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Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study

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Martin, S., Schneider, B., Heinemann, L., Lodwig, V., Kurth, H.-J., Kolb, H., Scherbaum, W. A., for the ROSSO Study Group·2006·Diabetologia

DOI 10.1007/s00125-005-0083-5

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Abstract

Aims/hypothesis The aim of this study was to obtain epidemiological data on self-monitoring of blood glucose (SMBG) in type 2 diabetes and to investigate the relationship of SMBG with disease-related morbidity and mortality.Methods The German multicentre Retrolective Study 'Self-monitoring of Blood Glucose and Outcome in Patients with Type 2 Diabetes' (ROSSO) followed 3,268 patients from diagnosis of type 2 diabetes between 1995 and 1999 until the end of 2003. Endpoints were diabetes-related morbidity (non-fatal myocardial infarction, stroke, foot amputation, blindness or haemodialysis) and all-cause mortality. SMBG was defined as self-measurement of blood glucose for at least 1 year.Results During a mean follow-up period of 6.5 years, 1,479 patients (45.3%) began SMBG prior to an endpoint and an additional 64 patients started SMBG after a non-fatal endpoint. Interestingly, many patients used SMBG while being treated with diet or oral hypoglycaemic drugs (808 of 2,515, 32%). At baseline, the SMBG cohort had higher mean fasting blood glucose levels than the non-SMBG cohort (p<0.001), suggesting that insufficient metabolic control was one reason for initiating SMBG. This was associated with a higher rate of microvascular endpoints. However, the total rate of non-fatal events, micro- and macrovascular, was lower in the SMBG group than in the non-SMBG group (7.2 vs 10.4%, p=0.002). A similar difference was found for the rate of fatal events (2.7 vs 4.6%, p=0.004). Cox regression analysis identified SMBG as an independent predictor of morbidity and mortality, with adjusted hazard ratios of 0.68 (95% CI 0.51-0.91, p=0.009) and 0.49 (95% CI 0.31-0.78, p=0.003), respectively. A better outcome for both endpoints was also observed in the SMBG cohort when only those patients who were not receiving insulin were analysed.Conclusions/interpretation SMBG was associated with decreased diabetes-related morbidity and all-cause mortality in type 2 diabetes, and this association remained in a subgroup of patients who were not receiving insulin therapy. SMBG may be associated with a healthier lifestyle and/or better disease management.

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Self-citation
Practical approaches for self-monitoring of blood glucose: an Asia-Pacific perspective
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Authors: Martin, S., Schneider, B., Heinemann, L., Lodwig, V., Kurth, H.-J., Kolb, H., Scherbaum, W. A., & for the ROSSO Study Group
Affiliations: Deutsches Diabetes-Zentrum e.V. (DE)
Medizinische Hochschule Hannover (DE)
Profil Institute for Metabolic Research (DE)
Institute for Medical Informatics and Biostatistics (CH)
Corresponding author: Martin, S.
ORCID: Martin, S.
Heinemann, L.
Kolb, H.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2005-12-17
Volume: 49
Issue: 2
Pages: 271-278
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-005-0083-5
OpenAlex: W2142280025
Cited by: 284
References: 40
Citations by year: 2026: 2 · 2025: 3 · 2024: 8 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 11 · 2019: 11 · 2018: 6 · 2017: 16 · 2016: 7 · 2015: 13 · 2014: 19 · 2013: 13 · 2012: 21
FWCI: 14.69
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Funders: Bundesministerium für Bildung und Forschung
Bundesministerium für Gesundheit
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: self-monitoring of blood glucose, type 2 diabetes, all-cause mortality, microvascular complications, macrovascular complications, glycemic control, fasting blood glucose, insulin therapy, oral antidiabetic drugs, myocardial infarction, stroke, foot amputation, blindness
MeSH terms: Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Insulin, Longitudinal Studies, Male, Middle Aged, Regression Analysis, Retrospective Studies, Blood Glucose Self-Monitoring, Cohort Studies, Survival Analysis, Outcome Assessment, Health Care, Disease Management, Diabetes Complications

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Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study

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