The effects of structured self-monitoring of blood glucose on therapeutic effectiveness and adherence in patients with type 2 diabetes mellitus initiating insulin treatment

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 To compare the efficiency of standard and structured approaches to self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) initiating insulin treatment.
Materials and Methods.
This open prospective randomized clinical trial included 51 T2DM patients who initiated insulin therapy in either outpatient or inpatient setting. Subjects were randomized in standard and structured SMBG groups, the structured group used an advanced Accu-Chek 360 View protocol. Evaluation included clinical examination and laboratory testing of HbA1c levels at the beginning of the treatment and after 3 months of the follow-up period.
70% of the structured self-monitoring group and 32% of the control group achieved therapeutic goals (p=0.008). Higher adherence was associated with better glycemic control in both groups ? and vice versa. However, among patients with low adherence, 73% of advanced SMBG group managed to achieve therapeutic goals vs. 19% in the control group (p=0.005). In addition, patients in the structured monitoring group gained less weight as compared to the control (1.0?2.88 kg vs. 3.2?2.56 kg; p=0.005).
Structured SMBG commenced at the initiation of insulin therapy improves glycemic control in a greater fraction of patients, especially in those with low adherence to treatment. Structured SMBG also partially alleviates weight gain as side effect of insulin treatment.

About the authors

Lyudmila Alexandrovna Suvorova

Nizhny Novgorod State Medical Academy

Author for correspondence.

Russian Federation postgraduate student in the endocrinology and internal deseases department

Alexander Vladimirovich Petrov

Nizhny Novgorod State Medical Academy


Russian Federation MD, PhD, Assistant Professor in the endocrinology and internal deseases department

Leonid Grigor'evich Strongin

Nizhny Novgorod State Medical Academy


Russian Federation MD, PhD, Professor, Head of the endocrinology and internal deseases department


  1. Дедов ИИ, Шестакова МВ, и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (5-й выпуск). Сахарный диабет. 2011;(3s):2–72. [Dedov I, Shestakova M, Aleksandrov A, Galstyan G, Grogoryan O, Esayan R, et al. Algorithms of Specialized Medical Care for Diabetes Mellitus Patients. Diabetes mellitus. 2011;(3s):2–72. doi: 10.14341/2072-0351-5612 ].
  2. Karter AJ, Ackerson LM, Darbinian JA, D’Agostino RB, Ferrara A, Liu J, et al. Self-monitoring of blood glucose levels and glycemic control: the Northern California Kaiser Permanente Diabetes registry. The American journal of medicine. 2001;111(1):1–9.
  3. doi: 10.1016/S0002-9343(01)00742-2
  4. Lowe J. Self-monitoring of blood glucose in type 2 diabetes. Australian Prescriber. 2010;(33):138–140.
  5. Петров АВ, Калинникова АА, Суворова ЛА, Стронгин ЛГ, Логутова ДВ, Глебов СП. Практика самоконтроля гликемии у пациентов с сахарным диабетом 2 типа по результатам работы областного мобильного диабетологического центра. Сахарный диабет. 2012;(2):32–37. [Petrov A, Suvorova A, Suvorova L, Strongin L, Logutova D, Glebov S. Self-monitoring practice in patients with type 2 diabetes mellitus: data from regional mobile diabetes centre. Diabetes mellitus. 2012;(2):32–37. doi: 10.14341/2072-0351-5516 ].
  6. Sabate E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.
  7. Polonsky WH, Fisher L, Shikman CH, Hinnen DA, Parkin GC, Jelsovsky Z. Structured SMBG significantly reduces HbA1c levels in poorly-controlled, non-insulin treated type 2 Diabetes: Results from the Structured Testing Program study. Diabetes Care. 2011; 34:262–267.
  8. doi: 10.2337/dc10-1732



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Copyright (c) 2013 Suvorova L.A., Petrov A.V., Strongin L.G.

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