Urine, blood glucose self-monitoring equally effective for new type 2 patients

Patients with newly diagnosed type 2 diabetes had equal improvement in HbA1c whether they self-monitored by testing their blood or urine glucose, a study found.

Researchers conducted a randomized, controlled trial with 292 type 2 diabetes patients from 75 practices in the U.K. All patients attended a structured education program that included a section on self-monitoring via blood or urine glucose. Patients were randomized at the practice level (cluster randomization) to the blood or urine glucose monitoring arms but were free to change their method of monitoring or to stop self-monitoring at any time. The main outcome was mean HbA1c level at 18 months; secondary outcomes included biomedical and psychosocial variables measured at 6, 12, and 18 months, including lipid profile, body weight, treatment satisfaction treatment, and well-being. Results were published online Nov. 5 by Diabetic Medicine.

HbA1c levels were significantly reduced at 18 months compared to baseline in both groups, with no difference between groups (mean change in HbA1c of −1.1% for blood glucose group and −1.2% for urine glucose group). About 18% of patients in the urine monitoring group switched to blood monitoring, while only 1% in the blood monitoring group switched to urine monitoring (P<0.001). Both groups had improvements in body mass index, weight, blood pressure, waist circumference, and cholesterol at each follow-up point, most of which were significant; these improvements didn't differ by group. Both groups also had improvements in total treatment satisfaction, overall well-being, and diabetes-specific well-being and a less threatening view of diabetes; most of these changes were also significant and didn't differ by group.

The results indicate that urine glucose monitoring is as effective as blood glucose monitoring in the first 18 months after diagnosis and could lead to “substantial cost savings without impairing outcomes,” the authors wrote. The significant number of patients who switched from urine to blood monitoring, however, suggests many may find blood monitoring preferable, they added.