title: Randomized trial of technology-assisted self-monitoring of blood glucose by low-income seniors: improved glycemic control in type 2 diabetes mellitus.
abstract: Self-monitoring of blood glucose (SMBG) has been recommended for people with type 2 diabetes mellitus. This trial tested an automated self-management monitor (ASMM) that reminds patients to perform SMBG, provides feedback on results of SMBG, and action tips for improved self-management. This delayed-start trial randomized participants to using the ASMM immediately (IG), or following a delay of 6 months (DG). Glycated hemoglobin (HgbA1c) level and survey data was collected at home visits every 3 months. 44 diabetic men and women, mean age 70, completed the 12-month trial. Baseline HgbA1c was 8.1 % ± 1.0, dropping to 7.3 ± 1.0 by 9 months, with a 3-month lag in the DG (F = 3.56, p = 0.004). Decrease in HgbA1c was significantly correlated to increased frequency of SMBG, R = 0.588, p < 0.01. Providing older diabetics with objective immediate contingent feedback resulted in more frequent SMBG that correlated with better glycemic control. This type of technology may provide real-time feedback not only to patient users, but to the health care system, allowing better integration of provider recommendations with patient-centered action.
authors.affiliation: Department of Psychology, University of Toledo, 2801 W. Bancroft St. Mail Stop #948, Toledo, OH, 43606, USA. Jason.levine2@utoledo.edu.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Levine
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Edith
authors.initials: E
authors.lastname: Burns
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Whittle
authors.affiliation: University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Fleming
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Knudson
authors.affiliation: FlexTech Systems, Brookfield, WI, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Flax
authors.affiliation: Rutgers University, New Brunswick, NJ, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
mesh_terms: D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D011203:Poverty; D012648:Self Care / Q000295:instrumentation*; D012984:Software; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin
keywords: Blood glucose monitoring; Health technology; Randomized controlled trials; Self-regulation; Type 2 diabetes