An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study
Open accessAbstract
BACKGROUND: Self-monitoring of blood glucose (SMBG) has been recommended as a useful tool for improving glycemic control, but is still an underutilized strategy and most diabetic patients are not aware of the actions that must be taken in response to its results and do not adjust their treatment. The purpose of this study was to evaluate the effectiveness and safety of an educational program for insulin self-adjustment based on SMBG in poorly controlled patients with type 2 diabetes (T2DM). METHODS: A prospective, randomized, controlled 12-week intervention study was conducted on poorly controlled insulin-requiring patients with T2DM. Twenty-three subjects were randomized to two educational programs: a 2-week basic program with guidance about SMBG and types and techniques of insulin administration (group A, n = 12) and a 6-week program including the basic one and additional instructions about self-titration of insulin doses according to a specific protocol (group B, n = 11). Patients were reviewed after 12 weeks and baseline to endpoint changes in glycated hemoglobin (A1C), insulin doses, body weight and incidence of hypoglycemia were compared by paired and independent Student t-tests. RESULTS: After 12 weeks, there was a significant reduction in A1C only in group B, but group comparison showed no significant difference (p = 0.051). A higher percentage of subjects in group B achieved an A1C near the treatment target (<7.5%) than in group A. Daily insulin dose increased non-significantly in the two groups and there was no significant difference in the incidence of hypoglycemia or body weight changes between groups. CONCLUSIONS: Training for self-titrating insulin doses combined with structured SMBG can safely improve glycemic control in poorly controlled insulin-treated T2DM patients. This strategy may facilitate effective insulin therapy in routine medical practice, compensating for any reluctance on the part of physicians to optimize insulin therapy and thus to improve the achievement of recommended targets of diabetes care.
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In a Brazilian study, training for self-titrating insulin doses combined with structured SMBG improved glycemic control in poorly controlled people with T2DM on insulin therapy.
“The importance of education was shown to be relevant in a Brazilian study in which training for self-titrating insulin doses was combined with structured SMBG. Improvement of glycemic control was found in poorly controlled people with T2DM on insulin therapy [66].”
From Self-Monitoring of Blood Glucose as an Integral Part in the Management of People with Type 2 Diabetes Mellitus (2022) · cites this paper as [66]
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- Authors
- Silva, D. D. R., & Bosco, A. A.
- Affiliations
- Grupo Santa Casa de Belo Horizonte (BR)
- Corresponding author
- Silva, Daniel Dutra Romualdo
- Venue
- Diabetology & Metabolic Syndrome
- Published
- 2015-01-15
- Volume
- 7
- Issue
- 1
- Pages
- 2-2
- ISSN
- 1758-5996 (ISSN-L)
- PMC
- PMC4405992
- OpenAlex
- W2172030285
- Cited by
- 35
- References
- 33
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 2
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Diabetology & Metabolic Syndrome (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- 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
- type 2 diabetes, self-monitoring of blood glucose, glycemic control, patient education, HbA1c, hypoglycemia, insulin dose adjustment, uncontrolled diabetes
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