BACKGROUND: Daily self-monitored blood glucose testing is recommended for patients with insulin-treated type 2 diabetes. However, most patients do not test frequently enough for optimal glycemic control. Less frequent testing may be sufficient for assessing glycemic control among stable patients as well as improving patient compliance. The study objective was to evaluate the weekly contribution of glucose readings to hemoglobin (Hb)A1c during an 8-week period of intensified self-monitored blood glucose testing. METHODS: The authors randomly selected stable, insulin-treated subjects with type 2 diabetes. Subjects monitored their blood glucose four times daily for 8 weeks; the authors then downloaded glucose meters and measured an HbA1c. Mean blood glucose values were calculated for each of the 8 weeks. Multiple linear regression analyses examined the contribution of these mean values to the HbA1c. RESULTS: A total of 182 subjects completed the monitoring protocol; mean HbA1c was 7.63 +/- 1.42%, mean glucose was 9.78 +/- 2.27 mmol/L, the regression correlation was 0.77, P < 0.001. A fitted multiple linear model using all 8 weekly mean blood glucose values showed large variation in their independent contributions to the HbA1c. Mean blood glucose values from consecutive weeks were highly correlated and did not provide independent information about glycemic control. Stepwise regression showed that the mean blood glucose values from weeks 4, 6, and 8 significantly and equally influenced HbA1c. CONCLUSIONS: Glycemic control can be efficiently assessed by reviewing at least 5 weeks' worth of monitoring results, focusing on alternate weeks and giving less weight to more remote readings.
BACKGROUND: Daily self-monitored blood glucose testing is recommended for patients with insulin-treated type 2 diabetes. However, most patients do not test frequently enough for optimal glycemic control. Less frequent testing may be sufficient for assessing glycemic control among stable patients as well as improving patient compliance. The study objective was to evaluate the weekly contribution of glucose readings to hemoglobin (Hb)A1c during an 8-week period of intensified self-monitored blood glucose testing. METHODS: The authors randomly selected stable, insulin-treated subjects with type 2 diabetes. Subjects monitored their blood glucose four times daily for 8 weeks; the authors then downloaded glucose meters and measured an HbA1c. Mean blood glucose values were calculated for each of the 8 weeks. Multiple linear regression analyses examined the contribution of these mean values to the HbA1c. RESULTS: A total of 182 subjects completed the monitoring protocol; mean HbA1c was 7.63 +/- 1.42%, mean glucose was 9.78 +/- 2.27 mmol/L, the regression correlation was 0.77, P < 0.001. A fitted multiple linear model using all 8 weekly mean blood glucose values showed large variation in their independent contributions to the HbA1c. Mean blood glucose values from consecutive weeks were highly correlated and did not provide independent information about glycemic control. Stepwise regression showed that the mean blood glucose values from weeks 4, 6, and 8 significantly and equally influenced HbA1c. CONCLUSIONS: Glycemic control can be efficiently assessed by reviewing at least 5 weeks' worth of monitoring results, focusing on alternate weeks and giving less weight to more remote readings.
Authors: David B Sacks; Mark Arnold; George L Bakris; David E Bruns; Andrea Rita Horvath; M Sue Kirkman; Ake Lernmark; Boyd E Metzger; David M Nathan Journal: Diabetes Care Date: 2011-06 Impact factor: 19.112
Authors: Graham R Law; Mark S Gilthorpe; Anna L Secher; Rosemary Temple; Rudolf Bilous; Elisabeth R Mathiesen; Helen R Murphy; Eleanor M Scott Journal: Diabetologia Date: 2017-01-19 Impact factor: 10.122
Authors: David M Nathan; Judith Kuenen; Rikke Borg; Hui Zheng; David Schoenfeld; Robert J Heine Journal: Diabetes Care Date: 2008-06-07 Impact factor: 19.112