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Blood-glucose self-monitoring in insulin treated type 2 diabetes mellitus a cross-sectional study with an intervention group.
Diabetes Metab. 1999 Sep; 25(4):334-40.DM

Abstract

Up to the present there is controversy about blood-glucose self-monitoring in type 2 diabetes. In 842 insulin-treated type 2 diabetic patients (age 60.1 +/- 10.9, diabetes duration since diagnosis 12.6 +/- 7.6 years, relative HbA1c 1.83 +/- 0.39% [relative HbA1c = HbA1c/mean normal, HPLC, Diamat]) a cross-sectional study was conducted to assess blood-glucose self-monitoring and interactions with quality of diabetes care. There was a negative correlation (r = -0.17, p < 0.001) between the frequency of blood-glucose self-tests/week and HbA1c. Performing multivariate analysis the most important parameters associated with HbA1c (R-square = 0.10) were: The frequency of blood-glucose self-tests/week (c = -0.005, p < 0.001), the insulin-dosage/kg body weight (c = 0.001, p = 0.0032) and the participation in a 5-day structured treatment and teaching programme for patients with conventional insulin therapy (5-TTP, c = 0.085, p < 0.0001). Other factors investigated in the model (age, diabetes duration, number of insulin injections/day, sex) showed no associations. Performing a sub-group analysis in patients older than 60 years (n = 396) parameters associated with HbA1c (R-square = 0.16) were the participation in a 5-TTP (c = 0.09, p = 0.002) and the frequency of blood-glucose self-tests/week (c = -0.006, p = 0.0018) too. In an further subgroup analysis patients (n = 249) were investigated who have not participated in a 5-TTP. In this cohort there were no correlations and no associations between the frequency of blood-glucose self-monitoring and HbA1c. Then, an intervention was started: 33 out of the 249 patients participated in a 5-TTP. At the time of re-examination 1 year after participating in the 5-TTP, the relative HbA1c decreased from 1.84 +/- 0.38% to 1.61 +/- 0.30% (p = 0.007) and there was a strong association between the frequency of blood-glucose self-tests/week and HbA1c (c = -0.016, p = 0.0032, R-square = 0.25). Daily blood-glucose self-monitoring was statistically associated with better quality of metabolic control. Participation in a 5-TTP and regularly blood-glucose self-monitoring is mandatory for all insulin-treated patients with type 2 diabetes mellitus.

Authors+Show Affiliations

University of Jena Medical School, Department of Internal Medicine II, Germany. rschi@polkim.med.uni-jena.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10566123

Citation

Schiel, R, et al. "Blood-glucose Self-monitoring in Insulin Treated Type 2 Diabetes Mellitus a Cross-sectional Study With an Intervention Group." Diabetes & Metabolism, vol. 25, no. 4, 1999, pp. 334-40.
Schiel R, Müller UA, Rauchfub J, et al. Blood-glucose self-monitoring in insulin treated type 2 diabetes mellitus a cross-sectional study with an intervention group. Diabetes Metab. 1999;25(4):334-40.
Schiel, R., Müller, U. A., Rauchfub, J., Sprott, H., & Müller, R. (1999). Blood-glucose self-monitoring in insulin treated type 2 diabetes mellitus a cross-sectional study with an intervention group. Diabetes & Metabolism, 25(4), 334-40.
Schiel R, et al. Blood-glucose Self-monitoring in Insulin Treated Type 2 Diabetes Mellitus a Cross-sectional Study With an Intervention Group. Diabetes Metab. 1999;25(4):334-40. PubMed PMID: 10566123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blood-glucose self-monitoring in insulin treated type 2 diabetes mellitus a cross-sectional study with an intervention group. AU - Schiel,R, AU - Müller,U A, AU - Rauchfub,J, AU - Sprott,H, AU - Müller,R, PY - 1999/11/24/pubmed PY - 2000/3/11/medline PY - 1999/11/24/entrez SP - 334 EP - 40 JF - Diabetes & metabolism JO - Diabetes Metab VL - 25 IS - 4 N2 - Up to the present there is controversy about blood-glucose self-monitoring in type 2 diabetes. In 842 insulin-treated type 2 diabetic patients (age 60.1 +/- 10.9, diabetes duration since diagnosis 12.6 +/- 7.6 years, relative HbA1c 1.83 +/- 0.39% [relative HbA1c = HbA1c/mean normal, HPLC, Diamat]) a cross-sectional study was conducted to assess blood-glucose self-monitoring and interactions with quality of diabetes care. There was a negative correlation (r = -0.17, p < 0.001) between the frequency of blood-glucose self-tests/week and HbA1c. Performing multivariate analysis the most important parameters associated with HbA1c (R-square = 0.10) were: The frequency of blood-glucose self-tests/week (c = -0.005, p < 0.001), the insulin-dosage/kg body weight (c = 0.001, p = 0.0032) and the participation in a 5-day structured treatment and teaching programme for patients with conventional insulin therapy (5-TTP, c = 0.085, p < 0.0001). Other factors investigated in the model (age, diabetes duration, number of insulin injections/day, sex) showed no associations. Performing a sub-group analysis in patients older than 60 years (n = 396) parameters associated with HbA1c (R-square = 0.16) were the participation in a 5-TTP (c = 0.09, p = 0.002) and the frequency of blood-glucose self-tests/week (c = -0.006, p = 0.0018) too. In an further subgroup analysis patients (n = 249) were investigated who have not participated in a 5-TTP. In this cohort there were no correlations and no associations between the frequency of blood-glucose self-monitoring and HbA1c. Then, an intervention was started: 33 out of the 249 patients participated in a 5-TTP. At the time of re-examination 1 year after participating in the 5-TTP, the relative HbA1c decreased from 1.84 +/- 0.38% to 1.61 +/- 0.30% (p = 0.007) and there was a strong association between the frequency of blood-glucose self-tests/week and HbA1c (c = -0.016, p = 0.0032, R-square = 0.25). Daily blood-glucose self-monitoring was statistically associated with better quality of metabolic control. Participation in a 5-TTP and regularly blood-glucose self-monitoring is mandatory for all insulin-treated patients with type 2 diabetes mellitus. SN - 1262-3636 UR - https://www.unboundmedicine.com/medline/citation/10566123/Blood_glucose_self_monitoring_in_insulin_treated_type_2_diabetes_mellitus_a_cross_sectional_study_with_an_intervention_group_ L2 - http://www.diseaseinfosearch.org/result/8215 DB - PRIME DP - Unbound Medicine ER -