Sustained improvement in diabetic control on long-term self-monitoring of blood glucose

Abstract

The benefits of self-monitoring of blood glucose (SMBG) were assessed in 38 Chinese adults on conventional insulin regimens who had been performing SMBG for a mean duration of 26 months (range 15-40). For analysis patients were divided into 2 groups. Group A consisted of 27 insulin-requiring patients who were referred for SMBG because of poor control or young age (≤35 years). Group B consisted of 11 IDDM patients who were on SMBG from diagnosis. Mean age and duration of SMBG were similar in the 2 groups though group A had longer duration of disease. In group A, mean haemoglobin A 1 (HbA 1) decreased from 12.4 ± 0.5% before SMBG to 10.9 ± 0.5% at 6 months (P < 0.005), 10.7 ± 0.5% at 12 months (P < 0.005) and 10.3 ± 0.4% after long-term SMBG. This was accompanied by a significant reduction in insulin requirement from 0.82 ± 0.07 U/kg/day to 0.72 ± 0.07 U/kg/day (P < 0.05). In group B, insulin requirement progressively decreased in the first 6 months. At 12 months, mean HbA 1 was 9.0 ± 0.5% and insulin requirement was 0.58 ± 0.08 U/kg/day. No significant change in HbA 1 or insulin requirement was observed beyond the first year. After long-term SMBG, 82% of patients in group B had good control (HbA 1 ≤ 10%) compared to 45% only in group A (P < 0.05). Long-term SMBG is associated with sustained improvement in diabetic control and is particularly beneficial if introduced to diabetic patients right from diagnosis.