Brief observation
The effect of self monitoring of blood glucose concentrations on glycated hemoglobin levels in diabetic patients not taking insulin: A blinded, randomized trial

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Methods

All type 2 diabetic patients not taking insulin who were either currently enrolled or on entrance into the DMCP were approached to enter the study. All 89 patients consented and were randomized. One patient did not return after being randomized to see the nurse or the dietitian (who provided nutritional counseling to all patients enrolled in the DMCP) and was not included in the study. All patients were followed for 6 months. Patients were instructed to measure glucose levels before and between

Results

There were no differences in the baseline characteristics of the patients randomized to the monitoring group and those who were randomized to the control group (Table 1). Patients in the monitoring group averaged 4.0 ± 1.0 dietary visits compared with 3.2 ± 0.9 visits in the control group. The average number of tests in patients who monitored was 129. There were no changes in weight or body mass index during the study in either group (Table 2). Medications at the end of the study were similar

Discussion

The results of this randomized, single blind study in type 2 diabetic patients not taking insulin failed to demonstrate lower A1C levels in those that perform pre- and postprandial glucose testing. This lack of an effect is consistent with 11 other studies as well as a meta-analysis of 6 of the randomized ones.22 Four studies did show an effect. In one,17 a “therapy decision scheme” was applied only to the group that tested but not to the control group, casting doubt on whether testing per se

Acknowledgments

The authors gratefully acknowledge Lifescan, Inc., for donating glucose meters and strips and the statistical help of Mohsen Bazargan, PhD.

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    This study was supported by grants from Eli Lilly and Company and the NIH (DK 54047).

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