The effect of simplified paired self-monitoring of blood glucose in patients with type 2 diabetes mellitus with persistent poor glycemic control

Aims: To investigate the effectiveness of paired self-monitoring of blood glucose (SMBG) in patients with persistent elevated hemoglobin A1C (A1C) under complex regimens. Methods: Patients with type 2 diabetes mellitus who had poor glycemic control with complex anti-hyperglycemic regimens were recruited for this study. During 3 months of intervention, at least 3 sets of paired SMBG (breakfast, lunch and dinner) in a week were proposed and scheduled consultations with a care team were arranged. After the program ended, a 9-month extension study was conducted to explore the A1C change. Results: The A1C level of the 33 patients enrolled was significantly improved as compared with that of the 30 controls 3 months after intervention (9.6 to 8.1%; P < 0.001). The improvement of glycemic control was maintained for 12 months. The A1C improvement was associated with a reduction of preprandial blood glucose (8.5 to 7.3 mmol/l; P < 0.05), post-prandial blood glucose excursion (2.9 to 2.0 mmol/l; P < 0.05), and SMBG frequency (r = -0.38; P = 0.029). Conclusions: A simplified paired SMBG accompanied by diet and physical activity recording may be helpful in patients with type 2 diabetes mellitus with persistent poor glycemic control.