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Randomized trial of technology-assisted self-monitoring of blood glucose by low-income seniors: improved glycemic control in type 2 diabetes mellitus

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Abstract

Self-monitoring of blood glucose (SMBG) has been recommended for people with type 2 diabetes mellitus. This trial tested an automated self-management monitor (ASMM) that reminds patients to perform SMBG, provides feedback on results of SMBG, and action tips for improved self-management. This delayed-start trial randomized participants to using the ASMM immediately (IG), or following a delay of 6 months (DG). Glycated hemoglobin (HgbA1c) level and survey data was collected at home visits every 3 months. 44 diabetic men and women, mean age 70, completed the 12-month trial. Baseline HgbA1c was 8.1 % ± 1.0, dropping to 7.3 ± 1.0 by 9 months, with a 3-month lag in the DG (F = 3.56, p = 0.004). Decrease in HgbA1c was significantly correlated to increased frequency of SMBG, R = 0.588, p < 0.01. Providing older diabetics with objective immediate contingent feedback resulted in more frequent SMBG that correlated with better glycemic control. This type of technology may provide real-time feedback not only to patient users, but to the health care system, allowing better integration of provider recommendations with patient-centered action.

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Acknowledgments

This article presents independent research commissioned by the National Institute of Health (NIH) and Agency for Healthcare Research and Quality (AHRQ). The views expressed in this publication are those of the author(s) and not necessarily those of the NIH or AHRQ. We thank all the research participants for their time and interest in the study.

Funding

This study was supported by NIA Grants R44 AG019528-02 and AHRQ R18 HS17276-01. Abbott Laboratories provided glucometers for study participants.

Disclosures

The author(s) report no financial or other relationship relevant to the subject of this article.

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Authors and Affiliations

  1. Department of Psychology, University of Toledo, 2801 W. Bancroft St. Mail Stop #948, Toledo, OH, 43606, USA

    Jason C. Levine

  2. Medical College of Wisconsin, Milwaukee, WI, USA

    Edith Burns, Jeffrey Whittle & Paul Knudson

  3. University of Wisconsin-Milwaukee, Milwaukee, WI, USA

    Raymond Fleming

  4. FlexTech Systems, Brookfield, WI, USA

    Steve Flax

  5. Rutgers University, New Brunswick, NJ, USA

    Howard Leventhal

Authors
  1. Jason C. Levine
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  2. Edith Burns
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  3. Jeffrey Whittle
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  7. Howard Leventhal
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Correspondence to Jason C. Levine.

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Conflict of interest

Jason C. Levine, Edith Burns, Jeffrey Whittle, Raymond Fleming, Paul Knudson, Steve Flax and Howard Leventhal declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Levine, J.C., Burns, E., Whittle, J. et al. Randomized trial of technology-assisted self-monitoring of blood glucose by low-income seniors: improved glycemic control in type 2 diabetes mellitus. J Behav Med 39, 1001–1008 (2016). https://doi.org/10.1007/s10865-016-9763-5

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  • DOI: https://doi.org/10.1007/s10865-016-9763-5

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