Tuesday, June 29, 2010

Home Monitoring Improves Diabetes Control

Self-monitoring of blood glucose can significantly improves the glycaemic control in patients with non-insulin-treated type 2 diabetes, say US researchers.

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 June at the 70th Scientific Sessions of the American Diabetes Association meeting in Orlando, Florida.

Both groups of patients are taught how to monitor their own blood glucose levels using the same model of blood glucose meter but only one group followed a structured testing protocol (STG) and discussed their readings with their doctor during quarterly appointments. The active control group (ACG) is not required to follow a regular testing schedule and doctor appointment.

After 12 months STG patients 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 STG 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.

Lead researcher Dr William Polonsky 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.’


Polonsky W, Fisher L, Schikman C, Hinnen D, Parkin C, Jelsovsky Z, Schweitzer M, Wagner R. Structured SMBG Significantly Reduces A1c Levels in Poorly Controlled, Non-Insulin Treated Type 2 Diabetes: Results from the STeP Study. 70th Scientific Sessions of the American Diabetes Association, (0004-LB) 2010

HbA1c - In the blood stream are the red blood cells, which are made of a molecule, haemoglobin. Glucose sticks to the haemoglobin to make a 'glycosylated haemoglobin' molecule, called haemoglobin A1C or HbA1C. The more glucose in the blood, the more haemoglobin A1C or HbA1C will be present in the blood. Red cells live for 8 -12 weeks before they are replaced. By measuring the HbA1C it can tell you how high your blood glucose has been on average over the last 8-12 weeks. A normal non-diabetic HbA1C is 3.5-5.5%. In diabetes about 6.5% is good.

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