SMBG for type 2 diabetes patients who are not treated with insulin.

“Routine self-monitoring of blood glucose levels does not significantly improve hemoglobin A1c levels or HRQOL for most patients with non-insulin-treated type 2 diabetes; patients and clinicians should consider the specifics of each clinical situation as they decide whether to test or not to test,” they conclude.

Using stem cells: A promising new method for regenerating bones using the body’s own stem cells may possibly eliminate the need for bone grafts. A new treatment that uses gene and stem cell therapies could promise success with a less-invasive procedure.

Researchers led by a team from Cedars-Sinai Medical Center in Los Angeles, tested the therapy on laboratory animals and found that it triggered bones to regrow their own tissue.

If it is found safe in humans, the process could replace bone grafting as the gold standard treatment.

“We are just at the beginning of a revolution in orthopedics,” Dan Gazit, co-director of the Skeletal Regeneration and Stem Cell Therapy Programme in the Department of Surgery and the Cedars-Sinai Board of Governors Regenerative Medicine Institute, said in a statement.

The new method involves implanting a collagen matrix made up of bone-inducing genes into stem cells.

It is inserted into the gap over a two-week span. An ultrasound pulse and microbubbles help the matrix get into the cells.

“Our method relies on the body’s own repair cells [stem cells],” Gadi Pelled, senior author, and an assistant professor of surgery at Cedars-Sinai, told Healthline. “We recruit them to the injury site and then activate them to regenerate bone in an efficient way.”

“The uniqueness of our method is that it is injectable and minimally invasive,” Pelled said.

Researchers found that the fractures were healed eight weeks after the procedure. The bone that grew into the empty space was as strong as surgical bone grafts.

“We showed that our method was equivalent, in terms of fracture healing, to the use of an autograft [bone graft obtained from the patient’s own body], which is the gold standard today,” Gazit said. “Our method does not require the harvest of bone, which often leads to prolonged pain and hospitalization and risk of infection, and that is our advantage.”

Because the process uses stem cells from the patient’s body without external manipulation, it may not face many of the hurdles that other stem cell treatments come up against.

“But obviously we will need to show that our method is not toxic and is safe to use in people before it is approved for use in the clinic,” added Zulma Gazit, PhD, co-director of the Skeletal Regeneration and Stem Cell Therapy Program in the Department of Surgery and the Cedars-Sinai Board of Governors Regenerative Medicine Institute.