Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Use of structured self-monitoring of blood glucose improves HbA1c without increasing diabetes-related distress in Australian adults with non-insulin-treated type 2 diabetes: Preliminary results of the STeP IT UP Trial (#337)

Jane Speight 1 2 , Jessica L Browne 1 2 , George Koumantakis 3 , Alan Barclay 4 , Hilton Shapiro 5 , Gary Deed 6 , Tracy Hunter 7 , Walter Koehler 8 , Luisa Capezio 3 , Matthias A Schweitzer 9 , Bettina Petersen 9
  1. The Australian Centre for Behavioural Research in Diabetes, Melbourne , VIC, Australia
  2. Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, Burwood, Victoria, Australia
  3. Roche Diagnostics Australia, Sydney, NSW
  4. Diabetes NSW, Sydney, NSW
  5. Private Practice, Mascot, VIC
  6. Clinical and Natural Health Centre, Coorparroo, QLD
  7. Roche Diagnostics, Indianapolis, Indiana, USA
  8. Baseline Statistics, Frankfurt, Germany
  9. Roche Diagnostics GmbH, Mannheim, Germany

Background: Structured self-monitoring of blood glucose (SMBG) involves gathering blood glucose data to a defined regimen (e.g. 3-day, 7-point profiles), interpreting and then using those data to make appropriate pharmacologic and/or lifestyle adjustments. The benefits of ‘structured SMBG’ have been demonstrated in US/European studies but generalizability has not yet been demonstrated in Australia.

Methods: The Structured Testing Program Implementation Trial (STeP IT UP) assessed the impact of ‘structured SMBG’ on HbA1c and diabetes-related distress (DDS) in 98 adults with non-insulin treated type 2 diabetes, with suboptimal HbA1c (>7.5%) at baseline and managed in primary care settings across Australia: 38% women, mean [SD] age 62[12] years, BMI 31.7[6.3] kg/m2, HbA1c 8.6[1.1]%. In this 24-week, multi-centre, observational study, primary care clinicians with ‘structured SMBG’ experience trained participants to use and interpret the Accu-Chek 360° View paper tool. Participants completed the tool prior to their visits at weeks 4, 12 and 24; results were discussed at each visit.

Results: 98 participants had HbA1c measurements available at screening and weeks 12 and 24. Reductions in HbA1c from week 4 were seen at weeks 12 and 24 (-0.95[1.26]%, P<0.0001; ‑1.15[1.40]%, P<0.0001, respectively), with no increase in hypoglycaemia (<4 mmol/L). Reductions in percentage of high glucose values (>10 mmol/L) were seen at weeks 12 and 24 (-8.3[22.9]%, P=0.0017; -9.7[28.9]%, P=0.0036, respectively). Slight decrease in diabetes-related distress was seen at week 12 (-0.16[0.74], P=0.0609) becoming significant by week 24 (-0.22[0.83], P=0.0226).

Conclusions: In this observational study, use of ‘structured SMBG’ by Australian adults with non-insulin-treated type 2 diabetes, supported by their primary care clinicians, appears to significantly improve glycaemic control and reduce diabetes-related distress. While the lack of control group is a limitation, these findings support previous RCT evidence and suggest that ‘structured SMBG’ can be effective for adults with non-insulin-treated type 2 diabetes.

This study was supported by Roche Diagnostics Australia & Roche Diagnostics GmbH