Article Text
Abstract
Objective We evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.
Research design and methods We conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1–2.9) times/day, 3.4 (3–3.9) times/day, and 5 (4–7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.
Results Participants in the highest tertile achieved a median change (IQR) in body weight of −10.4 kg (−7.6 to −14.4 kg) compared with −8.3 kg (−5.2 to −12.2 kg), and −6.9 kg (−4.2 to −8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of −1.25% (−0.6 to −3.1%) compared with −0.8% (−0.3% to −2%) and −0.5% (−0.2% to −1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.
Conclusions Increased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.
- self-monitoring of blood glucose
- type 2 diabetes
- obesity
- lifestyle intervention
- weight management
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Footnotes
Presented at Data from this work were presented at the 78th Scientific Sessions of the American Diabetes Association, 22–26 June 2018, Orlando, Florida, USA.
Contributors ST designed the study, collected data, conducted statistical analysis, and drafted the manuscript. NM collected data and drafted the manuscript. AM and SA collected data and reviewed and edited the manuscript. DMP contributed to the statistical analysis and reviewed and edited the manuscript. MWT collected data, contributed to the introduction section, and reviewed and edited the manuscript. OH designed the study, supervised the work, and reviewed and edited the manuscript. ST and OH are the guarantors of this work and take responsibility for its integrity and the accuracy of data analysis. All authors approved the final version of the manuscript.
Funding This is an investigator-initiated study funded internally at Joslin Diabetes Center.
Competing interests OH receives research support from the National Dairy Council; consults for Merck, Sanofi-Aventis and Abbott Nutrition; on the advisory board of Astra Zeneca and is a shareholder of Healthimation. ST is shareholder of Amarin. None of these entities supported this research in part or total.
Patient consent for publication Not required.
Ethics approval The Joslin Diabetes Center Committee on Human Studies.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No additional data are available.