Structured Blood Glucose Testing with Pattern Analysis Improves Blood Sugars

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Structured Blood Glucose Testing with Pattern Analysis Improves Blood Sugars

Structured self-monitored blood glucose with pattern analysis has been

associated with greater reductions in A1c. It also requires less testing

than the

standard approach, and promotes more timely and aggressive treatment changes

in poorly controlled, non-insulin-treated patients with Type 2 diabetes,

according

to study results....

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Lead author Pamela Kushner, MD, Long Beach, California, stated that, the

12-month, randomized, controlled, multicentre study assessed the effect of

structured

testing on results of HbA1c.

In all, 483 insulin-naïve subjects were selected based on their poorly

controlled (HbA1c >= 7.5%) Type 2 diabetes. The patients were randomized

into 2

divisions: usual care in the Active Control Group or usual care with a

minimum quarterly use of structured testing with pattern analysis in the

Structured

Testing Group. All patients were instructed to monitor their blood glucose

as usual, based on their healthcare providers' instructions, but Structured

Testing Group members were also instructed on recording blood glucose

levels, food eaten, and energy levels as well as pattern analysis. Patients

in the

Structured Testing Group had to complete a 3-day structured testing session,

involving 7 tests per day, prior to quarterly visits, and all patients were

seen at least once quarterly as well as performing self-monitored blood

glucose between study visits.

Both groups did have significant reductions in HbA1c over the trial period,

but an intent-to-treat analysis showed greater reductions in the Structured

Testing Group than in the Active Control Group (-1.2% vs. -0.9%, P =.04).

Furthermore, mean daily blood glucose tests were significantly lower for the

Structured Testing Group than the Active Control Group at 6, 9, and 12

months (P =.007,.001, and.0004, respectively), reported Dr. Kushner.

Structured Testing Group healthcare providers were 31% more likely to

recommend at least 1 medical treatment change at the first treatment visit 1

month

post baseline, 33% were more likely to recommend lifestyle adjustments, and

33% were more likely to recommend a combination of the two (P =.0001).

Subjects

who received this treatment change at the first visit were able to achieve a

significantly larger HbA1c reduction than those who did not receive a

recommendation.

" And they were significantly less likely to have clinical inertia, " Dr.

Kushner added.

Ultimately, the researchers concluded that " early treatment changes are

linked to significant glycemic improvement over 12 months, and may be a

major reason

why subjects in the Structured Testing Group evidenced a significantly

greater reduction in HbA1c than Active Control Group subjects. " Dr. Kushner

also

noted that patients and physicians reported that they " liked having the

ability to track patterns in their results based on their behavior. "

For a copy of the form used by the patients for the pattern analysis see our

Tool for Your Practice,

360 View -- A Simple Blood Glucose Analysis System (PDF).

[structured Blood Glucose Testing Leads to Improvements in HbA1c in Patients

With Poorly Controlled, Non-Insulin-Treated Type 2 Diabetes. Results from

the

Structured Testing Program (STeP) Study. Abstract P058]