OBJECTIVES: To examine if close control of blood glucose levels in patients with type 2 diabetes treated with diet restrictions or oral medication has an economic benefit. METHODS: A decision analytic model with a time horizon of eight years has been developed. Costs are assessed from the perspective of the Swiss health care system. Data on the efficacy of SMBG come from the large observational ROSSO study conducted in Germany. The economic endpoint is the impact of blood glucose monitoring on direct medical costs, taking into account reduced costs due to five major diabetes-related complications (myocardial infarction (MI), stroke, haemodialysis due to renal failure, blindness, and foot amputation), and assuming no difference in all other direct medical costs of diabetes. The clinical endpoint is quality adjusted life years (QALYs) gained. RESULTS: Self-monitoring of blood glucose induces a cost saving of CHF1062 over eight years due to a reduction in the number of diabetes-related complications. This hints at an annual budget saving in diabetes related complications of CHF21 Mio. per year, based on an estimate of 160000 non-insulin treated type 2 diabetes patients in Switzerland. In addition, the quality of life is improved for patients performing SMBG. A critical parameter is the number of test strips used. A sensitivity analysis shows that with a weekly consumption of more than 5.25 strips per patient, SMBG is no longer a dominant strategy. No related, evidence-based guidelines are currently available. CONCLUSIONS: The potential economic benefit of self-monitoring of blood glucose among non insulin dependent type 2 diabetes patients seems to be substantial in Switzerland, due to a reduction in long-term diabetes complications.