Conclusions Telemonitoring interventions may be a better option than usual care in improving glycated haemoglobin control of patients with type 2 diabetes .
Aims This study evaluated clinical effectiveness of telemonitoring on the management of patients with type 2 diabetes .
Intensive Structured Self-Monitoring of Blood Glucose and Glycemic Control in Noninsulin-Treated Type 2 Diabetes
OBJECTIVE We aim ed to evaluate the added value of intensive self-monitoring of blood glucose ( SMBG ) , structured in timing and frequency , in noninsulin-treated patients with type 2 diabetes . RESEARCH DESIGN AND METHODS The 12-month , r and omized , clinical trial enrolled 1,024 patients with noninsulin-treated type 2 diabetes ( median baseline HbA1c , 7.3 % [ IQR , 6.9–7.8 % ] ) at 39 diabetes clinics in Italy . After st and ardized education , 501 patients were r and omized to intensive structured monitoring ( ISM ) with 4-point glycemic profiles ( fasting , prepr and ial , 2-h postpr and ial , and postabsorptive measurements ) performed 3 days/week ; 523 patients were r and omized to active control ( AC ) with 4-point glycemic profiles performed at baseline and at 6 and 12 months . Two primary end points were tested in hierarchical order : HbA1c change at 12 months and percentage of patients at risk target for low and high blood glucose index . RESULTS Intent-to-treat analysis showed greater HbA1c reductions over 12 months in ISM ( −0.39 % ) than in AC patients ( −0.27 % ) , with a between-group difference of −0.12 % ( 95 % CI , −0.210 to −0.024 ; P = 0.013 ) . In the per- protocol analysis , the between-group difference was −0.21 % ( −0.331 to −0.089 ; P = 0.0007 ) . More ISM than AC patients achieved clinical ly meaningful reductions in HbA1c ( > 0.3 , > 0.4 , or > 0.5 % ) at study end ( P < 0.025 ) . The proportion of patients reaching/maintaining the risk target at month 12 was similar in ISM ( 74.6 % ) and AC ( 70.1 % ) patients ( P = 0.131 ) . At visits 2 , 3 , and 4 , diabetes medications were changed more often in ISM than in AC patients ( P < 0.001 ) . CONCLUSIONS Use of structured SMBG improves glycemic control and provides guidance in prescribing diabetes medications in patients with relatively well-controlled noninsulin-treated type 2 diabetes
Conclusions Telemonitoring interventions may be a better option than usual care in improving glycated haemoglobin control of patients with type 2 diabetes .
Aims This study evaluated clinical effectiveness of telemonitoring on the management of patients with type 2 diabetes .