Evaluation of a simple policy for pre- and post-prandial blood glucose self-monitoring in people with type 2 diabetes not on insulin

• Published in: Diabetes research and clinical practice Vol. 87; no. 2; pp. 246 - 251
• Main Authors: Bonomo, Katia, De Salve, Alessandro, Fiora, Elisa, Mularoni, Elena, Massucco, Paola, Poy, Paolo, Pomero, Alice, Cavalot, Franco, Anfossi, Giovanni, Trovati, Mariella
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.02.2010
• Subjects: Aged; Blood Glucose - metabolism; Blood Glucose Self-Monitoring - standards; Body Mass Index; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - psychology; Endocrinology & Metabolism; Female; Glycated Hemoglobin A - analysis; HbA1c; Health Policy; Humans; Hypoglycemic Agents - therapeutic use; Male; Metformin - therapeutic use; Middle Aged; Patient Compliance; Post-prandial blood glucose; Postprandial Period; Pre-prandial blood glucose; Self-monitoring of blood glucose; Sulfonylurea Compounds - therapeutic use; Type 2 diabetes; Type 2 diabetes; Pre-prandial blood glucose; Post-prandial blood glucose; HbA1c; Self-monitoring of blood glucose
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2009.10.021

Since there is no agreement on regimens of self-monitoring of blood glucose (SMBG) in type 2 diabetes not on insulin, we evaluated the effects of a simple SMBG policy taking into account compliance. 273 type 2 diabetic patients not on insulin with HbA1c >7% attending our Diabetes Clinic and already using SMBG were randomized as follows: Group A, one BG profile/month with fasting and post-prandial values; Group B, one BG profile every 2 weeks with pre- and post-prandial values. Patients were followed-up by the same team every 3 months with the same education and treatment policies. At 3 and 6 months, SMBG profiles were evaluated and HbA1c measured. SMBG was carried out as recommended by 73% of Group A and 44% of Group B patients. In compliant patients, HbA1c and BG were unchanged in Group A whereas in Group B fasting, pre-prandial and two out of three post-prandial BG values were reduced and HbA1c decreased from 8.09 ± 0.84% to 7.60 ± 0.73% ( p < 0.001). The influence on BG control was similar for the two policies when compliance was not considered. The more intensive SMBG policy considered is associated with improvements in glycaemic control in compliant subjects.