Pre- and post-prandial capillary glucose self-monitoring achieves better glycaemic control than pre-prandial only monitoring

摘要

No consensus exists amongst professionals as to the timing of capillary blood glucose self-monitoring (CBGSM). No studies have addressed the timing of CBGSM in the general population with diabetes. This study was designed to compare the efficacy of pre- and post-prandial CBGSM with pre-prandial CBGSM only, in a cohort of insulin treated diabetic patients receiving a basal-bolus insulin regimen.A total of 24 patients, recruited from a diabetes review clinic, took part in a within-patient cross-over study. They were allocated, in random order, to one of two methods of CBGSM: 12 weeks pre- and post-prandial testing, followed by another 12 weeks of pre-prandial only testing (or vice versa) with a four-week washout period between. HbA_(1c), pre- and post-prandial blood glucose levels, weight and insulin dosage were used as indicators for comparing the two methods of testing.HbA_(1c) improved with both methods of monitoring but the improvement was significantly better during pre- and post-prandial monitoring (0.1% versus 0.6%; p=0.001). The mean pre-prandial blood glucose levels were significantly lower during pre- and post-prandial testing than during pre-prandial only testing (8.5 mmol/L versus 9.0 mmol/L, p=0.002). The patients' weight increased significantly during the combination testing method (2 kg, p<0.005), which was correlated with the improvement in HbA_(1c) (r=73, p<0.005), whilst there was no significant increase in weight during the pre-prandial only testing period.In patients receiving a basal-bolus insulin regimen a combination of pre- and post-prandial capillary blood glucose self-monitoring provides a better tool for achieving improved glycaemia than pre-prandial monitoring only.