Evaluation of a simple policy for pre- and post-prandial blood glucose self-monitoring in people with type 2 diabetes not on insulin

Abstract

Background and aims: Since there is no agreement on regimens of self-monitoring of blood glucose (SMBG) in type 2 diabetes not on insulin, we evaluated the effects of a simple SMBG policy taking into account compliance.

Methods and results: 273 type 2 diabetic patients not on insulin with HbA1c >7% attending our Diabetes Clinic and already using SMBG were randomized as follows: Group A, one BG profile/month with fasting and post-prandial values; Group B, one BG profile every 2 weeks with pre- and post-prandial values. Patients were followed-up by the same team every 3 months with the same education and treatment policies. At 3 and 6 months, SMBG profiles were evaluated and HbA1c measured. SMBG was carried out as recommended by 73% of Group A and 44% of Group B patients. In compliant patients, HbA1c and BG were unchanged in Group A whereas in Group B fasting, pre-prandial and two out of three post-prandial BG values were reduced and HbA1c decreased from 8.09+/-0.84% to 7.60+/-0.73% (p<0.001). The influence on BG control was similar for the two policies when compliance was not considered.

Conclusions: The more intensive SMBG policy considered is associated with improvements in glycaemic control in compliant subjects.