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Self‐monitoring of blood glucose versus self‐monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes receiving structured education: a cluster randomized controlled trial
Author(s) -
Dallosso H. M.,
Bodicoat D. H.,
Campbell M.,
Carey M. E.,
Davies M. J.,
Eborall H. C.,
Hadjiconstantinou M.,
Khunti K.,
Speight J.,
Heller S.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12598
Subject(s) - medicine , randomized controlled trial , urine , diabetes mellitus , type 2 diabetes , randomization , self monitoring , blood glucose self monitoring , type 1 diabetes , continuous glucose monitoring , endocrinology , psychology , social psychology
Aims To compare the effectiveness and acceptability of self‐monitoring of blood glucose with self‐monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes. Methods We conducted a multi‐site cluster randomized controlled trial with practice‐level randomization. Participants attended a structured group education programme, which included a module on self‐monitoring using blood glucose or urine glucose monitoring. HbA 1c and other biomedical measures as well as psychosocial data were collected at 6, 12 and 18 months. A total of 292 participants with Type 2 diabetes were recruited from 75 practices. Results HbA 1c levels were significantly lower at 18 months than at baseline in both the blood monitoring group [mean ( se ) −12 (2) mmol/mol; −1.1 (0.2) %] and the urine monitoring group [mean ( se ) −13 (2) mmol/mol; −1.2 (0.2)%], with no difference between groups [mean difference adjusted for cluster effect and baseline value = −1 mmol/mol (95% CI −3, 2); −0.1% (95% CI −0.3, 0.2)]. Similar improvements were observed for the other biomedical outcomes, with no differences between groups. Both groups showed improvements in total treatment satisfaction, generic well‐being, and diabetes‐specific well‐being, and had a less threatening view of diabetes, with no differences between groups at 18 months. Approximately one in five participants in the urine monitoring arm switched to blood monitoring, while those in the blood monitoring arm rarely switched (18 vs 1% at 18 months; P < 0.001). Conclusions Participants with newly diagnosed Type 2 diabetes who attended structured education showed similar improvements in HbA 1c levels at 18 months, regardless of whether they were assigned to blood or urine self‐monitoring.