J Med Assoc Thai 2016; 99 (2):125

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A Participatory Randomized Controlled Trial in Knowledge Translation (KT) to Promote the Adoption of Self-Monitoring of Blood Glucose for Type 2 Diabetes Mellitus Patients in An Urban District of Thailand
Suriyawongpaisal P Mail, Tansirisithikul R , Sakulpipat T , Charoensuk P , Aekplakorn W

Objective: To examine effectiveness of self-monitoring of blood glucose (SMBG) in glycemic control for poor control diabetes
patients, and test whether the glycemic outcome for those with the 7-point SMBG was better than those with 5-point SMBG or
usual care.
Material and Method: Randomized-controlled trial (RCT) of patients with type 2 diabetes mellitus aged 30 years or older,
HbA1c >7. Patients were randomly allocated to one of three groups; 7-point SMBG, 5-point SBMG and control group.
Differences in HbA1c at 6 months and baseline were compared among groups.
Results: A total of 191 patients with poor control of diabetes were included. Compared with baseline, at 6 months, average
change in HbA1c among control, 7-point, and 5-point SMBG were -0.38, -0.87, and -0.99 (p = 0.04), respectively. The
corresponding percentages of patients with reduced HbA1c were 57.1%, 77.6% and 75.5%, respectively (p = 0.03). Using different cut-off values for HbA1c (<7 and <7.5) resulted in different percentage distribution of T2DM patients among the 3 groups, yet the differences were not statistically significant. Reductions in body weight were observed in both SMBG groups
but not in the control group.
Conclusion: Using RCT on participatory basis, SMBG with individual dietary counseling was effective in short term. Further
engagement with the provider team, the patients/care takers and the health care financing agency to integrate SMBG in the
care protocol for poor control diabetes should be considered.

Keywords: Randomized controlled trial, Self-monitoring blood glucose, Diabetes


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