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Effect on compliance, acceptability of blood glucose self-monitoring and HbA(1c) of a self-monitoring system developed according to patient's wishes. The ACCORD study.
Diabetes Metab. 2001 Dec; 27(6):681-7.DM

Abstract

OBJECTIVES

To test a blood glucose monitor developed upon diabetic's recommendations (Glucotrend Premium). Self-monitoring of blood glucose (SMBG) generates hope when introduced, however several studies questioned its efficacy and many diabetics judge it too constraining.

MATERIAL AND METHODS

Thirty diabetes centres in France, for 6 months in 179 insulin-treated diabetics, using SMBG but non optimally and with HbA(1c) (>=130% of the upper limit). Randomisation to 3 groups: either their previous system (Group A), or to the Glucotrend Premium monitor with a memory to assess compliance (Group B), or to another monitor, new for the patient, and with a memory too, the One Touch Profile (Group C). At entry, and then at 3 and 6 months, patients had an acceptability and compliance questionnaire, HbA(1c), count of weekly hypoglycaemia, record of insulin doses and an assessment of the key compliance factors.

RESULTS

HbA(1c) improved significantly in the 3 groups, more markedly in groups B (Glucotrend) and C (One Touch), e.g. - 0.6 +/- 1.1% (group A), - 0.9 +/- 1.2% (group B) and - 1.0 +/- 0.9% (group C) at M6. Acceptability was judged better for groups B and C, an additional benefit for Glucotrend: better accuracy vs laboratory blood glucose (C/L) determinations and a lower utilisation cost. Intermediate (lente) and regular insulin doses only significantly decreased (26% and 10% respectively) in group B (Glucotrend) despite a decrease in HbA(1c). Compliance (defined as 75-150% of recommended self-monitoring) improved within the 3 groups (from 34% to 65%), this improvement was maintained after month 3 (M6: 76%) only in group B (Glucotrend), vs a worsening in groups A and C (M6: 62 and 57% respectively). A better accuracy of C/L was observed with Glucotrend at M0, M3 and M6.

CONCLUSION

SMBG has limits due to various causes, and to specific difficulties of this invasive and repetitive technique. The development of a system based on advices formulated by patients themselves, Glucotrend Premium, has resulted in a marked improvement on acceptability, compliance and glucose control.

Authors+Show Affiliations

Service Endocrinologie Diabétologie Nutrition, CHU de Grenoble, 38043 Grenoble Cedex, France. Shalimi@chu-grenoble.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11852377

Citation

Halimi, S, et al. "Effect On Compliance, Acceptability of Blood Glucose Self-monitoring and HbA(1c) of a Self-monitoring System Developed According to Patient's Wishes. the ACCORD Study." Diabetes & Metabolism, vol. 27, no. 6, 2001, pp. 681-7.
Halimi S, Charpentier G, Grimaldi A, et al. Effect on compliance, acceptability of blood glucose self-monitoring and HbA(1c) of a self-monitoring system developed according to patient's wishes. The ACCORD study. Diabetes Metab. 2001;27(6):681-7.
Halimi, S., Charpentier, G., Grimaldi, A., Grenier, J. L., Baut, F., Germain, B., & Magnette, J. (2001). Effect on compliance, acceptability of blood glucose self-monitoring and HbA(1c) of a self-monitoring system developed according to patient's wishes. The ACCORD study. Diabetes & Metabolism, 27(6), 681-7.
Halimi S, et al. Effect On Compliance, Acceptability of Blood Glucose Self-monitoring and HbA(1c) of a Self-monitoring System Developed According to Patient's Wishes. the ACCORD Study. Diabetes Metab. 2001;27(6):681-7. PubMed PMID: 11852377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect on compliance, acceptability of blood glucose self-monitoring and HbA(1c) of a self-monitoring system developed according to patient's wishes. The ACCORD study. AU - Halimi,S, AU - Charpentier,G, AU - Grimaldi,A, AU - Grenier,J L, AU - Baut,F, AU - Germain,B, AU - Magnette,J, PY - 2002/2/20/pubmed PY - 2002/3/30/medline PY - 2002/2/20/entrez SP - 681 EP - 7 JF - Diabetes & metabolism JO - Diabetes Metab VL - 27 IS - 6 N2 - OBJECTIVES: To test a blood glucose monitor developed upon diabetic's recommendations (Glucotrend Premium). Self-monitoring of blood glucose (SMBG) generates hope when introduced, however several studies questioned its efficacy and many diabetics judge it too constraining. MATERIAL AND METHODS: Thirty diabetes centres in France, for 6 months in 179 insulin-treated diabetics, using SMBG but non optimally and with HbA(1c) (>=130% of the upper limit). Randomisation to 3 groups: either their previous system (Group A), or to the Glucotrend Premium monitor with a memory to assess compliance (Group B), or to another monitor, new for the patient, and with a memory too, the One Touch Profile (Group C). At entry, and then at 3 and 6 months, patients had an acceptability and compliance questionnaire, HbA(1c), count of weekly hypoglycaemia, record of insulin doses and an assessment of the key compliance factors. RESULTS: HbA(1c) improved significantly in the 3 groups, more markedly in groups B (Glucotrend) and C (One Touch), e.g. - 0.6 +/- 1.1% (group A), - 0.9 +/- 1.2% (group B) and - 1.0 +/- 0.9% (group C) at M6. Acceptability was judged better for groups B and C, an additional benefit for Glucotrend: better accuracy vs laboratory blood glucose (C/L) determinations and a lower utilisation cost. Intermediate (lente) and regular insulin doses only significantly decreased (26% and 10% respectively) in group B (Glucotrend) despite a decrease in HbA(1c). Compliance (defined as 75-150% of recommended self-monitoring) improved within the 3 groups (from 34% to 65%), this improvement was maintained after month 3 (M6: 76%) only in group B (Glucotrend), vs a worsening in groups A and C (M6: 62 and 57% respectively). A better accuracy of C/L was observed with Glucotrend at M0, M3 and M6. CONCLUSION: SMBG has limits due to various causes, and to specific difficulties of this invasive and repetitive technique. The development of a system based on advices formulated by patients themselves, Glucotrend Premium, has resulted in a marked improvement on acceptability, compliance and glucose control. SN - 1262-3636 UR - https://www.unboundmedicine.com/medline/citation/11852377/Effect_on_compliance_acceptability_of_blood_glucose_self_monitoring_and_HbA_1c__of_a_self_monitoring_system_developed_according_to_patient's_wishes__The_ACCORD_study_ L2 - https://ClinicalTrials.gov/search/term=11852377 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -