Evaluating once- and twice-daily self-monitored blood glucose testing strategies for stable insulin-treated patients with type 2 diabetes: The diabetes outcomes in veterans study

Richard M. Hoffman, Jayendra H. Shah, Christopher S. Wendel, William C. Duckworth, Karen D. Adam, Syed U. Bokhari, Cheri Dalton, Glen H. Murata

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

OBJECTIVE - To evaluate once- and twice-daily self-monitored blood glucose testing strategies in assessing glycemic control and detecting hypoglycemia or hyperglycemia in patients with stable insulin-treated type 2 diabetes. RESEARCH DESIGN AND METHODS - Subjects with stable insulin-treated type 2 diabetes monitored blood glucose four times daily (prebreakfast, prelunch, predinner, and bedtime) for 8 weeks. We correlated mean blood glucose values with HbA 1c measured after 8 weeks and determined the number of hypoglycemic (≤3.33 mmol/l) and hyperglycemic (≥22.20 mmol/l) readings captured at the various testing times. RESULTS - A total of 150 subjects completed the monitoring period; their average age was 67 years, 90% were men, and the mean HbA1c at baseline was 8.0 ± 1.8%. The overall correlation of glucose testing and HbA1c was 0.79 (P < 0.0001). Mean blood glucose values for each of the four once-daily testing strategies were significantly correlated with HbA1c (r = 0.65-0.70, P < 0.0001), as were mean blood glucose values for each of the six twice-daily testing strategies (r = 0.73-0.75, P < 0.0001). The prebreakfast/prelunch measurements captured the largest proportion (63.6%) of the hypoglycemic readings, the predinner/bedtime measurements captured the largest proportion (66.2%) of hyperglycemic readings, and the prelunch/predinner measurements captured the largest proportion (57.7%) of all out-of-range readings. CONCLUSIONS - Twice-daily testing strategies, particularly prelunch/predinner, effectively assess glycemic control and capture a substantial proportion of out-of-range readings. However, personal testing strategies will vary depending on an individual's risk for hypoglycemia and hyperglycemia.

Original languageEnglish (US)
Pages (from-to)1744-1748
Number of pages5
JournalDiabetes care
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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