Contribution of Structured Self-Monitoring of Blood Glucose to the Glycemic Control and the Quality of Life in Both Insulin- and Noninsulin-Treated Patients with Poorly Controlled Diabetes

Diabetes Technol Ther. 2017 Dec;19(12):707-714. doi: 10.1089/dia.2017.0275. Epub 2017 Nov 3.

Abstract

Background: The rate of glycemic control among diabetes patients in China is currently low. The current study aims at determining the effect of structured self-monitoring of blood glucose (SMBG) on blood glucose control as well as quality of life (QoL) in Chinese diabetes patients.

Methods: In a 24-week, single-center, randomized, open-label, prospective trial, patients with glycated hemoglobin A1c (HbA1c) >8.0% were randomized to an intervention group for structured SMBG (n = 121) or a control group (n = 129). Patient data were analyzed separately according to treatment with or without insulin. At 0, 3rd, and 6th months, life satisfaction was assessed using the Chinese Normal Audit of Diabetes-Dependent Quality of Life (CN-ADDQoL) questionnaire.

Results: The mean HbA1c decrease from baseline to the study end was significant for both groups with insulin treatment (intervention group: -1.79% ± 1.97%, P < 0.001; control group: -1.05% ± 1.87%, P < 0.001) or without insulin treatment (intervention group: -1.91% ± 1.90%, P < 0.001; control group: -1.35% ± 1.82%, P < 0.001). Moreover, the insulin-treated patients in the intervention group showed a significantly more robust HbA1c decrease than those in the control group (P = 0.007). Both therapeutic subgroups in the intervention group had a significantly higher frequency of SMBG than those in the control group (P < 0.001), but no strict deterioration of the QoL was detected. In addition, a significant HbA1c reduction after 6 months of SMBG was seen for both insulin-treated patients (P = 0.027) and noninsulin-treated patients (P = 0.006) younger than 66 years.

Conclusions: Featured with no strict deterioration of QoL, structured SMBG was proven to be effective on the glycemic control in patients with insulin treatment, as well as in young and middle-aged patients without insulin treatment.

Keywords: Diabetes; Glycemic control; Quality of life; Self-monitoring of blood glucose.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Age Factors
  • Aged
  • Blood Glucose / analysis*
  • Blood Glucose Self-Monitoring*
  • Diabetes Mellitus / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life

Substances

  • Blood Glucose