"Frequent blood glucose (BG) monitoring is a critical component of diabetes management, yet many barriers exist to consistent monitoring," write C. Moreland, MD, from the Joslin Diabetes Center in Boston, Mass, and colleagues. "Recognizing the link between BG monitoring and improved glycemic control, [we] designed an educational booklet, the Blood Sugar Monitoring Owner's Manual (BGMOM), with the goal of improving the physical and emotional well-being of patients with diabetes by increasing adherence to BG monitoring."

Of the 199 participants who were recruited from a multidisciplinary diabetes clinic and who had high-risk diabetes (hemoglobin A1C, >/= 8.0%), 35% had type 1 diabetes mellitus. These 199 participants were randomized to 1 of 3 groups: BGMOM intervention (BGM+), attention control (BG meter only [MT]), or standard care. The BGM+ and MT groups received BG meters and meter education, and the BGM+ group also received BGMOM booklets. During 6 months of follow-up, the investigators determined BG monitoring frequency and hemoglobin A1C measurement.

Monitoring frequency increased significantly in the BGM+ group, from 1.9 ± 1.3 to 2.8 ± 1.5 times daily (P < .001). In the MT group, monitoring frequency increased only slightly, from 1.7 ± 1.3 to 2.0 ± 1.3 times daily. The BGM+ group had the greatest improvement in hemoglobin A1C level (BGM+, -0.13 ± 1.28; MT, -0.04 ± 1.31; standard care, 0.04 ± 1.10) and the highest percentage of those who improved glycemic control (61% vs 44% in the other groups; P = .05). Compared with the other groups, the BGM+ group displayed the most knowledge about the definition of hemoglobin A1C (P = .04) and reported the least amount of negative effect concerning out-of-range BG monitoring results (P = .03).