Blood glucose monitoring is associated with better glycemic control in type 2 diabetes

A database study

Glen H. Murata, William C. Duckworth, Jayendra H. Shah, Christopher S Wendel, Martha J Mohler, Richard M. Hoffman

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial. OBJECTIVE: To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA). DESIGN: Observational database study. SUBJECTS: Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004. MEASUREMENTS: OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group. RESULTS: We evaluated 5,862 patients with a mean follow-up duration of 798 ± 94 days. Overall, 44.2% received GTS. Ultimately, 47% of subjects ended up in group 1, 21% in group 2, 9% in group 3, 8% in group 4, and 16% in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22% to -0.94% for every ten GTS/week. CONCLUSIONS: Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification.

Original languageEnglish (US)
Pages (from-to)48-52
Number of pages5
JournalJournal of General Internal Medicine
Volume24
Issue number1
DOIs
StatePublished - Jan 2009

Fingerprint

Blood Glucose Self-Monitoring
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Blood Glucose
Databases
Hemoglobins
Veterans
Glucose
Observational Studies
Prescriptions
Linear Models
Regression Analysis
Insulin
Delivery of Health Care
Therapeutics

Keywords

  • Blood glucose self-monitoring
  • Diabetes mellitus
  • Glycoslyated
  • Hemoglobin A
  • Hypoglycemic agents
  • Type 2

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Blood glucose monitoring is associated with better glycemic control in type 2 diabetes : A database study. / Murata, Glen H.; Duckworth, William C.; Shah, Jayendra H.; Wendel, Christopher S; Mohler, Martha J; Hoffman, Richard M.

In: Journal of General Internal Medicine, Vol. 24, No. 1, 01.2009, p. 48-52.

Research output: Contribution to journalArticle

Murata, Glen H. ; Duckworth, William C. ; Shah, Jayendra H. ; Wendel, Christopher S ; Mohler, Martha J ; Hoffman, Richard M. / Blood glucose monitoring is associated with better glycemic control in type 2 diabetes : A database study. In: Journal of General Internal Medicine. 2009 ; Vol. 24, No. 1. pp. 48-52.
@article{4e9499a41bf74e98b18ea2644b010aa9,
title = "Blood glucose monitoring is associated with better glycemic control in type 2 diabetes: A database study",
abstract = "BACKGROUND: The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial. OBJECTIVE: To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA). DESIGN: Observational database study. SUBJECTS: Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004. MEASUREMENTS: OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group. RESULTS: We evaluated 5,862 patients with a mean follow-up duration of 798 ± 94 days. Overall, 44.2{\%} received GTS. Ultimately, 47{\%} of subjects ended up in group 1, 21{\%} in group 2, 9{\%} in group 3, 8{\%} in group 4, and 16{\%} in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22{\%} to -0.94{\%} for every ten GTS/week. CONCLUSIONS: Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification.",
keywords = "Blood glucose self-monitoring, Diabetes mellitus, Glycoslyated, Hemoglobin A, Hypoglycemic agents, Type 2",
author = "Murata, {Glen H.} and Duckworth, {William C.} and Shah, {Jayendra H.} and Wendel, {Christopher S} and Mohler, {Martha J} and Hoffman, {Richard M.}",
year = "2009",
month = "1",
doi = "10.1007/s11606-008-0830-7",
language = "English (US)",
volume = "24",
pages = "48--52",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Blood glucose monitoring is associated with better glycemic control in type 2 diabetes

T2 - A database study

AU - Murata, Glen H.

AU - Duckworth, William C.

AU - Shah, Jayendra H.

AU - Wendel, Christopher S

AU - Mohler, Martha J

AU - Hoffman, Richard M.

PY - 2009/1

Y1 - 2009/1

N2 - BACKGROUND: The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial. OBJECTIVE: To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA). DESIGN: Observational database study. SUBJECTS: Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004. MEASUREMENTS: OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group. RESULTS: We evaluated 5,862 patients with a mean follow-up duration of 798 ± 94 days. Overall, 44.2% received GTS. Ultimately, 47% of subjects ended up in group 1, 21% in group 2, 9% in group 3, 8% in group 4, and 16% in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22% to -0.94% for every ten GTS/week. CONCLUSIONS: Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification.

AB - BACKGROUND: The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial. OBJECTIVE: To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA). DESIGN: Observational database study. SUBJECTS: Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004. MEASUREMENTS: OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group. RESULTS: We evaluated 5,862 patients with a mean follow-up duration of 798 ± 94 days. Overall, 44.2% received GTS. Ultimately, 47% of subjects ended up in group 1, 21% in group 2, 9% in group 3, 8% in group 4, and 16% in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22% to -0.94% for every ten GTS/week. CONCLUSIONS: Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification.

KW - Blood glucose self-monitoring

KW - Diabetes mellitus

KW - Glycoslyated

KW - Hemoglobin A

KW - Hypoglycemic agents

KW - Type 2

UR - http://www.scopus.com/inward/record.url?scp=58149156422&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149156422&partnerID=8YFLogxK

U2 - 10.1007/s11606-008-0830-7

DO - 10.1007/s11606-008-0830-7

M3 - Article

VL - 24

SP - 48

EP - 52

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 1

ER -