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The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin
Dissertation (MSc)--University of Pretoria, 2016.
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| Format: | Thesis |
| Language: | English |
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University of Pretoria
2017
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| _version_ | 1867613498901528576 |
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| access_status_str | Open Access |
| author2 | Rheeder, Paul |
| author_browse | Rheeder, Paul |
| author_facet | Rheeder, Paul |
| collection | Thesis |
| dc_rights_str_mv | @ 2017 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Dissertation (MSc)--University of Pretoria, 2016. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/58769 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:37:06.816Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/58769 The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin Rheeder, Paul Van Zyl, Danie G. Kalweit, Kerry Leigh Diabetes Epidemiology Insulin titration Type 2 diabetes mellitus (T2DM) UCTD Health sciences theses SDG-03 Health sciences theses SDG-17 Dissertation (MSc)--University of Pretoria, 2016. Background: Self-monitoring of blood glucose (SMBG) can inform on the timing of hyperglycaemia; however there is currently no standardised approach to utilise these data to improve glycaemic control in type 2 diabetes patients. Aims: To assess the efficacy of structured blood glucose testing in guiding an insulin titration algorithm in poorly controlled, insulin-treated type 2 diabetes patients. The secondary aim was to compare change in HbA1c between the study subjects and matched controls receiving standard treatment. Methods: This six-month prospective intervention recruited 39 poorly controlled (HbA1C ≥ 8.5% or 69.4 mmol/mol), type 2 diabetes subjects using twice-daily biphasic insulin from two public hospitals in Tshwane, South Africa. Patients were asked to perform structured SMBG over 4 weeks and return monthly for consultations where physicians titrated insulin doses using a standardised algorithm guided by the data collected. Post-hoc analysis was performed to assess glycaemic control of study participants compared to those receiving standard treatment. Results: It was found that mean HbA1c decreased over the study period by 1.89% (95% CI: -2.46 to -1.33, p-value<0.001). Mean SMBG and mean fasting plasma glucose (FPG) decreased by 1.6 mmol/L (95% CI: -2.5 to -0.6 mmol/L, p-value: 0.002) and 1.5 mmol/L (95% CI: -2.2 to -0.2 mmol/L, p-value: 0.024), respectively. Hypoglycaemic event rate (≤3.9 mmol/L) was 33.08 events per patient-year. Total daily insulin use increased by a mean 40.12 units.day-1 (SE: 7.7, p-value<0.001); weight increased by an average 3.98 kg (95% CI: 2.56 to 5.41, p-value <0.001) over the study period. Study participants were found to have a greater mean (SE) reduction of 0.777% (0.404) in HbA1c compared to patients receiving standard care, which fell short of statistical significance (95% CI: -1.569 to 0.015%, p-value: 0.054) due to lack of power (56.5%) in the post-hoc comparison. Conclusion: A structured SMBG programme that advises monthly algorithmic insulin titration can improve glucose control in type 2 diabetes patients using insulin, with moderate hypoglycaemic events and weight gain. National Research Foundation (NRF) Roche Products (South Africa) School of Health Systems and Public Health, University of Pretoria School of Medicine, University of Pretoria em2026 School of Health Systems and Public Health (SHSPH) MSc Unrestricted SDG-03: Good health and well-being SDG-17: Partnerships for the goals 2017-02-01T07:38:23Z 2017-02-01T07:38:23Z 2017-04 2016 Dissertation Kalweit, KL 2016, The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin, MSc Dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/58769> http://hdl.handle.net/2263/58769 en @ 2017 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | Diabetes Epidemiology Insulin titration Type 2 diabetes mellitus (T2DM) UCTD Health sciences theses SDG-03 Health sciences theses SDG-17 The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title | The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title_full | The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title_fullStr | The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title_full_unstemmed | The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title_short | The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| title_sort | effect of a structured self monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin |
| topic | Diabetes Epidemiology Insulin titration Type 2 diabetes mellitus (T2DM) UCTD Health sciences theses SDG-03 Health sciences theses SDG-17 |
| url | http://hdl.handle.net/2263/58769 |