Early management of type 2 diabetes based on a SMBG strategy: the way to diabetes regression—the St Carlos study: A 3-year, prospective, randomized, clinic-based, interventional study with parallel groups
Abstract
The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos study is a 3-year, prospective, randomized, clinic-based, interventional study with three parallel groups. Hundred and ninety-five patients were randomized to the SMBG intervention group [I group; n = 130; Ia: SMBG (n = 65) and Ib: SMBG + supervised exercise (n = 65)] and to the HbA1c control group (C group) (n = 65). The primary outcome was to estimate the regression rate of type 2 diabetes (HbA1c <6 % on metformin treatment). After 3 years of follow-up, diabetes regression was achieved by 56 patients, 6 (9.2 %) from the C group, 21 (32.3 %) from the Ia group and 29 (44.6 %) from the Ib group. RR (95 % CI) for diabetes regression in the intervention group (Ia + Ib) was 4.5 (2.1-9); p < 0.001 and remained after stratification by gender, age and BMI. This difference was associated with healthier changes in lifestyle and greater weight loss. RR for a weight loss >4 kg was 3.6 (1.8-7); p < 0.001. This study shows that the use of SMBG in an educational program effectively increases the regression rate in newly diagnosed type 2 diabetic patients after 3 years of follow-up. These data suggest that SMBG-based programs should be extended to primary care settings where diabetic patients are usually attended.
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- Authors
- García de la Torre, N., Durán, A., del Valle, L., Fuentes, M., Barca, I., Martín, P., Montañez, C., Perez-Ferre, N., Abad, R., Sanz, F., Galindo, M., Rubio, M. A., & Calle-Pascual, A. L.
- Affiliations
- Hospital Clínico San Carlos (ES)
- Venue
- Acta Diabetologica
- Published
- 2013-03-27
- Volume
- 50
- Issue
- 4
- Pages
- 607-614
- ISSN
- 0940-5429 (ISSN-L)
- 1432-5233
- OpenAlex
- W1794035978
- Cited by
- 24
- References
- 23
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 2
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Acta Diabetologica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, self-monitoring of blood glucose, newly diagnosed diabetes, supervised exercise, lifestyle intervention, metformin, weight loss, HbA1c, primary care, patient education
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Life Style, Male, Metformin, Middle Aged, Prospective Studies, Blood Glucose Self-Monitoring
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