Title

Once Per Week Self-Monitoring Of Blood Glucose Is Sufficient To Maintain Glycemic Control

Clinical Question

For adult diabetic patients, does administering the SMBG (self-monitored blood glucose) test several times per week diagnose the level of glycemic control more accurately than administering the SMBG test once per week?

Clinical Bottom Line

One SMBG test per week is as effective as four SMBG tests per week in diagnosing the diabetic patient’s level of glycemic control when compared to Hba1c gold standard. (See Comments on the CAT below)

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
18769484	Scherbaum/2008	202 Patients with Type 2 Diabetes, 100 were randomly assigned to the low and 102 to the high group.	Randomized Controlled Trial
Key results	A difference from baseline HbA1c% to 6 months of 0.24 in the low frequency group and of 0.16 in the high frequency group was observed, which was not statistically significant. The results of this study show that one SMBG per week is as sufficient and safe as four SMBG per week to maintain HbA(1)c in diabetic patients.
18619176	Bajkowska-Fiedziukiewicz/2008	600 Patients with Type 2 Diabetes were randomly grouped into 6 levels of testing frequency.	Randomized
Key results	The mean values of glucose and Hba1c levels did not vary significantly between the different groups. Study reported no correlation between the frequency of SMBG and HbA1C test results.

Evidence Search

"Diabetes Mellitus"[Mesh] AND "Blood Glucose Self-Monitoring"[Mesh] AND "Frequency"[All Fields]

Comments on
The Evidence

The best available evidence is from a randomized controlled trial which investigated two glycemic testing regimens for 202 subjects (Scherbaum et al. 2008). One group was assigned to low frequency of SMBG testing (one test per week) and the other group assigned to high frequency of SMBG testing (four tests per week). Primary outcome parameter was the change in HbA1c (gold standard for measuring glycemic control over 2-4 month period) between baseline and 6 months for the two groups. Secondary outcome parameters were safety, compliance and HbA1c at 3 and 12 months. Compliance with the testing regimen was 82-90% in both groups. There was a difference from baseline HbA1c% to 6 months of 0.24 in the low frequency group and of 0.16 in the high frequency group. The results of this study show that one SMBG per week is as sufficient and safe as four SMBG per week to maintain HbA(1)c in diabetic patients. Additionally Bajkowska-Fiedziukiewicz et al. (2008) also reported no correlation between the frequency of SMBG and HbA1C test results.

Applicability

These results are relevant to all diabetic patients who are practicing self monitored blood glucose testing, or would be interested in starting a self monitoring regimen, as a means of diagnosing/assessing their level of glycemic control.

Specialty

(General Dentistry) (Oral Surgery) (Periodontics) (Restorative Dentistry)

Keywords

Periodontics, Self Monitored Blood Glucose Test (SMBG), frequency and Hba1c.

ID#

263

Date of submission

11/19/2009

E-mail

pedalino@livemail.uthscsa.edu

Author

Peter M. Pedalino, DDS

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Faculty mentor e-mail

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

by Han Truong Hayslett (San Antonio, TX) on 04/11/2012
I did a PubMed search on April, 2012. The author has the most current and highest level of evidence available answering the clinical question.

by Robert Lemke, DDS, MD (San Antonio, TX) on 02/25/2014
Nice review. I have found this to generally be true in a clinical sense, however, do recall an article that showed significantly less bone loss in the posterior when four implants were used over two. While the patients may not know differently, they preserve more of their mandible’s bone with four implants.