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. 2014 Sep 3;1(4):161-166.
doi: 10.1016/j.jcte.2014.08.003. eCollection 2014 Dec.

Use of an integrated strip-free blood glucose monitoring system increases frequency of self-monitoring and improves glycemic control: Results from the ExAct study

Alberto Maran  1 , Diethelm Tschoepe  2 , Maurizio Di Mauro  3 , William A Fisher  4   5 , Kurt Loeffler  6 , Iris Vesper  7 , Sandra Bloethner  8 , Oliver Mast  7 , Joerg Weissmann  8 , Ildikó Amann-Zalán  9 , Annette Moritz  7 , Christopher G Parkin  10 , Taylor Kohut  4 , Iain Cranston  11
Affiliations

Use of an integrated strip-free blood glucose monitoring system increases frequency of self-monitoring and improves glycemic control: Results from the ExAct study

Alberto Maran et al. J Clin Transl Endocrinol. .

Abstract

Aims: We investigated the impact of using an integrated, strip-free system compared to the use of single-strip systems on testing frequency and glycemic control in individuals with insulin-treated diabetes.

Methods: This multinational, comparative, cluster-randomized, observational study included 311 patients with type 1 and insulin-treated type 2 diabetes who were performing SMBG at suboptimal frequencies. Sites were cluster-randomized to "integrated strip-free" system (EXP group) or any "single-strip" system (CNL group). Testing frequency and HbA1c were measured at baseline, 12 weeks and 24 weeks.

Results: At week 24, the EXP group showed an increase in SMBG frequency from baseline of 4.17 tests/week (95% CI 2.76, 5.58) compared with an increase of 0.53 tests/week (95% CI -0.73, 1.79) among CNL patients, resulting in a between-group difference of 3.63 tests/week (p < 0.0002). Mixed-effects models for repeated measurements (MMRM) controlling for baseline frequency of testing, country and clinical site confirmed a higher SMBG testing frequency in the EXP group compared to the CNL group, with a between-group difference of 2.70 tests/week (p < 0.01). Univariate analysis showed greater HbA1c reductions in the EXP group than CNL group: -0.44% (95% CI -0.59, -0.29) vs. -0.13% (95% CI -0.27, 0.01), respectively, p < 0.0002. MMRM analyses confirmed these HbA1c reductions. A greater percentage of EXP than CNL patients achieved HbA1c reductions of ≥0.5%: 45.1% vs. 29.1%, respectively, p < 0.01.

Conclusions: The use of an integrated, strip-free SMBG system improved testing adherence and was associated with improvements in glycemic control.

Keywords: Adherence; Glycemic control; HbA1c; Insulin; Integrated strip-free system; SMBG; Self-monitoring of blood glucose; Testing frequency; Type 1 diabetes; Type 2 diabetes.

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Figures

Figure 1
Figure 1
Subject disposition.
Figure 2
Figure 2
Change over time in (A) mean weekly SMBG frequency and (B) mean HbA1c values.
See this image and copyright information in PMC

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