By Lilian Anekwe
Self-monitoring of blood glucose can significantly improves the glycaemic control in patients with type 2 diabetes, say US researchers.
The clinical value and utility of patient self-management of blood glucose remains controversial, but a randomised controlled trial of the technique in over 500 patients in the US found a collaborative programme, where patients and doctors interpret self-monitored blood sugar readings, can improve blood sugar control.
The data from 522 patients with type 2 diabetes and a HbA1c level of 7.5% or higher from 35 primary care practices in the US was presented this weekend at the American Diabetes Association meeting in Orlando, Florida.
Patients were randomised to a structured testing protocol using a home blood glucose test that collects and interprets a 7-point glucose profiles over three consecutive days, or an active control group. Patients who monitored their own blood glucose completed the tool quarterly and brought it to quarterly doctor appointments.
The GPs involved in the intervention were given training in suggested medication strategies in response to the patient’s blood glucose patterns over the previous three months.
After 12 months patients who self-monitored had an average HbA1c level 1.2% lower than at baseline and significantly greater reductions in HbA1c over time compared with active controls, whose HbA1c was 0.9% lower.
94% of self-monitoring patients received at least one treatment change recommendation during the 12 months, compared with 63% in the active control group.
Over the year, both groups showed significant reductions in diabetes-related distress and depression and a significant increase in positive well-being.
Dr William Polonsky, chief executive officer of the behavioral diabetes institute at the University of California, concluded: ‘Use of structured self-monitoring of blood glucose significantly improves glycaemic control in non-insulin-treated type 2 diabetes, without increasing emotional distress, when both patients and physicians collaborate to gather, interpret and appropriately utilise structured self-monitored blood glucose data.’
American Diabetes Association scientific sessions, abstract 26-LB.
Diabetes self-testing ‘improves glycaemic control’