Self-monitoring of blood glucose in overweight type 2 diabetic patients
Self-monitoring of blood glucose (SBGM) is widely recommended for both type 1 and type 2 diabetic patients despite the lack of evidence of benefit in glucose control or as an aid in weight loss in type 2 subjects. This study tested the hypothesis that combined use of SMBG and dietary carbohydrate (CHO) counting, using the blood monitoring results to shape dietary CHO quotas, is beneficial in managing type 2 diabetes. Twenty-three over-weight (body mass index, BMI 27.5–44 kg/m2) patients aged 40–75 participated in a 28-week behavioral weight control program. Baseline hemoglobin HbA 1c ranged between 9.5% and 13.5% (normal range 5.5%–7.7%). Subjects were matched for weight, sex, and HbAlc and assigned to small (4–8 participants) groups which met weekly for 12 weeks and then monthly for 16 weeks. After 8 weeks, the group were randomized either to continue the behavioral program or to have SMBG and dietary CHO counting. Glucose monitoring was performed 6 times daily (pre- and 2h postprandially) for the first month, focusing on the meal increment and correlating this to dietary CHO intake. Weight loss was identical in both groups during the year of follow-up. The HbA1c level showed a progressive decline in experimental subjects (P<0.05), whereas there was no improvement in control subjects.