Structured self‐monitoring of blood glucose reduces glycated hemoglobin in insulin‐treated diabetes

Kato, Noriko; Cui, Jia; Kato, Mitsutoshi

doi:10.1111/jdi.12072

Cited by 36 publications

(38 citation statements)

References 7 publications

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“…Although key elements of the cycle (such as patient education 45 , structured glucose measurements within the context of a collaborative patient-physician relationship [16][17][18][19][20] with shared decision-making and use of diabetes management software programs) have been shown to be beneficial 42,43 , large clinical trials are needed to assess the impact of the PDM cycle on quality of care and improved clinical outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…First and foremost is the potential to improve clinical outcomes. As discussed earlier, several of the components that are integrated into the cycle (e.g., structured SMBG, use of electronic data management software) have been demonstrated to be effective in improving diabetes control [14][15][16][17][18][19][20][21] .…”

Section: Commitmentmentioning

confidence: 99%

“…Patient-clinician interactions also improved and therapy was optimized 14 . Furthermore, structured selfmonitoring of blood glucose (SMBG) led to improved metabolic control in both insulin-treated 15,16 and non-insulin-treated patients with diabetes [17][18][19][20] . An additional observational study showed that structured SMBG is practical in real-world outpatient settings 21 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program

Lange

Ziegler²,

Neu

et al. 2015

Current Medical Research and Opinion

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Use of continuous subcutaneous insulin infusion (CSII) therapy improves glycemic control, reduces hypoglycemia and increases treatment satisfaction in individuals with diabetes. As a number of patient- and clinician-related factors can hinder the effectiveness and optimal usage of CSII therapy, new approaches are needed to address these obstacles. Ceriello and colleagues recently proposed a model of care that incorporates the collaborative use of structured SMBG into a formal approach to personalized diabetes management within all diabetes populations. We adapted this model for use in CSII-treated patients in order to enable the implementation of a workflow structure that enhances patient-physician communication and supports patients' diabetes self-management skills. We recognize that time constraints and current reimbursement policies pose significant challenges to healthcare providers integrating the Personalised Diabetes Management (PDM) process into clinical practice. We believe, however, that the time invested in modifying practice workflow and learning to apply the various steps of the PDM process will be offset by improved workflow and more effective patient consultations. This article describes how to implement PDM into clinical practice as a systematic, standardized process that can optimize CSII therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Commitmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program

Lange

Ziegler²,

Neu

et al. 2015

Current Medical Research and Opinion

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show abstract

“…When utilized within a structured testing regimen, SMBG has been shown to improve glycemic control and quality of life in individuals with T1D and T2D. [1][2][3][4][5][6] However, despite the immediate availability of bG information, many patients with diabetes cannot correctly interpret or appropriately act on their SMBG results. 8,9 This knowledge deficit can adversely affect adherence to testing and, ultimately, clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Use of an Integrated Tool for Interpretation of Blood Glucose Data Improves Correctness of Glycemic Risk Assessment in Individuals With Type 1 and Type 2 Diabetes

Parkin¹,

Schwenke²,

Ossege³

et al. 2016

J Diabetes Sci Technol

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Use of structured self-monitoring of blood glucose (SMBG) regimens improves clinical outcomes and quality of life in patients with insulin-treated 1,2 and non-insulin-treated diabetes.3-6 However, effective utilization of structured SMBG requires that patients are able to correctly interpret their blood glucose (bG) results and take appropriate actions when needed. 7Anecdotal evidence suggests that many patients with diabetes do not know how to identify and interpret SMBG results or how their medications and health behaviors (eg, diet, exercise) influence their bG levels. 8,9 This not only impacts patients' ability to achieve and maintain desired glycemic control but can also negatively affect adherence to their prescribed testing frequency. 10To assist SMBG users in better understanding their glucose testing results, many manufacturers are now incorporating bG result interpretation tools into their SMBG meters. Some systems utilize simple 2-or 3-color bar configurations to indicate within-range and out-of-range glucose values; 11,12 whereas, others utilize basic interfaces, such as "smiley" icons, to inform users. AbstractBackground: Manufacturers now incorporate blood glucose (bG) value interpretation tools into their monitoring systems; however, usability of these support tools has not been well studied. We evaluated the utility and perceived benefits of support tool use by individuals with type 1 (T1D) and type 2 diabetes (T2D). Methods:This 3-arm, randomized, simulation study assessed the impact of use of bG value interpretation support tools on participants' ability to correctly interpret bG values, using 1 of 3 tools: a new tool that uses colored scales with target range indicator (TRI), Colors and Smiley icons (already available). Participants assessed 50 bG values without use of any tool and repeated the assessment using 1 of the 3 tool configurations. Changes in percentage of correct responses when using a support tool and user perceptions were assessed.Results: Data sets from 140 participants were analyzed. Increases in correct responses were seen in all study groups but most notably in the TRI group (26%, P < .001) versus the Colors (3%, P = .018) and Smiley icons (6%, P < .001) groups. Significant improvements in confidence were seen among TRI users (P = .023) but not among other tool users (P > .627). Most TRI users felt confident (94%), agreed the tool will help them identify high and low values (96%) and will help them to make correct insulin dosage decisions (80%). Conclusions:Use of the TRI significantly increases users' ability to correctly and confidently determine their glycemic risk when self-monitoring bG levels. This suggests the tool may offer clinical value to individuals with T1D and T2D.

