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Blood Glucose Monitoring is Associated with Better Glycemic Control in Type 2 Diabetes: A Database Study

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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.

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ACKNOWLEDGMENTS

This research was supported by the Department of Veterans Affairs. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. This work was presented, in part, at the American Diabetes Association’s 67th Scientific Sessions, Chicago, IL, 23 June 2007.

Conflicts of Interest

Drs. Murata, Duckworth, Shah, and Mr. Wendel have grant funding from Roche Diagnostics. Dr. Duckworth has also consulted for Novo and Caremark and received grant funding from Novo, Aventis, Roche Diagnostics, Kos, and Glaxo. Drs. Hoffman and Mohler have no conflicts to report

Author information

Authors and Affiliations

  1. New Mexico VA Health Care System, Albuquerque, NM, USA

    Glen H. Murata MD & Richard M. Hoffman MD, MPH

  2. University of New Mexico School of Medicine, Albuquerque, NM, USA

    Glen H. Murata MD & Richard M. Hoffman MD, MPH

  3. Carl T. Hayden VA Medical Center, Phoenix, AZ, USA

    William C. Duckworth MD

  4. University of Arizona College of Medicine, Tucson, AZ, USA

    William C. Duckworth MD, Jayendra H. Shah MD & M. Jane Mohler PhD, MPH

  5. Southern Arizona VA Health Care System (JHS, CSW), Tucson, AZ, USA

    Jayendra H. Shah MD & Christopher S. Wendel MS

Authors
  1. Glen H. Murata MD
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  2. William C. Duckworth MD
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  3. Jayendra H. Shah MD
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  4. Christopher S. Wendel MS
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  5. M. Jane Mohler PhD, MPH
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  6. Richard M. Hoffman MD, MPH
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Corresponding author

Correspondence to Richard M. Hoffman MD, MPH.

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Murata, G.H., Duckworth, W.C., Shah, J.H. et al. Blood Glucose Monitoring is Associated with Better Glycemic Control in Type 2 Diabetes: A Database Study. J GEN INTERN MED 24, 48–52 (2009). https://doi.org/10.1007/s11606-008-0830-7

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  • DOI: https://doi.org/10.1007/s11606-008-0830-7

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