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Monitoring glucose once weekly as effective as four times weekly
Low frequency of SMBG did not increase the risk for serious adverse events.
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CHICAGO — Just one self-monitoring of blood glucose per week was sufficient to maintain target blood glucose control, according to data from a new study.
Recommendations on the frequency of SMBG vary widely among physicians who treat patients with type 2 diabetes, especially noninsulin-treated patients, according to Werner A. Scherbaum, MD, who presented these data at the American Diabetes Association 67th Annual Scientific Sessions.
Scherbaum and colleagues conducted an intention-to-treat analysis of 202 patients with type 2 diabetes who were treated with oral agents and of stable metabolic control.
“In contrast to common consensus guidelines, our data show that one SMBG per week is as effective as four SMBG per week to maintain blood glucose control,” said Scherbaum, medical director, German Diabetes Center, German Diabetes Clinic, and head of the department of endocrinology, diabetes and rheumatology, University Hospital, Dusseldorf.
Recent consensus recommendations are for 11 SMBG per week in patients with type 2 diabetes on oral agents and at glycemic target, he said.
Low- vs. high-frequency SMBG
Researchers randomly assigned patients to the low-frequency group, one SMBG per week (n=100), or the high frequency group, four SMBG per week (n=102). Patients were required to keep a blood glucose diary. Scherbaum and colleagues were particularly interested in change in HbA1c and in quality of life and adverse and/or serious adverse events. They followed up with patients after three and six months.
Patients were similar at baseline (mean duration of diabetes, 7.81 years in the low-frequency group and 8.17 in the high-frequency group). HbA1c was roughly 7.2% in both groups. After three months, there was a 0.237% change in the low-frequency group vs. a 0.282% change in the high-frequency group (P<.0001) compared with 0.243% and 0.15% at six months (P<.0022).
Overall compliance was good, according to the researchers. Patients in the low-frequency group reported compliance rates that ranged between 82% and 88% from baseline to six months compared with 84% to 90% among patients assigned to the high-frequency group.
The lower frequency of SMBG was not associated with an increased risk for serious adverse events, such as hypoglycemia, hyperglycemia or impaired quality of life, according to Scherbaum. – by Katie Kalvaitis
For more information:
- Scherbaum WA, Ohmann C, Abholz HH, Lankisch M. Evaluating the optimal frequency of self-monitoring blood glucose in type 2 diabetes at glycemic target – a multicenter, randomized controlled trial. #91. Presented at: the American Diabetes Association 67th Annual Scientific Sessions; June 22-26, 2007; Chicago.