ACT: Actions with the CONTOUR Blood Glucose Meter and Behaviors in Frequent Testers
Year: 2010 Abstract Number: 2063-PO Authors: RICHARD M. BERGENSTAL, BRUCE BODE, RONALD TAMLER, DACE L. TRENCE, JEANELLEN FULLAM, PATRICIA STENGER, HOLLY C. SCHACHNER, SCOTT PARDO, TANISHA BROWN, RASHONDA JACKSON, DORI KHAKPOUR, ARLENE M. MONK, WILLIAM A. FISHER Institutions:
Minneapolis, MN, Atlanta, GA, New York, NY, Seattle, WA, Tarrytown, NY, London, ON, Canada
Results: Self monitoring of blood glucose (SMBG) is a self-management tool for patients with diabetes. Features on blood glucose (BG) meters, such as meal markers for pre- and post-prandial BG levels and reminders for post-prandial testing, may prompt more focused self management, especially around mealtimes. This 6-month randomized, multicenter study evaluated if use of a BG meter (Bayer's CONTOUR) with meal marker + audible reminder and diabetes education maintains or increases frequency of post-prandial testing in frequent testers compared to diabetes education and standard meter features alone. The impact of the 2 trial conditions on patients' SMBG information, motivation, and behavioral skill, and via changes in these parameters, on SMBG practice and decision-making was evaluated. Subjects (n = 211) had type 1 (n = 120) or type 2 (n = 90) diabetes, used meal-time insulin at least 1 meal per day and tested their BG levels at least 3 times per day. Subjects received diabetes education and were randomized to Basic (no meal marker or reminder) or Advanced (meal marker + reminder) and were instructed to record BG levels in their logbook. Subjects were seen at baseline, 6 weeks, 3 months, and 6 months with no mandated actions between visits. Baseline testing frequency was self-reported, and meters were downloaded at visit 2-4. For the primary endpoint of frequency of post-prandial testing, the Advanced testing group had significantly more frequent weekly post-prandial tests (Table 1) and significantly more paired pre- and post-prandial tests than the Basic group at each follow-up.
Table 1: Post-prandial Weekly Tests
|
|
Visit 2
6 weeks
|
Visit 3
12 weeks
|
Visit 4
24 weeks
|
V3-V2
|
V4-V3
|
|
Basic
|
9.2
|
7.9
|
7.1
|
P <0.01
|
P = 0.07
|
|
Advanced
|
13.0
|
12.1
|
10.1
|
P = 0.01
|
P = 0.001
|
|
P values (Basic vs Advanced)
|
<0.001
|
<0.001
|
<0.001
|
|
|
Both groups had significant declines in A1c values (Basic 8.3 to 7.9 and Advanced 8.0 to 7.8). Correlation of changes in SMBG information, motivation, and behavioral skills as they relate to changes in A1c may provide further insight. Current findings demonstrate that a meter with a meal marker + audible reminder increases post-prandial and paired testing.
Principal Investigators
|
Richard M. Bergenstal, MD
|
International Diabetes Center, Minneapolis, MN
|
|
Bruce W. Bode, MD
|
Atlanta Diabetes Center, Atlanta, GA
|
|
Ronald Tamler, MD, PhD, MBA
|
Mount Sinai School of Medicine New York, NY
|
|
Dace Trence, MD, FACE
|
University of Washington Medical Center, Seattle, WA
|