Online reporting of blood glucose may lower HbA1c in diabetes patients on oral meds
The results suggest that highly adherent diabetes patients who self-monitor their blood glucose could benefit from reporting their results, study authors concluded.
Frequent blood glucose self-monitoring coupled with regular online feedback from a clinician helped lower HbA1c in patients taking oral medications, a recent study found.
Researchers analyzed the medical charts of 191 patients recommended for the Internet Blood Glucose Monitoring System (IBGMS). Patients were instructed to test their blood glucose before meals and report back to their clinicians online on a biweekly basis. Patients were also offered the same short-term and yearly follow-up appointments as non-IBGMS patients. Results were published online on April 29 by BMJ Open Diabetes Research & Care.
A multiple regression analysis showed that frequency of reporting had an inverse correlation to HbA1c (P<0.05), whereas frequency of blood glucose self-monitoring, age, and weight did not significantly affect HbA1c. Researchers observed no relationship between the number of patients' diabetes complications and their testing or reporting frequency.
To examine the effect of reporting on self-monitoring, they conducted an analysis using frequency of reporting as a dependent variable against frequency of testing. The frequent tester subgroup (those who tested their blood glucose roughly 2 times or more per day) showed a difference in HbA1c: 7.4±0.2% in frequent reporters (more than 1 report per 3-month interval) compared to 7.9±0.4% in infrequent reporters (1 or fewer reports per 3-month interval). The interval of 1 report every 3 months was chosen to simulate the typical frequency of follow-up by an endocrinologist. The infrequent testing group did not show a similar statistically significant difference.
The positive correlation between monitoring and reporting frequency suggests that highly adherent patients self-monitoring their blood glucose could benefit from reporting their results, according to the study authors. “Further investigation into an interactive effect between [self-monitoring] and reporting suggests that only frequent testers may see the benefit of reporting their sugars,” they wrote.
The authors noted limitations to the retrospective study, such as how the time frame for each patient's data was not controlled, which may have led to differences in reporting consistency. They added that the patient subgroups were unequally distributed, which resulted in less power in the infrequent testing group to detect differences.