Blood glucose monitoring is associated with better glycemic control in type 2 diabetes: a database study.
BACKGROUND
The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial.


OBJECTIVE
To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA).


METHODS
Observational database study.


METHODS
Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004.


METHODS
OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group.


RESULTS
We evaluated 5,862 patients with a mean follow-up duration of 798 +/- 94 days. Overall, 44.2% received GTS. Ultimately, 47% of subjects ended up in group 1, 21% in group 2, 9% in group 3, 8% in group 4, and 16% in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22% to -0.94% for every ten GTS/week.


CONCLUSIONS
Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification.
Murata
Glen H
GH
New Mexico VA Health Care System, Albuquerque, NM 87108, USA.
Duckworth
William C
WC
Shah
Jayendra H
JH
Wendel
Christopher S
CS
Mohler
M Jane
MJ
Hoffman
Richard M
RM
D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000639:trends; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy; D005500:Follow-Up Studies; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D014728:Veterans
D001786:Blood Glucose