Effect of the frequency of self-monitoring blood glucose in patients with type 2 diabetes treated with oral antidiabetic drugs-a multi-centre, randomized controlled trial

• Published in: PloS one 2008-08, Vol.3 (8), p.e3087-e3087
• Main Authors: Scherbaum, Werner A, Ohmann, Christian, Abholz, Heinz-Harald, Dragano, Nico, Lankisch, Mark
• Format: Article
• Language: English
• Subjects: Activities of daily living; Administration, Oral; Adult; Aged; Aged, 80 and over; Antidiabetics; Blood; Blood glucose; Blood Glucose Self-Monitoring - methods; Blood Glucose Self-Monitoring - statistics & numerical data; Care and treatment; Clinical trials; Control methods; Demographics; Diabetes; Diabetes and Endocrinology; Diabetes and Endocrinology/Endocrinology; Diabetes and Endocrinology/Type 2 Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes therapy; Drug development; Drugs; Education; Endocrinology; Female; Glucose; Glycated Hemoglobin A - metabolism; Glycosylated hemoglobin; Health maintenance organizations; Hemoglobin; HMOs; Hospitals; Humans; Hyperglycemia; Hypoglycemia; Hypoglycemic agents; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Insulin; Male; Medical personnel; Medical research; Metabolism; Middle Aged; Monitoring; Patients; Physicians; Randomization; Research design; Statistical analysis; Surveillance; Treatment Outcome; Type 2 diabetes; Urine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0003087

Recommendations on the frequency of self-monitoring of blood glucose (SMBG) vary widely among physicians treating patients with type 2 diabetes (T2D). Aim of this study was to investigate two testing regimen of SMBG in patients with stable metabolic control. Patients with T2D treated with oral antidiabetic drugs were randomized to two groups: either one SMBG (low) or four SMBG (high) per week. Subjects were followed up after 3, 6 and 12 months. Primary outcome parameter was the change in HbA1c between baseline and 6 months. Primary outcome criterion was tested by a one-sided t- test for non- inferiority. Secondary outcome parameters were safety, compliance and HbA1c at 3 and 12 months. There were no differences in the 202 subjects for demographic and sociodemographic parameters and drug treatment. HbA(1)c (%) at baseline was similar in both groups (7.2+/-1.4 vs. 7.2+/-1.0). Non- inferiority was demonstrated for the low group (p = 0.0022) with a difference from baseline to 6 months of 0.24 in the low and of 0.16 in the high group. Compliance with the testing regimen was 82-90% in both groups. There were no statistical significant differences for compliance, HbA(1)c at 3 and 12 months and serious adverse events (SAE). One SMBG per week is as sufficient and safe as four SMBG per week to maintain HbA(1)c in non-insulin treated T2D close to metabolic target. The results of this study are in contrast to current international consensus guidelines. Controlled-Trials.com ISRCTN79164268.