Nishimura Akiko, Harashima Shin-Ichi, Fujita Yoshihito, Tanaka Daisuke, Wang Yu, Liu Yanyan, Inagaki Nobuya
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan.
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan.
J Diabetes Complications. 2017 Jan;31(1):228-233. doi: 10.1016/j.jdiacomp.2016.08.019. Epub 2016 Aug 28.
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.
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.
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.
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.
比较血糖自我监测(SMBG)中结构化和常规检测方案对初治2型糖尿病患者血糖控制和糖尿病自我管理的影响。
62例初治2型糖尿病门诊患者被随机分为两个较少进行SMBG的使用组:结构化检测组(STG)和常规检测组(RTG)。STG组的受试者每两个月连续3天每天进行7点血糖自我监测,而非每日检测;RTG组的受试者每周在周一和周五早餐前以及周三晚餐前各进行3次血糖自我监测。主要终点是糖化血红蛋白(HbA1c)降低。次要终点是体重、血压变化、治疗方案改变和自我管理表现变化。
STG组的HbA1c水平显著降低了0.32%(3.50mmol/mol),部分原因是医生更积极地调整了药物。相比之下,RTG组的体重和收缩压/舒张压分别显著降低了0.94kg和6.8/4.7mmHg,这可能与RTG组饮食和运动评分增加有关。
不进行每日检测的结构化检测有利于血糖控制;每周3次的常规检测对日常自我管理更有帮助。在SMBG使用频率较低的情况下,可根据个体糖尿病情况采用这两种方案。