title: ROSSO-in-praxi: a self-monitoring of blood glucose-structured 12-week lifestyle intervention significantly improves glucometabolic control of patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  As healthy diet and physical activity can improve glucometabolic control in patients with type 2 diabetes, lifestyle changes should be the basis for each therapy. The only tool to visualize immediate effects of food pattern and exercise on blood glucose levels is self-monitoring of blood glucose (SMBG). Therefore, the aim of the 12-week lifestyle intervention ROSSO-in-praxi was to evaluate the impact of an SMBG-structured motivation and education program on glucometabolic and health parameters in diabetes patients not treated with insulin.
  
  
  METHODS
  Participants (n = 405) generated a seven-point blood glucose diurnal profile every 4 weeks, including actual weight, waist circumference, and steps/day. At baseline and the end of the study, glycated hemoglobin A1c (HbA1c), blood pressure, and cholesterol levels, lifestyle changes, and well-being (SF36 and Center for Epidemiologic Studies Depression Scale questionnaires) were assessed.
  
  
  RESULTS
  Three hundred twenty-seven participants (81%) completed the program and significantly improved quality of diet and physical activity, accompanied by an increase of >2,300 steps/day. Participants significantly reduced weight, body mass index, waist circumference, blood glucose, blood pressure, low-density lipoprotein cholesterol, and HbA1c by 0.3% (all P < 0.001), accompanied by increased physical and mental health and reduced depression measurements. Weight loss was significantly associated with overall improvements of glucometabolic and health parameters and mean reduction of 0.05% HbA1c/kg.
  
  
  CONCLUSIONS
  The evaluated SMBG-structured lifestyle intervention is applicable to motivate individuals with type 2 diabetes for lifestyle changes. Integration of this short-term, highly motivational, and low-cost intervention into basic therapy for patients without insulin therapy could strengthen patient empowerment in order to change lifestyle and to improve glucometabolic and general health.
authors.affiliation: West-German Centre of Diabetes and Health, Sana Hospital Gerresheim, Sana Clinics Düsseldorf GmbH, Düsseldorf, Germany. kerstin.kempf@wdgz.de
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kempf
authors.forename: Johannes
authors.initials: J
authors.lastname: Kruse
authors.forename: Stephan
authors.initials: S
authors.lastname: Martin
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000523:psychology / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008019:Life Style; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin