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Randomized Controlled Trial
. 2008 May 24;336(7654):1174-7.
doi: 10.1136/bmj.39534.571644.BE. Epub 2008 Apr 17.

Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial

Maurice J O'Kane  1 , Brendan Bunting, Margaret Copeland, Vivien E Coates; ESMON study group
Collaborators, Affiliations
Randomized Controlled Trial

Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial

Maurice J O'Kane et al. BMJ. .

Abstract

Objectives: To assess the effect of self monitoring of blood glucose concentrations on glycaemic control and psychological indices in patients with newly diagnosed type 2 diabetes mellitus.

Design: Prospective randomised controlled trial of self monitoring versus no monitoring (control).

Setting: Hospital diabetes clinics.

Participants: 184 (111 men) people aged <70 with newly diagnosed type 2 diabetes referred to the participating diabetes clinics. Major exclusion criteria were secondary diabetes, insulin treatment, previous self monitoring of blood glucose.

Interventions: Participants were randomised to self monitoring or no monitoring (control) groups for one year with follow-up at three monthly intervals. Both groups underwent an identical structured core education programme. The self monitoring group received additional education on monitoring.

Main outcome measures: Between group differences in HbA(1c), psychological indices, use of oral hypoglycaemic drugs, body mass index (BMI), and reported hypoglycaemia rates.

Results: 96 patients (55 men) were randomised to monitoring and 88 (56 men) to control. There were no baseline differences in mean (SD) age (57.7 (11.0) in monitoring group v 60.9 (11.5) in control group) or HbA(1c) (8.8 (2.1)% v 8.6 (2.3)%, respectively). Those in the monitoring group had a higher baseline BMI (34 (7) v 32 (6.2)). There were no significant differences between groups at any time point (12 months values given) in HbA(1c) (6.9 (0.8)% v 6.9 (1.2)%, P=0.69; 95% confidence interval for difference -0.25% to 0.38%), BMI (33.1 (6.4) v 31.8 (6.0); adjusted for baseline BMI, P=0.32), use of oral hypoglycaemic drugs, or reported incidence of hypoglycaemia. Monitoring was associated with a 6% higher score on the depression subscale of the well-being questionnaire (P=0.01).

Conclusions: In patients with newly diagnosed type 2 diabetes self monitoring of blood glucose concentration has no effect on glycaemic control but is associated with higher scores on a depression subscale.

Trial registration: ISRCTN 49814766.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Fig 1 Treatment algorithm for oral hypoglycaemic agents
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Fig 2 Flow of patients through study
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Comment in

References

    1. IDF Clinical Guidelines Taskforce. Global guidelines for type 2 diabetes: recommendations for standard, comprehensive and minimal care. Diabet Med 2006;23:579-93. - PubMed
    1. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long term complications of insulin dependent diabetes mellitus. N Engl J Med 1993;329:977-86. - PubMed
    1. Bradley C. Diabetes treatment satisfaction questionnaire [DTSQ]. In: Bradley C, ed. The handbook of psychology and diabetes; a guide to psychological measurement in diabetes research and practice Chur, Switzerland: Harwood Academic Publishers, 1994:111-32.
    1. Anderson RM, Donnelly MB, Dedrick RF. Measuring the attitudes towards diabetes and its treatment. Patient Educ Couns 1990;16:231-45. - PubMed
    1. Bradley C. The well-being questionnaire. In: Bradley C, ed. The handbook of psychology and diabetes; a guide to psychological measurement in diabetes research and practice Chur, Switzerland: Harwood Academic Publishers, 1994:89-109.

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