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Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial

Sharon Parsons Orcid Logo, Steve Luzio Orcid Logo, J. N. Harvey, Steve Bain Orcid Logo, Ivy Cheung, Alan Watkins Orcid Logo, David Owens Orcid Logo

Diabetic Medicine, Volume: 36, Issue: 5, Pages: 578 - 590

Swansea University Authors: Sharon Parsons Orcid Logo, Steve Luzio Orcid Logo, Steve Bain Orcid Logo, Ivy Cheung, Alan Watkins Orcid Logo, David Owens Orcid Logo

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DOI (Published version): 10.1111/dme.13899

Abstract

AimTo examine the impact of structured self-monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub-optimally controlled Type 2 diabetes.MethodsWe conducted a 12-month, multicentre, randomized controlled trial in people with established (>1 year) Typ...

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Published in: Diabetic Medicine
ISSN: 0742-3071 1464-5491
Published: Wiley 2019
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URI: https://cronfa.swan.ac.uk/Record/cronfa54346
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A total of 446 participants were randomized to a control group (n =151) receiving usual diabetes care, a group using structured self-monitoring of blood glucose alone (n =147) or a group using structured self-monitoring of blood glucose with additional monthly &#x2018;TeleCare&#x2019; support (n =148). The primary outcome was HbA1c at 12 months.ResultsA total of 323 participants (72%) completed the study; 116 (77%) in the control group, 99 (67%) in the self-monitoring of blood glucose alone group and 108 (73%) in the self-monitoring of blood glucose plus TeleCare group. Compared to baseline, the mean HbA1c was lower in all groups at 12 months, with reductions of 3.3 mmol/mol (95% CI &#x2013;5.71 to &#x2013;0.78) or 0.3% (95% CI &#x2013;0.52 to &#x2013;0.07; P=0.01) in the control group, 11.4 mmol/mol (95% CI &#x2013;14.11 to &#x2013;8.76) or 1.1% (&#x2013;1.29 to &#x2013;0.81; P&lt;0.0001) in the group using self-monitoring of blood glucose alone and 12.8 mmol/mol (95% CI &#x2013;15.34 to &#x2013;10.31) or 1.2% (95% CI &#x2013;1.40 to -0.94; P&lt;0.0001) in the group using self-monitoring of blood glucose plus TeleCare. This represents a reduction in HbA1c of 8.9 mmol/mol (95% CI &#x2013;11.97 to &#x2013;5.84) or 0.8% (95% CI &#x2013;1.10 to -0.54; P&#x2264;0.0001) with structured self-monitoring of blood glucose compared to the control group. Participants with lower baseline HbA1c, shorter duration of diabetes and higher educational achievement were more likely to achieve HbA1c &#x2264;53 mmol/mol (7.0%).ConclusionsStructured self-monitoring of blood glucose provides clinical and statistical improvements in glycaemic control in Type 2 diabetes. No additional benefit, over and above the use of structured self-monitoring of blood glucose, was observed in glycaemic control with the addition of once-monthly TeleCare support.(Clinical trial registration no.: ISRCTN21390608)</abstract><type>Journal Article</type><journal>Diabetic Medicine</journal><volume>36</volume><journalNumber>5</journalNumber><paginationStart>578</paginationStart><paginationEnd>590</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0742-3071</issnPrint><issnElectronic>1464-5491</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2019</publishedYear><publishedDate>2019-05-01</publishedDate><doi>10.1111/dme.13899</doi><url/><notes/><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Roche Diabetes Care GmbH; European Foundation for the Study of Diabetes; LifeScan Programme</funders><projectreference/><lastEdited>2022-11-03T15:15:15.3687776</lastEdited><Created>2019-02-18T00:00:00.0000000</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Sharon</firstname><surname>Parsons</surname><orcid>0000-0002-5841-8309</orcid><order>1</order></author><author><firstname>Steve</firstname><surname>Luzio</surname><orcid>0000-0002-7206-6530</orcid><order>2</order></author><author><firstname>J. N.