Titrating insulin in patients with type 2 diabetes using a structured self-monitoring blood glucose regimen

Background. Self-monitoring of blood glucose (SMBG) can inform on the timing of hyperglycaemia, but there is currently no standardised approach to utilising these data to improve glycaemic control in patients with type 2 diabetes.Objectives. To assess the improvement in glycaemic control when an ins...

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Bibliographic Details
Published in:South African medical journal 2018-08, Vol.108 (8), p.654-659
Main Authors: Rheeder, P., van Zyl, D.G., Kalweit, K.L.
Format: Article
Language:English
Subjects:
Blood glucose
Care and treatment
Development and progression
Health aspects
Insulin
Measurement
Methods
Self care (Health)
Type 2 diabetes
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Summary:Background. Self-monitoring of blood glucose (SMBG) can inform on the timing of hyperglycaemia, but there is currently no standardised approach to utilising these data to improve glycaemic control in patients with type 2 diabetes.Objectives. To assess the improvement in glycaemic control when an insulin titration algorithm was used in combination with SMBG in patients with poorly controlled, insulin-treated type 2 diabetes.Methods. This 6-month prospective study recruited 39 poorly controlled (glycated haemoglobin (HbA1c) ≥8.5%; 69.4 mmol/mol) type 2 diabetes subjects using twice-daily biphasic insulin from two state hospitals in Tshwane, South Africa. Patients were asked to perform structured SMBG over 4 weeks and return monthly for consultations where physicians titrated insulin doses using an algorithm guided by the data collected. The primary endpoint was the trend in HbA1c measured at baseline and 3 and 6 months.Results. Mean HbA1c decreased over the study period by 1.89% (95% confidence interval (CI) –2.46 - –1.33; p
ISSN:0256-9574
2078-5135
DOI:10.7196/SAMJ.2018.v108i8.12801