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Defeat Diabetes
150 153rd Ave,
Suite 300

Madeira Beach, FL 33708

Structured Diabetes Management Can Significantly Improve Overall Glycemic Control and Reduce A1c

Posted: Sunday, April 17, 2011

An innovative diabetes management concept including structured self-monitoring of blood glucose (SMBG), data visualization, pattern analysis and derived therapy adjustments can significantly reduce HbA1c values, improve glycemic control and enhance patients' quality of life.

These are the key findings of the 12-month data from the Structured Testing Protocol (STeP) Study presented at an exclusive event on effective and structured diabetes management held in London last month.

Self-monitoring of blood glucose (SMBG) is a well-established element of therapy management for people with Type 1 or Type 2 diabetes on insulin therapy. However, there have been controversial views on the question of whether regular SMBG is similarly beneficial for non-insulin treated people with Type 2 diabetes. To gain new insights on this subject, the STeP Study was performed: a prospective, cluster-randomized, multi-center clinical trial, which examined the impact of structured SMBG upon glycemic control in 483 non-insulin treated people with Type 2 diabetes who evidenced poor glycemic control (HbA1c ≥ 7.5%) at baseline. The results provide new and significant evidence on its effectiveness.

Participants were recruited from various primary care practices across the eastern United States. Practices were randomly assigned to an active control group (ACG; n=227) or to a structured testing group (STG; n=256). Duration of the study was 12 months, and evaluations of clinical parameters were performed at baseline and during scheduled visits at months 1, 3, 6, 9 and 12. During the visits, healthcare professionals obtained relevant laboratory data, and all participants completed questionnaires relating to their quality of life. Patients in the ACG received enhanced usual care, complying with U.S. standard of care recommendations. STG patients received the same care, but their protocol was complemented by the SMBG-focused structured diabetes management concept. Patients in both groups received free BG monitors and strips.

The innovative concept is based on structured 7-point blood glucose profiles (fasting, preprandial and 2-hour postprandial at each meal, and bedtime), collected and documented over 3 consecutive days prior to each scheduled quarterly healthcare professional visit. To document blood glucose values, meal sizes and energy levels, and to comment on their SMBG experiences, STG participants used the Accu--Chek® 360° View 3-day profile tool. They discussed the obtained profiles with their caregivers at all medical visits. To familiarize them with the protocol, patients in the STG arm of the study received a standardized training in SMBG and pattern analysis, while their doctors were equally trained and equipped with an algorithm suggesting appropriate medication strategies.

Source:, Diabetes Care, April 2011.

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