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Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial

Sharon Parsons Orcid Logo, Steve Luzio Orcid Logo, J. N. Harvey, Steve Bain Orcid Logo, Ivy Cheung, Alan Watkins Orcid Logo, David Owens Orcid Logo

Diabetic Medicine, Volume: 36, Issue: 5, Pages: 578 - 590

Swansea University Authors: Sharon Parsons Orcid Logo, Steve Luzio Orcid Logo, Steve Bain Orcid Logo, Ivy Cheung, Alan Watkins Orcid Logo, David Owens Orcid Logo

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DOI (Published version): 10.1111/dme.13899

Abstract

AimTo examine the impact of structured self-monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub-optimally controlled Type 2 diabetes.MethodsWe conducted a 12-month, multicentre, randomized controlled trial in people with established (>1 year) Typ...

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Published in: Diabetic Medicine
ISSN: 0742-3071 1464-5491
Published: Wiley 2019
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa54346
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Abstract: AimTo examine the impact of structured self-monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub-optimally controlled Type 2 diabetes.MethodsWe conducted a 12-month, multicentre, randomized controlled trial in people with established (>1 year) Type 2 diabetes not on insulin therapy, with sub-optimal glycaemic control [HbA1c ≥58 to ≤119 mmol/mol (≥7.5% to ≤13%)]. A total of 446 participants were randomized to a control group (n =151) receiving usual diabetes care, a group using structured self-monitoring of blood glucose alone (n =147) or a group using structured self-monitoring of blood glucose with additional monthly ‘TeleCare’ support (n =148). The primary outcome was HbA1c at 12 months.ResultsA total of 323 participants (72%) completed the study; 116 (77%) in the control group, 99 (67%) in the self-monitoring of blood glucose alone group and 108 (73%) in the self-monitoring of blood glucose plus TeleCare group. Compared to baseline, the mean HbA1c was lower in all groups at 12 months, with reductions of 3.3 mmol/mol (95% CI –5.71 to –0.78) or 0.3% (95% CI –0.52 to –0.07; P=0.01) in the control group, 11.4 mmol/mol (95% CI –14.11 to –8.76) or 1.1% (–1.29 to –0.81; P<0.0001) in the group using self-monitoring of blood glucose alone and 12.8 mmol/mol (95% CI –15.34 to –10.31) or 1.2% (95% CI –1.40 to -0.94; P<0.0001) in the group using self-monitoring of blood glucose plus TeleCare. This represents a reduction in HbA1c of 8.9 mmol/mol (95% CI –11.97 to –5.84) or 0.8% (95% CI –1.10 to -0.54; P≤0.0001) with structured self-monitoring of blood glucose compared to the control group. Participants with lower baseline HbA1c, shorter duration of diabetes and higher educational achievement were more likely to achieve HbA1c ≤53 mmol/mol (7.0%).ConclusionsStructured self-monitoring of blood glucose provides clinical and statistical improvements in glycaemic control in Type 2 diabetes. No additional benefit, over and above the use of structured self-monitoring of blood glucose, was observed in glycaemic control with the addition of once-monthly TeleCare support.(Clinical trial registration no.: ISRCTN21390608)
College: Faculty of Medicine, Health and Life Sciences
Funders: Roche Diabetes Care GmbH; European Foundation for the Study of Diabetes; LifeScan Programme
Issue: 5
Start Page: 578
End Page: 590