title: Blood glucose monitoring is associated with better glycemic control in type 2 diabetes: a database study.
abstract: 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.
authors.affiliation: New Mexico VA Health Care System, Albuquerque, NM 87108, USA.
authors.forename: Glen H
authors.initials: GH
authors.lastname: Murata
authors.forename: William C
authors.initials: WC
authors.lastname: Duckworth
authors.forename: Jayendra H
authors.initials: JH
authors.lastname: Shah
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hoffman
mesh_terms: 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
chemical_list: D001786:Blood Glucose