[acb-diabetics] Structured Blood Glucose Testing with Pattern Analysis Improves Blood Sugars

[Patricia LaFrance-Wolf]

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....

 

Advertisement 

1089869/4-Lantus_Oad_0_300x250_Gif_0  

 

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]

 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://www.acb.org/pipermail/acb-diabetics/attachments/20101017/1dc0c72b/attachment.htm>