Document Detail


Postprandial glucose monitoring further improved glycemia, lipids, and weight in persons with type 2 diabetes mellitus who had already reached hemoglobin A1c goal.
MedLine Citation:
PMID:  22538137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postprandial hyperglycemia contributes to poor glucose control and is associated with increased cardiovascular risk in type 2 diabetes mellitus (T2DM). The objective of the study was to determine the effect of postprandial self-monitoring of blood glucose (pp-SMBG) on glucose control, lipids, body weight, and cardiovascular events.
METHOD: Subjects with T2DM hemoglobin A1c (A1C) between 6.5 to 7.0% were randomized into the study group (at least two pp-SMBG a day and dietary modification based on glucose readings) and control group (dietary modification based on glucose readings but no mandatory pp-SMBG) for a 6-month, observational study. Oral antidiabetic drugs or insulin regimen was unchanged in either group if A1C remained less than 7.0% during the study. End points included A1C, lipids, body weight, and cardiovascular events.
RESULTS: One hundred sixty-nine subjects, mean age 63 years, and body weight 88 kg were recruited. Hemoglobin A1c, weight, low-density lipoprotein (LDL), and triglycerides (TGs) were similar in the groups at baseline. By the end of 6 months, A1C (6.7 ± 0.1 to 6.4 ± 0.1%, p < .05), body weight (88.5 ± 7.3 to 85.2 ± 6.3 kg, p < .05), LDL (92.3 ± 2 8.4 to 81.1 ± 22.6 mg/dl, p < .05), and TGs (141 ± 21 to 96 ± 17 mg/dl, p < .05) decreased in the study group, but did not change in the control group. No cardiovascular events were observed in either group during the 6-month study period.
CONCLUSIONS: In T2DM subjects who had already reached their A1C goal, pp-SMBG at least twice a day was associated with further improvement in glycemia, lipids, and weight, as well as exercise and dietary habit. We assume that lifestyle modification promoted by postprandial hyperglycemia awareness may underlie these findings. These results substantiate the importance of implementing pp-SMBG into lifestyle modification, and emphasize that pp-SMBG is critical in the control of T2DM.
Authors:
David A Zhang; Laurence Katznelson; Ming Li
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2012-03-01
Journal Detail:
Title:  Journal of diabetes science and technology     Volume:  6     ISSN:  1932-2968     ISO Abbreviation:  J Diabetes Sci Technol     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-04-27     Completed Date:  2012-08-20     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  101306166     Medline TA:  J Diabetes Sci Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-93     Citation Subset:  IM    
Copyright Information:
© 2012 Diabetes Technology Society.
Affiliation:
Dartmouth College, Hanover, New Hampshire, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Awareness
Biological Markers / blood
Blood Glucose / drug effects,  metabolism*
Blood Glucose Self-Monitoring*
Body Weight* / drug effects
Cardiovascular Diseases / etiology
Diabetes Mellitus, Type 2 / blood,  complications,  diagnosis*,  drug therapy,  physiopathology
Dietary Carbohydrates / administration & dosage
Energy Intake
Exercise
Female
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated / metabolism*
Humans
Hypoglycemic Agents / therapeutic use
Lipids / blood*
Male
Middle Aged
Postprandial Period*
Predictive Value of Tests
Risk Reduction Behavior*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Blood Glucose; 0/Dietary Carbohydrates; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Lipids; 0/hemoglobin A1c protein, human
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