Structured Self-Monitoring Improves Glycemic Control

Reduced A1C levels and more treatment changes in patients with poorly controlled type 2 diabetes

TUESDAY, Feb. 22 (HealthDay News) -- Structured self-monitoring of blood glucose (SMBG) improves glycemic control in patients with poorly controlled type 2 diabetes who do not use insulin, according to a study published in the February issue of Diabetes Care.

William H. Polonsky, Ph.D., of the University of California in San Diego, and colleagues investigated the effects of structured blood glucose testing in insulin-naïve patients with poorly controlled type 2 diabetes. A total of 483 patients in 34 primary care practices were randomly divided into an active control group with enhanced standard care or a testing group with enhanced standard care and structured SMBG using the Accu-Chek blood glucose analysis system for 12 months. The researchers evaluated the patients' hemoglobin A1C levels and the impact of the intervention on the frequency of self-monitoring, treatment modifications, and general well-being.

The researchers identified significant reductions in A1C levels in the structured SMBG group compared to the active control group, although even the control group showed decreased A1C levels. Regardless of baseline A1C levels, significantly more patients in the SMBG group were recommended a treatment change at the one-month visit relative to the control group. Both groups of patients had significant improvements in their general well-being.

"Our findings demonstrate that appropriate use of SMBG in poorly controlled, insulin-naïve type 2 diabetic patients can be efficacious and clinically meaningful," the authors write. "Integrating SMBG into a collaborative program of care may lead to improved glycemic control without increasing strip consumption."

Funding for the study was provided by Roche Diagnostics, manufacturer of the Accu-Chek system. Several authors disclosed financial relationships with Roche Diagnostics and Abbott Diabetes Care.

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