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Self-Monitoring of Blood Glucose in Youth with T2D

Diabetes Care; ePub 2019 Mar 4; Weinstock, et al

Low self-monitoring of blood glucose (SMBG) adherence was common and associated with higher HbA1c in youth with type 2 diabetes. This according to a recent study that sought to determine whether SMBG is associated with lower HbA1c in youth with T2D taking oral medications only or after starting insulin for persistently elevated HbA1c. Participants (n=699) taking oral medications were asked to perform SMBG twice daily. After reaching primary outcome (PO) (HbA1c ≥8% [64 mmol/mol] over 6 months or an inability to wean from temporary insulin because of metabolic decompensation), insulin glargine was started. HbA1c and percent of SMBG (SMBG%) (percent days when the meter was used ≥1 times) before and after PO were analyzed. Researchers found:

  • SMBG declined over time and was inversely related to HbA1c.
  • Of 298 youth who reached PO and started insulin, 282 had SMBG data.
  • Median SMBG% was 40% at PO, which increased to 49% after 6 months and fell to 41% after 1 year on insulin.
  • At PO, 22% of youth checked ≥80% of days, which increased to 25% and fell to 19% after 6 and 12 months using insulin, respectively.

Weinstock RS, Braffett BH, McGuigan P, et al, for the TODAY Study Group. Self-monitoring of blood glucose in youth-onset type 2 diabetes: Results from the TODAY Study. [Published online ahead of print March 4, 2019]. Diabetes Care. doi:10.2337/dc18-1854.