Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial

Abstract

Aims:To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Methods:Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. Results:HbA1c levels were significantly decreased by 0.32% (3.50 mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94 kg and 6.8/4.7 mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Conclusions:Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions.

Diabetes management intervention studies: lessons learned from two studies

“…Improvements in the control group reduced the size of the effect of the intervention in these studies. Similar outcomes were observed in other studies, which report conservative or weakened between-group differences due to improvements in the control group [ 6 , 11 , 14 , 21 ]. Therefore, solely the recruitment to a clinical trial, independent of the interventions, resulted in improvements in HbA1c [ 22 ].…”

Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

“…In previous studies, structured SMBG was shown to be effective for glycaemic control in type 2 diabetes patients treated with insulin . In a clinical trial with type 2 diabetes patients without insulin treatment, structured SMBG reduced the HbA 1c level by 0.32% . Mannucci E et al performed a meta‐analysis of the effect of structured SMBG on type 2 diabetes patients without insulin treatment and found that structured SMBG effectively reduced the HbA 1c level .…”

“…11 In a clinical trial with type 2 diabetes patients without insulin treatment, structured SMBG reduced the HbA 1c level by 0.32%. 12 Mannucci E et al performed a meta-analysis of the effect of structured SMBG on type 2 diabetes The data are expressed as the mean ± SD or the median. Statistics for categorical variables are expressed as the number of patients (percentage of patients).…”

Enhanced self‐monitoring blood glucose in non‐insulin‐requiring Type 2 diabetes: A qualitative study in primary care

“…There is strong evidence that the usefulness of SMBG is related to the response and management of the BG measurements by both the healthcare professional and the client (Benhalima & Mathieu, ; Nishimura et al., ; Parkin, Buskirk, Hinnen, & Axel‐Schweitzer, ). Diabetes Self‐Management Education‐Support (DSME‐S) is a complex intervention (Powers et al., ).…”