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

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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. HbA1c, pre- and post-prandial blood glucose levels, weight and insulin dosage were used as indicators for comparing the two methods of testing.HbA1c 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 HbA1c (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. Copyright © 2005 John Wiley & Sons, Ltd.

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