NEW YORK (Reuters Health) Nov 29 - A self-monitoring program built around mealtime blood glucose measurements helps improve glycemic control in most non-insulin treated type 2 diabetic patients, German researchers report in the November issue of Diabetes Care.

Dr. Ulrich Schwedes of General Hospital Barmbek, Hamburg, and colleagues note that "monitoring blood glucose status is an important tool in diabetes treatment procedures." To investigate whether a structured approach to such monitoring might be helpful, the researchers conducted a study of more than 200 non-insulin treated type 2 diabetics.

They were randomized to a control or intervention group. Those in the intervention group used a blood glucose monitoring device before and after 3 main meals on 2 days a week, and kept a daily diary covering general well being, details of meals and blood glucose levels.

They also received standard counseling. The control group received nonstandard counseling on their diet and lifestyle.

At the end of the 6-month study, use of the glucose monitoring device led to a 1.0% reduction in hemoglobin a1c levels, significantly more than the 0.54% reduction seen in the control group. There was also a marked improvement in general well being.

Body weight, total cholesterol and microalbumin also showed improvements, but there were no significant between-group differences.

Overall, the researchers, who note that the intervention was well received and that there was a high rate of compliance, conclude that the approach can lead to a significant improvement in glycemic control.

Furthermore, Dr. Schwedes told Reuters Health that "knowledge of the actual value of blood glucose helps patients to handle their illness in a better way." This appears to be true, he pointed out, of "all patients with diabetes," not only those receiving insulin therapy.

Diabetes Care 2002;25:1928-1932.