</firstname><surname>Harvey</surname><order>3</order></author><author><firstname>Steve</firstname><surname>Bain</surname><orcid>0000-0001-8519-4964</orcid><order>4</order></author><author><firstname>Ivy</firstname><surname>Cheung</surname><order>5</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>6</order></author><author><firstname>David</firstname><surname>Owens</surname><orcid>0000-0003-1002-1238</orcid><order>7</order></author></authors><documents><document><filename>54346__25645__9a56c6bcab5f42df881813e108948e61.pdf</filename><originalFilename>54346_VoR.pdf</originalFilename><uploaded>2022-11-03T15:14:22.8292143</uploaded><type>Output</type><contentLength>500699</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This is an open access article under the terms of the Creative Commons Attribution NonCommercial-NoDerivs License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc-nd/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-11-03T15:15:15.3687776 v2 54346 2019-02-18 Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial f428211d8324336eb2bc7f4e6a08a421 0000-0002-5841-8309 Sharon Parsons Sharon Parsons true false 01491e1cd582746a654fad9addf0de16 0000-0002-7206-6530 Steve Luzio Steve Luzio true false 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false a9142ffd398f89eff40ada503e315639 Ivy Cheung Ivy Cheung true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 2fd4b7c3f82c6d3bd546eff61ff944e9 0000-0003-1002-1238 David Owens David Owens true false 2019-02-18 BMS AimTo examine the impact of structured self-monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub-optimally controlled Type 2 diabetes.MethodsWe conducted a 12-month, multicentre, randomized controlled trial in people with established (>1 year) Type 2 diabetes not on insulin therapy, with sub-optimal glycaemic control [HbA1c ≥58 to ≤119 mmol/mol (≥7.5% to ≤13%)]. A total of 446 participants were randomized to a control group (n =151) receiving usual diabetes care, a group using structured self-monitoring of blood glucose alone (n =147) or a group using structured self-monitoring of blood glucose with additional monthly ‘TeleCare’ support (n =148). The primary outcome was HbA1c at 12 months.ResultsA total of 323 participants (72%) completed the study; 116 (77%) in the control group, 99 (67%) in the self-monitoring of blood glucose alone group and 108 (73%) in the self-monitoring of blood glucose plus TeleCare group. Compared to baseline, the mean HbA1c was lower in all groups at 12 months, with reductions of 3.3 mmol/mol (95% CI –5.71 to –0.78) or 0.3% (95% CI –0.52 to –0.07; P=0.01) in the control group, 11.4 mmol/mol (95% CI –14.11 to –8.76) or 1.1% (–1.29 to –0.81; P<0.0001) in the group using self-monitoring of blood glucose alone and 12.8 mmol/mol (95% CI –15.34 to –10.31) or 1.2% (95% CI –1.40 to -0.94; P<0.0001) in the group using self-monitoring of blood glucose plus TeleCare. This represents a reduction in HbA1c of 8.9 mmol/mol (95% CI –11.97 to –5.84) or 0.8% (95% CI –1.10 to -0.54; P≤0.0001) with structured self-monitoring of blood glucose compared to the control group. Participants with lower baseline HbA1c, shorter duration of diabetes and higher educational achievement were more likely to achieve HbA1c ≤53 mmol/mol (7.0%).ConclusionsStructured self-monitoring of blood glucose provides clinical and statistical improvements in glycaemic control in Type 2 diabetes. No additional benefit, over and above the use of structured self-monitoring of blood glucose, was observed in glycaemic control with the addition of once-monthly TeleCare support.(Clinical trial registration no.: ISRCTN21390608) Journal Article Diabetic Medicine 36 5 578 590 Wiley 0742-3071 1464-5491 1 5 2019 2019-05-01 10.1111/dme.13899 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University Roche Diabetes Care GmbH; European Foundation for the Study of Diabetes; LifeScan Programme 2022-11-03T15:15:15.3687776 2019-02-18T00:00:00.0000000 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Sharon Parsons 0000-0002-5841-8309 1 Steve Luzio 0000-0002-7206-6530 2 J. N. Harvey 3 Steve Bain 0000-0001-8519-4964 4 Ivy Cheung 5 Alan Watkins 0000-0003-3804-1943 6 David Owens 0000-0003-1002-1238 7 54346__25645__9a56c6bcab5f42df881813e108948e61.pdf 54346_VoR.pdf 2022-11-03T15:14:22.8292143 Output 500699 application/pdf Version of Record true This is an open access article under the terms of the Creative Commons Attribution NonCommercial-NoDerivs License true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
