Effect of self-monitoring of blood glucose on glycaemic outcome among type 2 diabetic patients

Abstract

Background: Diabetes mellitus is a chronic metabolic disorder which leads to complications especially when not properly managed. The role of self-monitoring of blood glucose (SMBG) in type 2 diabetic patients using oral hypoglycaemic agents has been a source of controversy.
Objective: The objective was to study the effect of SMBG on glycaemic outcome among type 2 diabetics in a primary care setting.
Methodology: A randomised control study was conducted between March 2013 and November 2013 at the General Outpatient Clinic of the Family Medicine Department (FMD) in Lagos State University Teaching hospital. A total of 120 diabetic patients were randomised into intervention and control groups; 107 patients (55 in the intervention and 52 in the control group) completed the study. Intention-to-treat analysis was done. Chi-square, Students t- and paired t-test were used to determine variables significantly associated with SMBG.
Results: More than three-quarters (77.5%) of the participants were aware of SMBG prior to commencement of the study. Both the SMBG (8.7% vs. 7.2%; p-value < 0.001) and non-SMBG (8.7% vs 7.7%; p-value < 0.001) groups had a significant improvement in HbA1c at the end of the study. Similarly there was a significant improvement in FBG among both groups (SMBG 153 mg/dl vs. 123 mg/dl; p-value < 0.001 and non-SMBG (158 mg/dl vs. 137 mg/dl; p-value 0.022). The HbA1c at the end of the study was 7.2% for the SMBG vs 7.7% for the non-SMBG group with no statistical difference (p-value 0.174).
Conclusion: The use of SMBG among type 2 DM patients did not result in better glycaemic control compared with patients who did not practise SMBG. It could be due to close follow-up and education of both groups.

Keywords: diabetes mellitus, fasting blood glucose, glycosylated haemoglobin, self-monitoring of blood glucose