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Structured Diabetes Management can Significantly Improve Overall Glycemic Control and Reduce HbA1c Values in Non-insulin Treated Type 2 Diabetes
Date:2/1/2011

he same care, but their protocol was complemented by the SMBG-focused structured diabetes management concept. Patients in both groups received free BG monitors and strips.

Analysis of individual blood glucose profiles – key to effective structured diabetes managementThe innovative concept is based on structured 7-point blood glucose profiles (fasting, preprandial and 2hour postprandial at each meal, and bedtime), collected and documented over 3 consecutive days prior to each scheduled quarterly healthcare professional visit. To document blood glucose values, meal sizes and energy levels, and to comment on their SMBG experiences, STG participants used the Accu-Chek® 360 Degree View 3-day profile tool. They discussed the obtained profiles with their caregivers at all medical visits. To familiarize them with the protocol, patients in the STG arm of the study received a standardized training in SMBG and pattern analysis, while their doctors were equally trained and equipped with an algorithm suggesting appropriate medication strategies.

Significantly reduced HbA1c values with use of structured diabetes managementIntent-to-treat (ITT) analysis showed significant improvements in mean HbA1c values for patients in both the ACG and STG. After 12 months, however, HbA1c values were significantly lower for STG patients than for ACG participants (-1.2% vs. -0.9%; delta= -0.3%, p=0.04). The per protocol analysis showed an even greater reduction in HbA1c (-1.3% vs. -0.8%; delta= 0.5%, p<0.003). Further evaluation of STG data also revealed significant reductions in glucose levels at all pre- and postprandial time points (p<0.001). More importantly, there was a significant drop from month 1 to month 12 in pre- to postprandial glucose excursions at all meals: breakfast (44 mg/dl to 35 mg/dl, p<0.005), lunch (25 mg/dl to 17 mg/dl, p<0.03) and dinner (34 mg/dl to 26 mg/dl, p<0.05). In addition, the mean amplitude of glucose excur
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SOURCE Roche Diabetes Care
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