OBJECTIVES: The study compared patterns of blood glucose monitoring among patients with type-2 diabetes initiating therapy with insulin or oral medication and examined the relationship between the quantity of prescribed monitoring strips and glycaemic control. METHODS: Data were obtained from the UK General Practice Research Database. Patients were eligible if they were identified as having type-2 diabetes, initiated therapy with insulin or an oral agent, and had 12-month post-initiation data. Differences in patient characteristics and number of test strips prescribed between the insulin (n=347) and oral cohorts (n=2436) were examined. Multivariate regressions analyzed the relationship between quantity of monitoring and glycaemic control for a subset of patients (n=245 insulin; n=1795 oral) with available glycosylated haemoglobin (HbA1c) data. RESULTS: During the 12-month post-initiation period, patients in the insulin cohort were prescribed approximately twice as many test strips compared to those patients in the oral medication cohort. Multivariate regression revealed that individuals who initiated therapy with insulin and were prescribed enough test strips to test at least once per day in the six months prior to the test date had, on average, a 0.65% lower HbA1c value (p = 0.02) compared to the HbA1c values for individuals who were prescribed fewer test strips. In contrast there was no significant relationship between HbA1c levels and quantity of test strips prescribed for individuals who initiated therapy with oral antidiabetic agents. CONCLUSIONS: Results indicate significant differences in the prescription of blood glucose monitoring strips, with patients initiated on insulin prescribed almost twice as many test strips compared to patients initiated on oral agents. The greater number of blood glucose test strips prescribed was associated with lower HbA1c values for insulin patients only. Physicians may therefore wish to encourage frequent blood glucose monitoring among patients with type-2 diabetes who are treated with insulin.