Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Shen, Yun; Zhu, Wei; Lu, Ling; Lu, Fengdi; Kan, Kai; Bao, Yuqian; Zhou, Jian; Jia, Weiping

doi:10.1002/dmrr.3067

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…The data are quantitively synthesized and presented as weighted mean difference. SMBG interpretation I Diabetes clinics Cli I 7.4:7.3 (57:56) -1 (-2, -0) Industry Kan et al, 2017(Kan et al, 2017Shen et al, 2019)…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

2021

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The benefit of self-monitoring of blood glucose (SMBG) in the reduction of HbA1c in non-insulintreated participants remains unclear. HbA1c may be improved in this population with SMBG. We aimed to investigate this. Materials and methodsMeta-analyses of randomized controlled trials (RCTs) were performed comparing SMBG versus usual care and structured versus unstructured SMBG; the effect of clinician therapy adjustment based on SMBG readings was examined. Medline, Embase and Cochrane Central were electronically searched to identify articles published from 1 January 2000 to 30 June 2020. Trials investigating changes in HbA1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA1c at baseline and follow-up for each trial. ResultsNineteen RCTs, involving 4,965 participants were included. Overall, SMBG reduced HbA1c. Preplanned subgroup analysis showed that using SMBG readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA1c was shown in SMBG without therapy adjustment). The same difference was observed in structured SMBG compared to unstructured SMBG. ConclusionsHbA1c is improved with therapy adjustment based on structured SMBG readings. Implications are for clinicians to prescribe structured SMBG with an aim for therapy adjustment based on the readings, and not prescribing unstructured SMBG. Participants with suboptimal glycemic control may benefit most. A SMBG regimen that improves clinical-and cost-effectiveness is presented. Future studies can investigate this regimen specifically.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

2021

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“…For patients treated with intensive insulin regimens, self‐monitoring of blood glucose (SMBG) 4 to 10 times per day is recommended for optimal insulin dosing and to prevent hypoglycemia 9,10 . Several studies have demonstrated a strong correlation between frequency of SMBG and glycemic control, 11‐14 however there is a practical limitation to the number of glucose tests that can be performed per day. Furthermore, there are several barriers to frequent testing such as pain and discomfort associated with finger‐stick testing, inconvenience and self‐consciousness in public 15‐17 .…”

Section: Introductionmentioning

confidence: 99%

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Tsur

Cahn

Israel

et al. 2020

Diabetes Metabolism Res

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BackgroundWe evaluated the impact of flash continuous glucose monitoring (FCGM) on glycemic control and healthcare burden in a large real‐world cohort of patients with type 1 diabetes (T1D) initiating FCGM technology.MethodsIn this retrospective cohort study, we included adults (age ≥18 years) with T1D from a large Health Maintenance Organization in Israel, who initiated FCGM during 2018. Primary outcomes included change in HbA1c ≥3 months following FCGM commencement and change in rate of internal‐medicine hospitalization. Additional outcomes included changes in glucose test strip purchases, diabetes related outpatient health care visits and hospitalization for diabetic ketoacidosis (DKA) and/or severe hypoglycemia.ResultsThe study included 3490 patients, followed for a median of 14 (inter‐quartile range 11‐15) months after FCGM commencement. Among 2682 patients with an HbA1c measured both at baseline and ≥3 months after FCGM initiation, average HbA1c declined from 8.1% ± 1.46% to 7.9% ± 1.31% (P < .001) at first measurement and was maintained during follow up. Specifically, in those with HbA1c ≥8%, a mean decline of 0.5% (P < .001) was observed. A clinically significant HbA1c reduction of ≥0.5% was experienced by 25.5% of the patients. The rate of internal medicine hospitalization, visits to primary care, or visits to endocrine/diabetes specialists in the period following FCGM commencement vs the 6 months prior was significantly reduced (P < .001). Hospitalization for DKA and/or hypoglycemia declined as well (P = .004).ConclusionsFCGM was associated with significant and durable improvement in glycemic control as well as reduced consumption of healthcare services.

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“…161 Some studies have shown the beneficial effects of structured SMBG in persons with newly diagnosed T2D and individuals with suboptimally controlled non-insulin-treated T2D 160,162 and could contribute to improved selfefficacy. 163 Although the use of structured SMBG in adults with noninsulin-treated T2D has not been associated with a deterioration of QoL and locus of control, 162 worsening A1C and low adherence to prescribed SMBG have been observed in youth-onset T2D. 164 Recommendation 2.1.3…”

Section: Evidence Basementioning

confidence: 99%

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

et al. 2021

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automated insulin dosing continuous glucose monitoring continuous subcutaneous insulin infusion diabetes diabetes technology glucose sensors hybrid closed loop insulin pumps sensor-augmented pump low-glucose suspend predictive low-glucose suspend a b s t r a c t Objective: To provide evidence-based recommendations regarding the use of advanced technology in the management of persons with diabetes mellitus to clinicians, diabetes-care teams, health care professionals, and other stakeholders. Methods: The American Association of Clinical Endocrinology (AACE) conducted literature searches for relevant articles published from 2012 to 2021. A task force of medical experts developed evidence-based guideline recommendations based on a review of clinical evidence, expertise, and informal consensus, according to established AACE protocol for guideline development. Main Outcome Measures: Primary outcomes of interest included hemoglobin A1C, rates and severity of hypoglycemia, time in range, time above range, and time below range. Results: This guideline includes 37 evidence-based clinical practice recommendations for advanced diabetes technology and contains 357 citations that inform the evidence base.Recommendations: Evidence-based recommendations were developed regarding the efficacy and safety of devices for the management of persons with diabetes mellitus, metrics used to aide with the assessment of advanced diabetes technology, and standards for the implementation of this technology. Conclusions: Advanced diabetes technology can assist persons with diabetes to safely and effectively achieve glycemic targets, improve quality of life, add greater convenience, potentially reduce burden of Disclaimer: The American Association of Clinical Endocrinology medical guidelines for clinical practice are systematically developed statements to assist health care professionals in medical decision-making for specific clinical conditions. Most of the content herein is based on clinical evidence. In areas of uncertainty, or when clarification is required, expert opinion and professional judgment were applied.This guideline is a working document that reflects the state of the field at the time of publication. Because rapid changes are expected in this area, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made considering local resources and individual patient circumstances.

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Contribution of structured self‐monitoring of blood glucose to self‐efficacy in poorly controlled diabetes patients in China

Abstract: Structured SMBG could contribute to the effective and persistent improvement of diabetes self-efficacy. (ClinicalTrials.gov, NCT02225691).

Cited by 8 publications

References 14 publications

Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

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