Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity

Abstract

Objective: We evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.

Research design and methods: We conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1-2.9) times/day, 3.4 (3-3.9) times/day, and 5 (4-7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.

Results: Participants in the highest tertile achieved a median change (IQR) in body weight of -10.4 kg (-7.6 to -14.4 kg) compared with -8.3 kg (-5.2 to -12.2 kg), and -6.9 kg (-4.2 to -8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of -1.25% (-0.6 to -3.1%) compared with -0.8% (-0.3% to -2%) and -0.5% (-0.2% to -1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.

Conclusions: Increased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.

Keywords: lifestyle intervention; obesity; self-monitoring of blood glucose; type 2 diabetes; weight management.

Conflict of interest statement

Competing interests: OH receives research support from the National Dairy Council; consults for Merck, Sanofi-Aventis and Abbott Nutrition; on the advisory board of Astra Zeneca and is a shareholder of Healthimation. ST is shareholder of Amarin. None of these entities supported this research in part or total.

Figures

Figure 1

Median change (IQR) in (A) body weight and (B) A1C across SMBG tertiles at 12 weeks . n=14 in each tertile. Mean (range) SMBG frequency was 2.3 (1.1 to 2.9) times per day in the lowest tertile, 3.4 (3 to 3.9) times per day in the middle tertile, and 5 (4 to7.7) times per day in the highest tertile.