Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial
Open accessAbstract
Aims To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients.Methods Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change.Results HbA1c levels were significantly decreased by 0.32% (3.50mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94kg and 6.8/4.7mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG.Conclusions Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions.
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No change was observed in physical activity or medication-taking in either of the two RCTs measuring those behaviors.
“while no change was observed in physical activity or medication-taking in either study (51, 57).”
From The impact of structured self-monitoring of blood glucose on clinical, behavioral, and psychosocial outcomes among adults with non-insulin-treated type 2 diabetes: a systematic review and meta-analysis (2023) · cites this paper as [57]
Section 3.4 (Self-management performance) reports that the medication-taking score did not change in either group. But the exercise score increased significantly in the routine-testing group, so the claim of no change in physical activity is not supported by this trial. (LLM, conf=0.91)
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- Authors
- Nishimura, A., Harashima, S.-I., Fujita, Y., Tanaka, D., Wang, Y., Liu, Y., & Inagaki, N.
- Affiliations
- Kyoto University (JP)
- Corresponding author
- Harashima, Shin-ichi
- Venue
- Journal of Diabetes and its Complications
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 31
- Issue
- 1
- Pages
- 228-233
- ISSN
- 0891-6632 (ISSN-L)
- 1056-8727
- OpenAlex
- W2514934404
- Cited by
- 18
- References
- 34
- Citations by year
- 2025: 2 · 2023: 5 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Diabetes and its Complications (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
- Kyoto University Research Information Repository (Kyoto University) (submittedVersion, cc-by-nc-nd)
- Funders
- Roche Diagnostics K.K.
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- routine testing, self-monitoring of blood glucose, type 2 diabetes, insulin-naive patients, glycemic control, HbA1c, diabetes self-management, test frequency, medication changes, body weight, blood pressure
- MeSH terms
- Self-Management, Activities of Daily Living, Aged, Blood Glucose, Combined Modality Therapy, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Hospitals, University, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Japan, Male, Middle Aged, Outpatient Clinics, Hospital, Patient Compliance, Time Factors, Blood Glucose Self-Monitoring, Drug Monitoring, Self Report
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