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“…13 Several recent studies have shown that use of structured SMBG in combination with education and clinician support, promotes desired behavioral changes, enhances patient motivation and empowerment, increases patient understanding of their treatment regimens and facilitates therapy intensification, leading to improved clinical outcomes and quality of life. [14][15][16][17][18][19][20][21] Among these was the Structured Testing Program (STeP) study, a cluster-randomized, controlled, multicenter trial, in which poorly controlled, non-insulin-treated T2D patients used a simple paper tool to collect 7-point glucose profiles on 3 consecutive days. 15 At 12 months, patients who utilized the structured testing tool showed significant improvements in glycemic control, HbA1c depression, and diabetes-related distress, 22 and patient self-efficacy and autonomous motivation in managing their diabetes.…”

mentioning

confidence: 99%

The Impact of Structured Self-Monitoring of Blood Glucose Combined With Intensive Education on HbA1c Levels, Hospitalizations, and Quality-of-Life Parameters in Insulin-Treated Patients With Diabetes at Primary Care in Serbia: The Multicenter SPA-EDU Study

Lalić

Jotić

et al. 2016

J Diabetes Sci Technol

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Background: We assessed the effect of structured self-monitoring of blood glucose (SMBG), in combination with intensive education, on metabolic control, SMBG frequency, hospitalizations, cardiovascular risk factors, and quality-of-life parameters in patients with insulin-treated diabetes in primary health care settings in Serbia. Methods: This 6-month, observational, noninterventional study, followed 346 insulin-treated diabetes patients (type 1 diabetes [T1D], n = 57; type 2 diabetes [T2D], n = 289) from 28 primary care centers. Patients attended a 10-day course at the specialized educational center and were followed monthly by their primary care physicians. Patients used a simple paper tool to document 3-day, 7-point glucose profiles prior to each monthly clinic visit. Physicians reviewed the completed forms at each visit and used a standardized education program to provide remedial training. Changes in HbA1c levels, SMBG frequency, metabolic risk factors, and Diabetes Distress Scale (DDS) were assessed. Results: Mean (± SD) HbA1c within the full cohort was significantly improved from baseline at 6 months (8.85 ± 1.17% vs 7.91 ± 1.24%, P < .01). Significant increases in average SMBG frequency per week were seen at 6 months versus baseline (14.6/week vs 4.3/week, P < .001). The mean (± SE) number of hospitalizations due to metabolic conditions was significantly lower during the 6-month study compared to the 6-month period prior to the study (0.14 ± 0.04 vs 0.59 ± 0.09). DDS scores decreased from 39.6 ± 13.9 to 33.9 ± 14.5, P < .01. Conclusion: The use of structured SMBG combined with intensive education was associated with clinically significant reductions in HbA1c, increased SMBG frequency, and improved quality of life.

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Structured self‐monitoring of blood glucose reduces glycated hemoglobin in insulin‐treated diabetes

Cited by 36 publications

References 7 publications

Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program

Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program

Use of an Integrated Tool for Interpretation of Blood Glucose Data Improves Correctness of Glycemic Risk Assessment in Individuals With Type 1 and Type 2 Diabetes

The Impact of Structured Self-Monitoring of Blood Glucose Combined With Intensive Education on HbA1c Levels, Hospitalizations, and Quality-of-Life Parameters in Insulin-Treated Patients With Diabetes at Primary Care in Serbia: The Multicenter SPA-EDU Study

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