Abstract
The benefits of self-monitoring of blood glucose (SMBG) on glycemic control among type 2 diabetes (T2DM) patients not receiving insulin remains controversial. This study aimed to examine the association between SMBG and glycemic control in these patients. This retrospective longitudinal study enrolled 4987 eligible patients from a medical center in Taiwan. Data were collected from electronic medical records at 0 (baseline), 3, 6, 9, and 12 (end-point) months after enrollment. Patients were assigned to the early SMBG group or to the non-user group depending on whether they performed SMBG at baseline. Differences in glycated hemoglobin (HbA1c) reduction between groups at each time-point were assessed using SMBG group-by-time interaction in generalized estimating equations models, which were established using backward elimination method for multivariate regression analysis. Subgroup analyses for patients using non-insulin and insulin secretagogues were performed additionally. The estimated maximal difference in HbA1c reduction between groups (early SMBG users vs. non-users) was 0.55% at 3 months. Subgroup analyses showed maximal differences of 0.61% and 0.52% at 3 months in the non-insulin and insulin secretagogues groups, respectively. SMBG group-by-time interaction was statistically significant at 3 months and lasted for 12 months. The finding suggests that performing SMBG at disease onset was positively associated with better glycemic control in newly diagnosed non-insulin-treated T2DM patients, regardless whether non-insulin secretagogues or insulin secretagogues were used.
Highlights
The benefits of self-monitoring of blood glucose (SMBG) on glycemic control among type 2 diabetes (T2DM) patients not receiving insulin remains controversial
The current study aimed to examine the association between SMBG and glycemic control in newly diagnosed non-insulin-treated patients with T2DM and subgroups of patients receiving non-insulin and insulin secretagogues
The SMBG group (+/+) was younger, had more males, had a higher education level, had more patients with a family history of diabetes, had better knowledge regarding glycemic control, had better willingness toward diabetes self-management (DSM), and was more physically active compared to the SMBG group (−/−) (Table 1)
Summary
The benefits of self-monitoring of blood glucose (SMBG) on glycemic control among type 2 diabetes (T2DM) patients not receiving insulin remains controversial. The finding suggests that performing SMBG at disease onset was positively associated with better glycemic control in newly diagnosed non-insulin-treated T2DM patients, regardless whether noninsulin secretagogues or insulin secretagogues were used. Most of the previous studies on SMBG had included patients with various diabetes durations, with only a few focusing on patients newly diagnosed with T2DM. Conclusions in these studies are still inconsistent, including in randomized controlled trials (RCTs) and observational s tudies[11,12,13,14]. Whether SMBG should be recommended to all newly diagnosed non-insulin-treated patients with T2DM remains an important practical issue for physicians and patients. Two broad categories are of particular concern: insulin secretagogues (insulin-releasing medications) with a potential adverse effect of hypoglycemia and non-insulin secretagogues that rarely cause hypoglycemia
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