Use of an integrated strip-free blood glucose monitoring system increases frequency of self-monitoring and improves glycemic control: Results from the ExAct study

• Published in: Journal of clinical & translational endocrinology Vol. 1; no. 4; pp. 161 - 166
• Main Authors: Maran, Alberto, MD, Tschoepe, Diethelm, MD, Di Mauro, Maurizio, MD, Fisher, William A., PhD, Loeffler, Kurt, PhD, Vesper, Iris, MS, Bloethner, Sandra, PhD, Mast, Oliver, MSc, Weissmann, Joerg, MD, Amann-Zalán, Ildikó, MD, Moritz, Annette, PhD, Parkin, Christopher G., MS, Kohut, Taylor, MSc, Cranston, Iain, MD, FRCP
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-12-2014; Elsevier
• Subjects: Adherence; Endocrinology & Metabolism; Glycemic control; HbA1c; Insulin; Integrated strip-free system; Research Paper; Self-monitoring of blood glucose; SMBG; Testing frequency; Type 1 diabetes; Type 2 diabetes; Adherence; Type 2 diabetes; Glycemic control; Type 1 diabetes; Self-monitoring of blood glucose; SMBG; Integrated strip-free system; Testing frequency; Insulin; HbA1c
• ISSN: 2214-6237; 2214-6237
• DOI: 10.1016/j.jcte.2014.08.003

Abstract Aims We investigated the impact of using an integrated, strip-free system compared to the use of single-strip systems on testing frequency and glycemic control in individuals with insulin-treated diabetes. Methods This multinational, comparative, cluster-randomized, observational study included 311 patients with type 1 and insulin-treated type 2 diabetes who were performing SMBG at suboptimal frequencies. Sites were cluster-randomized to “integrated strip-free” system (EXP group) or any “single-strip” system (CNL group). Testing frequency and HbA1c were measured at baseline, 12 weeks and 24 weeks. Results At week 24, the EXP group showed an increase in SMBG frequency from baseline of 4.17 tests/week (95% CI 2.76, 5.58) compared with an increase of 0.53 tests/week (95% CI −0.73, 1.79) among CNL patients, resulting in a between-group difference of 3.63 tests/week ( p  < 0.0002). Mixed-effects models for repeated measurements (MMRM) controlling for baseline frequency of testing, country and clinical site confirmed a higher SMBG testing frequency in the EXP group compared to the CNL group, with a between-group difference of 2.70 tests/week ( p  < 0.01). Univariate analysis showed greater HbA1c reductions in the EXP group than CNL group: −0.44% (95% CI −0.59, −0.29) vs. −0.13% (95% CI −0.27, 0.01), respectively, p  < 0.0002. MMRM analyses confirmed these HbA1c reductions. A greater percentage of EXP than CNL patients achieved HbA1c reductions of ≥0.5%: 45.1% vs. 29.1%, respectively, p  < 0.01. Conclusions The use of an integrated, strip-free SMBG system improved testing adherence and was associated with improvements in glycemic control.