Introduction 1 2 3 4 5 Subjects and methods Subjects 6 Clinical assessment 5 7 4 Hospital morbidity and mortality 8 7 Statistical analysis p p p p Results p SMBG and mortality 1 Table 1 Hazard ratios for all-cause and cardiac mortality in 1,280 type 2 diabetes patients by SMBG status for: (1) all diabetes treatment types; (2) those who were treated by diet with or without OHAs; and (3) those taking insulin with or without OHAs   No SMBG SMBG     Number of patients Number of events a Number of patients Number of events a p HR (95%CI) All patients  All-cause mortality   Model 1 (unadjusted) 382 168 46.7 898 318 35.8 0.004 0.76 (0.63–0.92) b        1.11 (0.92–1.35) c        1.15 (0.93–1.44)  Cardiac mortality   Model 1 (unadjusted) 382 61 17.0 898 135 15.2 0.46 0.89 (0.66–1.21) b        1.35 (0.99–1.86) d        1.55 (1.07–2.24) Diet ± OHAs  All-cause mortality   Model 1 (unadjusted) 354 145 42.6 773 252 32.5 0.008 0.76 (0.62–0.93) b        1.15 (0.93–1.43) e        1.20 (0.94–1.52)  Cardiac mortality   Model 1 (unadjusted) 354 51 15.0 773 108 13.9 0.65 0.93 (0.66–1.29) b        1.51 (1.06–2.14) f        1.79 (1.19–2.69) Insulin ± OHAs  All-cause mortality   Model 1 (unadjusted) 28 23 119.3 125 66 58.4 0.001 0.46 (0.29–0.75) b        0.68 (0.41–1.14) g        0.73 (0.43–1.26)  Cardiac mortality   Model 1 (unadjusted) 28 10 51.9 125 27 23.9 0.026 0.45 (0.22–0.93) b        0.58 (0.27–1.27) h        0.52 (0.22–1.19) a b c d e f g 1c h 1c 1 Five-year cohort 5 2 p Table 2 Hazard ratios of first-ever non-fatal complications in the 531 type 2 diabetes patients in the longitudinal arm for single and combined micro- and macrovascular events, and the ROSSO Study non-fatal endpoint, by SMBG status at: (1) baseline; and (2) each annual assessment (time-dependent covariate)   No SMBG at baseline SMBG at baseline     Time-dependent SMBG use No. of patients No. of events a No. of patients No. of events a p HR (95% CI) HR (95% CI) Retinopathy Model 1 (unadjusted) 116 47 90.0 349 112 68.4 0.11 0.76 (0.54–1.07) 0.51 (0.36–0.72) b        0.80 (0.57–1.13) 0.52 (0.37–0.74) c        0.82 (0.58–1.16) 0.52 (0.37–0.73) Neuropathy Model 1 (unadjusted) 84 62 199.3 256 186 203.0 0.76 1.05 (0.78–1.40) 0.77 (0.57–1.03) b        1.16 (0.87–1.55) 0.79 (0.59–1.07) d        1.30 (0.97–1.74) 0.89 (0.66–1.20) Microalbuminuria  Model 1 (unadjusted) 82 37 104.1 258 103 90.6 0.38 0.85 (0.58–1.23) 0.77 (0.52–1.14) b        0.88 (0.60–1.28) 0.78 (0.53–1.15) e        0.91 (0.62–1.33) 0.74 (0.50–1.10) Any microangiopathy  Model 1 (unadjusted) 58 50 280.5 172 153 302.6 0.59 1.09 (0.79–1.51) 0.99 (0.71–1.38) b        1.22 (0.89–1.68) 0.96 (0.69–1.33) f        1.34 (0.97–1.86) 0.98 (0.71–1.37) Myocardial infarction  Model 1 (unadjusted) 131 6 8.6 386 18 8.8 0.97 1.02 (0.41–2.57) 0.58 (0.24–1.41) b        1.13 (0.44–2.89) 0.63 (0.26–1.54) Stroke  Model 1 (unadjusted) 133 2 2.7 398 2 0.9 0.28 0.35 (0.05–2.52) 0.19 (0.03–1.36) b        0.82 (0.10–6.60) 0.30 (0.04–2.28) Peripheral arterial disease Model 1 (unadjusted) 101 51 119.3 307 134 99.3 0.29 0.84 (0.61–1.16) 0.74 (0.53–1.04) b        0.97 (0.70–1.36) 0.80 (0.57–1.13) g        1.13 (0.79–1.62) 0.89 (0.62–1.28) Any macroangiopathy Model 1 (unadjusted) 99 54 133.7 297 133 103.8 0.11 0.77 (0.56–1.06) 0.67 (0.48–0.93) b        0.88 (0.63–1.21) 0.71 (0.51–0.99) h        0.88 (0.63–1.22) 0.74 (0.52–1.04) All vascular disease Model 1 (unadjusted) 44 41 222.0 141 128 230.1 0.95 0.99 (0.69–1.41) 1.38 (0.89–2.15) b        1.15 (0.80–1.64) 1.43 (0.91–2.23) i        – – ROSSO endpoint Model 1 (unadjusted) 110 8 13.8 328 26 15.3 0.76 1.13 (0.51–2.50) 0.54 (0.26–1.14) b        1.29 (0.58–2.87) 0.58 (0.27–1.23) a b c d e f g h i b Discussion 4 5 4 9 10 1c 4 4 5 4 The results of the present study do not support a relationship between SMBG and improved survival in a well-characterised community-based sample of type 2 diabetic patients. We found evidence that SMBG was associated with an increased risk of cardiac death and a reduced risk of retinopathy. These conflicting results might reflect complex interactions between patient, physician and disease factors in particular circumstances, but may also represent the effects of confounding, incomplete covariate adjustment or chance.