PMID- 20663460 OWN - NLM STAT- MEDLINE DCOM- 20101104 LR - 20221207 IS - 1932-2968 (Electronic) IS - 1932-2968 (Linking) VI - 4 IP - 4 DP - 2010 Jul 1 TI - A single-center, open, comparative study of the effect of using self-monitoring of blood glucose to guide therapy on preclinical atherosclerotic markers in type 2 diabetic subjects. PG - 942-8 AB - BACKGROUND: The aim of our study was to determine the effect of treatment based on preprandial and postprandial self-monitoring of blood glucose (SMBG) on the progression of carotid intima-medial thickness (CIMT) in noninsulin-treated type 2 diabetes mellitus (T2DM) subjects. METHODS: In this 18-month prospective trial, we recruited subjects 18-70 years of age, treated with metformin and sulfonylurea, with a standardized hemoglobin A1c (HbA1c) level < or =9.0%. Subjects were randomized to use of fasting/preprandial (FP) SMBG results to adjust evening medication or use of postprandial (PP) SMBG results to adjust morning medication. The primary end point was change in CIMT; change in HbA1c was a secondary end point. RESULTS: Of the 300 subjects randomized, 280 (140 in each group) completed all biochemical tests and CIMT analysis. Carotid intima-medial thickness was reduced significantly in PP subjects from 0.78 (+/-0.15) mm to 0.73 (+/-0.14) mm (p < 0.005), but no significant CIMT reduction was seen in FP subjects. A significant reduction in HbA1c was also seen in the PP group (p < 0.005) but not in the FP group 1 (p = 0.165). Significant improvements in body mass index (p = 0.038), waist circumference (p < 0.001), systolic blood pressure (p = 0.008), and serum cholesterol (p = 0.02) were also seen in PP subjects but not in FP subjects. CONCLUSION: Use of postprandial SMBG data to adjust therapy was associated with a significant regression of carotid intima-medial thickening and a reduction in HbA1c in T2DM, whereas no significant improvement in these parameters was seen in subjects who used fasting/preprandial SMBG data for therapy adjustment. CI - 2010 Diabetes Technology Society. FAU - Mohan, Viswanathan AU - Mohan V AD - Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases, International Diabetes Federation Centre of Education, Gopalapuram, Chennai, India. drmohans@vsnl.net FAU - Ravikumar, Radhakrishnan AU - Ravikumar R FAU - Poongothai, Subramani AU - Poongothai S FAU - Amutha, Anandakumar AU - Amutha A FAU - Sowmya, Santhamma AU - Sowmya S FAU - Karkhuzali, Kulasegaran AU - Karkhuzali K FAU - Parkin, Christopher G AU - Parkin CG LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20100701 PL - United States TA - J Diabetes Sci Technol JT - Journal of diabetes science and technology JID - 101306166 RN - 0 (Biomarkers) RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (Sulfonylurea Compounds) RN - 9100L32L2N (Metformin) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Atherosclerosis/*etiology/*therapy MH - Biomarkers MH - Blood Glucose/analysis MH - Blood Glucose Self-Monitoring/*methods MH - Carotid Arteries/pathology MH - Diabetes Mellitus, Type 2/*complications/pathology/*therapy MH - Disease Progression MH - Fasting MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Hypoglycemic Agents/therapeutic use MH - Male MH - Metformin/therapeutic use MH - Middle Aged MH - Patient Compliance MH - Postprandial Period MH - Prospective Studies MH - Sulfonylurea Compounds/therapeutic use MH - Young Adult PMC - PMC2909528 EDAT- 2010/07/29 06:00 MHDA- 2010/11/05 06:00 PMCR- 2011/07/01 CRDT- 2010/07/29 06:00 PHST- 2010/07/29 06:00 [entrez] PHST- 2010/07/29 06:00 [pubmed] PHST- 2010/11/05 06:00 [medline] PHST- 2011/07/01 00:00 [pmc-release] AID - dst.4.4.0942 [pii] AID - 10.1177/193229681000400425 [doi] PST - epublish SO - J Diabetes Sci Technol. 2010 Jul 1;4(4):942-8. doi: 10.1177/193229681000400425.