The impact of self-monitoring of blood glucose on a behavioral weight loss intervention for patients with type 2 diabetes.
The purpose of the study was to examine the association of self-monitoring of blood glucose (SMBG) to weight loss and A1C among participants in a behavioral weight loss intervention.



Multivariate analyses were employed to evaluate the relationship between SMBG and changes in patient weight and A1C levels. Bootstrapping was used to determine whether there was an indirect effect of SMBG on weight loss through diet adherence and an indirect effect of SMBG on A1C through weight loss.



The relationship between increased SMBG and greater weight loss was mediated by better adherence to diet. The relationship of increased SMBG and greater reductions in A1C were mediated by greater weight loss.



Results of the study were consistent with the hypothesis that SMBG leads to an increased adherence to dietary recommendations. For patients who are taught to use their diet to lose weight, increased adherence to dietary recommendations is associated with increased weight loss and subsequently better glucose control. SMBG may be of value as an adjunctive intervention in behavioral programs for type 2 diabetes.
The Department of Veterans Affairs New Jersey Healthcare System, War Related Illness and Injury Study Center, East Orange, New Jersey (Dr McAndrew)|The University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey (Dr Pogach, Dr McAndrew)
Lisa M
LM
McAndrew
Temple University, Departments of Kinesiology and Public Health and Center for Obesity Research and Education, Philadelphia, Pennsylvania (Dr Napolitano)
Melissa A
MA
Napolitano
Department of Veterans Affairs New Jersey Healthcare System, Center for Healthcare Knowledge Management, East Orange, NJ (Dr Pogach)|The University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey (Dr Pogach, Dr McAndrew)
Leonard M
LM
Pogach
The Center for Health Quality, Outcomes, Economic Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, and the Department of Psychology, Northeastern University, Boston, MA (Dr Quigley)
Karen S
KS
Quigley
Temple University, Center for Obesity Research and Education, Philadelphia, Pennsylvania (Dr Foster, Ms. Shantz, Ms. Vander Veur)
Kerri Leh
KL
Shantz
Temple University, Center for Obesity Research and Education, Philadelphia, Pennsylvania (Dr Foster, Ms. Shantz, Ms. Vander Veur)
Stephanie S
SS
Vander Veur
Temple University, Center for Obesity Research and Education, Philadelphia, Pennsylvania (Dr Foster, Ms. Shantz, Ms. Vander Veur)
Gary D
GD
Foster
D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000523:psychology; D001835:Body Weight; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D009765:Obesity / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D010349:Patient Compliance; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human