Document Detail


The relationship between self-monitoring of blood glucose results and glycated haemoglobin in type 2 diabetes: The Fremantle Diabetes Study.
MedLine Citation:
PMID:  21862165     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The benefits of self-monitoring of blood glucose (SMBG) in type 2 diabetes remain contentious. If SMBG data do not accurately reflect HbA(1c), attempts to modify lifestyle/pharmacotherapy will be ineffective. We aimed to determine how well SMBG correlates with HbA(1c) and fasting serum glucose (FSG). Community-based type 2 patients using SMBG provided their highest and lowest pre- and post-prandial glucose results in the week before detailed assessment. The ability of average pre- and post-prandial SMBG to predict HbA(1c)>7.0% was determined by linear regression and receiver operating characteristic (ROC) analyses. Of 1286 patients with known SMBG status, 70% reported using SMBG. Pre-prandial SMBG data were obtained from 554 participants and post-prandial SMBG data from 418. The mean SMBG result and HbA(1c) correlated significantly (pre-prandial r(s)=0.55, post-prandial r(s)=0.47; P<0.001). Areas under the ROC curve (95% confidence limits) were 0.78 (0.74-0.83) and 0.74 (0.69-0.78) for pre- and post-prandial SMBG (P<0.04). The optimal cut-point was 6.5mmol/L for pre-prandial SMBG (sensitivity 79.3%, specificity 64.4%). Mean pre-prandial SMBG results correlated with FSG (r(s)=0.64, P<0.001) but were on average 1.4mmol/L lower, consistent with known whole blood vs. plasma differences. Since SMBG values reflect prevailing glycaemia, refinements in their interpretation and application may improve SMBG effectiveness.
Authors:
S A Paul Chubb; Kylie Van Minnen; Wendy A Davis; David G Bruce; Timothy M E Davis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-19
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  -     ISSN:  1872-8227     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
University of Western Australia, School of Pathology and Laboratory Medicine and Department of Biochemistry, PathWest Laboratory Medicine WA, Fremantle Hospital, Western Australia, Australia.
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