Effect of a standard schema of self-monitoring blood glucose in patients with poorly controlled, non-insulin treated type 2 diabetes mellitus: A controlled longitudinal study.

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Bruno Madeo
Chiara Diazzi
Antonio R M Granata
Marwan El Ghoch
Carla Greco
Stefania Romano
Sara Scaltriti
Vincenzo Rochira


glycated haemoglobin non-insulin treatment type 2 diabetes., self-monitoring of blood glucose.


The effect of self-monitoring of blood glucose (SMBG) on glycemic control with regard to non-insulin-treated Type 2 diabetes mellitus (NIT-Type 2 DM) is still a controversial topic. Against this backdrop, we sought to compare the effect of a continuous short-term SMBG schema with as-usual treatment, based on changes in oral antidiabetic treatment in patients with poorly controlled Type 2 DM.

We reviewed 492 NIT-Type 2 DM record charts, selecting 27 patients, with poor glycemic control, who were thought to self-monitor their blood glucose levels (SMBG group). We then compared them with 27 patients treated with modifying drugs or diets to achieve and maintain the glycemic target (Control Group). Haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were evaluated at baseline, after 3 and 6 months.

HbA1c values decreased after 3 and 6 months in the SMBG group (P < 0.001 on both occasions) and in the control group (P < 0.05 and P < 0.01, respectively), but without a significant difference between the two groups when compared at the same time. The FPG progressively decreased in both groups, reaching a significant difference in the SMBG group after 3 months and in the control group after 6 months, and without a significant difference between the two groups.

The SMBG schema used in our study could be adopted for target groups before proceeding to the next therapeutic enhancement drug step, representing a useful tool that can help diabetic patients in raising awareness of and treating their disease.

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1. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2020 Jan;43:S77–88. https://doi.org/10.2337/dc20-S007
2. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004;27: 1218–24. https://doi.org/10.2337/diacare.27.5.1218
3. Muchmore DB, Springer J, Miller M. Self-monitoring of blood glucose in overweight type 2 diabetic patients. Acta Diabetol 1994;31:215–9. https://doi.org/10.1007/BF00571954
4. Coster S, Gulliford MC, Seed PT, et al. Self monitoring in type 2 diabetes mellitus: A meta-analysis. Diabet Med 2000;17:755–61. https://doi. org/10.1046/j.1464-5491.2000.00390.x
5. Schwedes U, Siebolds M, Mertes G. Meal-related structured self-monitoring of blood glucose: Effect on diabetes control in non-insulin-treated type 2 diabetic patients. Diabetes Care 2002;25:1928–32. https://doi.org/10.2337/diacare.25.11.1928
6. Guerci B, Drouin P, Grange V, et al., ASIA Group. Self-monitoring of blood glucose significantly improves metabolic control in patients with type 2 diabetes mellitus: The Auto-Surveillance Intervention Active (ASIA) Study. Diabetes Metab 2003;29:587–94. https://doi.org/10.1016/ S1262-3636(07)70073-3
7. Welschen LM, Bloemendal E, Nijpels G, et al. Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin, Cochrane Database Syst Rev 2005;18(2):CD005060. https:// doi.org/10.1002/14651858.CD005060.pub2
8. Martin S, Schneider B, Heinemann L, et al. Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: An epidemiological cohort study. Diabetologia 2006;49:271–8. https:// doi.org/10.1007/s00125-005-0083-5
9. Bonomo K, De Salve A, Fiora E, et al. Evaluation of a simple policy for pre- and post-prandial blood glucose self-monitoring in people with type 2 diabe-tes not on insulin. Diabetes Res Clin Pract 2010;87: 246–51. https://doi.org/10.1016/j.diabres.2009.10.021
10. Bosi E, Scavini M, Ceriello A, et al. PRISMA Study Group. Intensive structured self-monitoring of blood glucose and glycaemic control in noninsulin-treated type 2 diabetes: The PRISMA randomized trial. Diabetes Care 2013;36(10):2887– 94. https://doi.org/10.2337/dc13-0092
11. Davidson MB, Castellanos M, Kain D, Duran P. The effect of self monitoring of blood glucose concentrations on glycated hemoglobin levels in diabetic patients not taking insulin: A blinded, randomized trial. Am J Med 2005;118:422–5. https://doi.org/10.1016/j.amjmed.2004.12.006
12. Farmer A, Wade A, Goyder E, et al. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabe-tes: Open parallel group randomised trial. BMJ 2007;335(7611):132. https://doi.org/10.1136/bmj. 39247.447431.BE
13. O’Kane MJ, Bunting B, Copeland M, Coates VE; ESMON study group. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): Randomised controlled trial. BMJ 2008;336:1174–7. https:// doi.org/10.1136/bmj.39534.571644.BE
14. Young LA, Buse JB, Weaver MA, et al. Monitor trial group, glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: A randomized trial. JAMA Intern Med 2017;177(7):920–9. https://doi. org/10.1001/jamainternmed.2017.1233
15. Kleefstra N, Hortensius J, Logtenberg SJ, et al. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC). Neth J Med 2010;268(1):311–6.
16. Polonsky WH, Fisher L, Schikman CH, et al. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: Results from the Structured Testing Program study. Diabetes Care 2011;34(2):262–7. https://doi.org/10.2337/ dc10-1732
17. Karter AJ, Parker MM, Moffet HH, et al. Longitudinal study of new and prevalent use of self-monitoring of blood glucose. Diabetes Care 2006;29:1757–63. https://doi.org/10.2337/dc06-2073
18. Franciosi M, Pellegrini F, De Berardis G, et al. QuED Study Group. The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients: An urgent need for better educational strategies, Diabetes Care 2001;24: 1870–7. https://doi.org/10.2337/diacare. 24.11.1870