Laura Young|John B. Buse|Mark A. Weaver|Maihan B. Vu|C. Madeline Mitchell|Tamara Blakeney|Kimberlea Grimm|Jennifer Rees|Franklin Niblock|Katrina E Donahue
Glucose Self-monitoring in Non–Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina Health Care|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill
value selfmonitoring blood glucose smbg levels patients noninsulintreated type 2 diabetes debatedto compare 3 approaches smbg effects hemoglobin a1c levels healthrelated quality life hrqol among people noninsulintreated type 2 diabetes primary care practicethe monitor trial study pragmatic openlabel randomized trial conducted 15 primary care practices central north carolina participants randomized january 2014 july 2015 eligible patients type 2 noninsulintreated diabetes older 30 years established primary care physician participating practice glycemic control hemoglobin a1c levels higher 65 lower 95 within 6 months preceding screening obtained electronic medical record willing comply results random assignment study group 1032 assessed eligibility 450 randomizedno smbg oncedaily smbg oncedaily smbg enhanced patient feedback including automatic tailored messages delivered via metercoprimary outcomes included hemoglobin a1c levels hrqol 52 weeksa total 450 patients randomized 418 929 completed final visit significant differences hemoglobin a1c levels across 3 groups p 74 estimated adjusted mean hemoglobin a1c difference smbg messaging vs smbg 009 95 ci 031 014 smbg vs smbg 005 95 ci 027 017 also significant differences found hrqol notable differences key adverse events including hypoglycemia frequency health care utilization insulin initiationin patients noninsulintreated type 2 diabetes observed clinically statistically significant differences 1 year glycemic control hrqol patients performed smbg compared perform smbg addition type tailored feedback provided messaging via meter provide advantage glycemic controlclinicaltrialsgov identifier nct02033499