spellingShingle Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
Sharon Parsons
Steve Luzio
Steve Bain
Ivy Cheung
Alan Watkins
David Owens
title_short Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
title_full Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
title_fullStr Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
title_full_unstemmed Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
title_sort Effect of structured self‐monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non‐insulin treated Type 2 diabetes: the SMBG Study, a 12‐month randomized controlled trial
author_id_str_mv f428211d8324336eb2bc7f4e6a08a421
01491e1cd582746a654fad9addf0de16
5399f4c6e6a70f3608a084ddb938511a
a9142ffd398f89eff40ada503e315639
81fc05c9333d9df41b041157437bcc2f
2fd4b7c3f82c6d3bd546eff61ff944e9
author_id_fullname_str_mv f428211d8324336eb2bc7f4e6a08a421_***_Sharon Parsons
01491e1cd582746a654fad9addf0de16_***_Steve Luzio
5399f4c6e6a70f3608a084ddb938511a_***_Steve Bain
a9142ffd398f89eff40ada503e315639_***_Ivy Cheung
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
2fd4b7c3f82c6d3bd546eff61ff944e9_***_David Owens
author Sharon Parsons
Steve Luzio
Steve Bain
Ivy Cheung
Alan Watkins
David Owens
author2 Sharon Parsons
Steve Luzio
J. N. Harvey
Steve Bain
Ivy Cheung
Alan Watkins
David Owens
format Journal article
container_title Diabetic Medicine
container_volume 36
container_issue 5
container_start_page 578
publishDate 2019
institution Swansea University
issn 0742-3071
1464-5491
doi_str_mv 10.1111/dme.13899
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description AimTo examine the impact of structured self-monitoring of blood glucose, with or without TeleCare support, on glycaemic control in people with sub-optimally controlled Type 2 diabetes.MethodsWe conducted a 12-month, multicentre, randomized controlled trial in people with established (>1 year) Type 2 diabetes not on insulin therapy, with sub-optimal glycaemic control [HbA1c ≥58 to ≤119 mmol/mol (≥7.5% to ≤13%)]. A total of 446 participants were randomized to a control group (n =151) receiving usual diabetes care, a group using structured self-monitoring of blood glucose alone (n =147) or a group using structured self-monitoring of blood glucose with additional monthly ‘TeleCare’ support (n =148). The primary outcome was HbA1c at 12 months.ResultsA total of 323 participants (72%) completed the study; 116 (77%) in the control group, 99 (67%) in the self-monitoring of blood glucose alone group and 108 (73%) in the self-monitoring of blood glucose plus TeleCare group. Compared to baseline, the mean HbA1c was lower in all groups at 12 months, with reductions of 3.3 mmol/mol (95% CI –5.71 to –0.78) or 0.3% (95% CI –0.52 to –0.07; P=0.01) in the control group, 11.4 mmol/mol (95% CI –14.11 to –8.76) or 1.1% (–1.29 to –0.81; P<0.0001) in the group using self-monitoring of blood glucose alone and 12.8 mmol/mol (95% CI –15.34 to –10.31) or 1.2% (95% CI –1.40 to -0.94; P<0.0001) in the group using self-monitoring of blood glucose plus TeleCare. This represents a reduction in HbA1c of 8.9 mmol/mol (95% CI –11.97 to –5.84) or 0.8% (95% CI –1.10 to -0.54; P≤0.0001) with structured self-monitoring of blood glucose compared to the control group. Participants with lower baseline HbA1c, shorter duration of diabetes and higher educational achievement were more likely to achieve HbA1c ≤53 mmol/mol (7.0%).ConclusionsStructured self-monitoring of blood glucose provides clinical and statistical improvements in glycaemic control in Type 2 diabetes. No additional benefit, over and above the use of structured self-monitoring of blood glucose, was observed in glycaemic control with the addition of once-monthly TeleCare support.(Clinical trial registration no.: ISRCTN21390608)
published_date 2019-05-01T04:07:50Z
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