FNS  Vol.3 No.9 , September 2012
Effect of Nutrition Education Using Self-Monitoring of Blood Glucose (SMBG) on Glycemic Control in Non-Insulin-Treated Obese Type 2 Diabetes Patients
Abstract: The effect of nutrition education using self-monitoring of blood glucose on glycemic control was investigated in the present study. Of 36 males and 25 females aged 30 - 69 years under outpatient treatment at 3 hospitals in Niigata prefecture, Japan, 61 non-insulin-treated obese type 2 diabetes patients with HbA1c of 6.9% - 9.3% and body mass index of 25 kg/m2 or higher were randomly allocated. Thirty and 31 patients were analyzed in intervention and control groups, respectively. The intervention group performed self-monitoring of blood glucose 2 hours after supper twice a week for 6 months and underwent nutrition education on the association between meals and postprandial blood glucose once every 2 months. The primary outcome was glycated hemoglobin, with the secondary outcome of body mass index. Stages of change for eating the appropriate supper amount were investigated to verify the process of the educational effect, and satisfaction with diabetes treatment and well-being were investigated to verify the continuity of treatment. On intention-to-treat analysis, glycated hemoglobin (mean ± SD) decreased from 7.9% ± 0.6% to 7.7% ± 0.6% in the intervention group but increased from 7.9% ± 0.6% to 8.1% ± 0.6% in the control group, showing a significant difference in the change after intervention between the groups (p = 0.027). In the intervention group, body mass index decreased from 28.9 ± 3.8 to 28.4 ± 3.7 kg/m2 (p = 0.019), the stages of change to learn the appropriate amount of supper progressed (p = 0.026), and satisfaction with diabetes treatment increased (p = 0.031).
Cite this paper: M. Hasegawa, H. Sasaki, M. Hara and N. Murayama, "Effect of Nutrition Education Using Self-Monitoring of Blood Glucose (SMBG) on Glycemic Control in Non-Insulin-Treated Obese Type 2 Diabetes Patients," Food and Nutrition Sciences, Vol. 3 No. 9, 2012, pp. 1202-1208. doi: 10.4236/fns.2012.39158.

[1]   I. M. Stratton, A. I. Adler, H. A. Neil, D. R. Matthews, S. E. Manley, C. A. Cull, D. Hadden, R. C. Turner and R. R. Holman, “Association of Glycaemia with Macrovascular and Microvascular Complications of Type 2 Diabetes (UKPDS 35): Prospective Observational Study,” British Medical Journal, Vol. 321, No. 12, 2000, pp. 405-412. doi:10.1136/bmj.321.7258.405

[2]   The DECODE Study Group, “Glucose Tolerance and Mortality; Comparison of WHO and American Diabetic Association Diagnostic Criteria,” Lancet, Vol. 354, No. 21, 1999, pp. 617-621.

[3]   M. Tominaga, H. Eguchi, H. Manaka, K. Igarashi, T. Kato and A. Sekikawa, “Impaired Glucose Tolerance Is a Risk Factor for Cardiovascular Disease, but not Impaired Fasting Glucose,” Diabetes Care, Vol. 22, No. 6, 1999, pp. 920-924. doi:10.2337/diacare.22.6.920

[4]   International Diabetes Federation, “Guideline for Management of Postmeal Glucose,” 2007.

[5]   American Association of Diabetes Educators, “A Core Curriculum for Diabetes Education,” 2003.

[6]   M. Franciosi, P. F. ellegrini, G. De Berardis, M. Belfiglio, D. Cavaliere, B. Di.Nardo, et al., “The Impact of Blood Glucose Self-Monitoring on Metabolic Control and Quality of Life in Type 2 Diabetic Patients,” Diabetes Care, Vol. 24, No. 11, 2001, pp. 1870-1877. doi:10.2337/diacare.24.11.1870

[7]   W. A. Davis, D. G. Bruce and T. M. Davis, “Is SelfMonitoring of Blood Glucose Appropriate for All Type 2 Diabetic Patients?” Diabetes Care, Vol. 29, No. 8, 2006, pp. 1764-1770. doi:10.2337/dc06-0268

[8]   D. G. Bruce, W. A. Davis, C. A. Cull and T. M. Davis, “Diabetes Education and Knowledge in Patients with Type 2 Diabetes from the Community. The Fremantle Diabetes Study,” Journal of Diabetes & Complications, Vol. 17, No. 2, 2003, pp. 82-89.

[9]   U. Schwedes, M. Siebolds and G. Mertes, “Meal-Related Structured Self-Monitoring of Blood Glucose,” Diabetes Care, Vol. 25, No. 11, 2002, pp. 1928-1932. doi:10.2337/diacare.25.11.1928

[10]   W. H. Polonsky, L. Fisher, S. C. H. Chikman, D. A. Hinnen, C. G. Parkin, Z. Jelsovsky, B. Petersen, M. Schweitzer and R. S. Wagner, “Structured Self-Monitoring of Blood Glucose Significantly Reduces A1C Levels in Poorly Controlled, Noninsulin-Treated Type 2 Diabetes,” Diabetes Care , Vol. 34, No. 2, 2011, pp. 262-267. doi:10.2337/dc10-1732

[11]   M. Hasegawa, “Effects on Glucose Control of Nutrition Education Using Self-Monitoring of Blood Glucose in obese Type 2 Diabetes Mellitus Patients not Receiving Insulin Therapy,” Tonyobyo, Vol. 53, No. 8, 2010, pp. 636-643.

[12]   M. Franciosi, G. Lucisano, F. Pellegrini, A. Cantarello, et al., “ROSES: Role of Self-Monitoring of Blood Glucose and intensive Education in Patients with Type 2 Diabetes not Receiving Insulin, A Pilot Randomized Clinical Trial,” Diabetic Medicine, Vol. 28, No. 7, 2011, pp. 789796. doi:10.1111/j.1464-5491.2011.03268.x

[13]   International Diabetes Federation, “Self-Monitoring of Blood Glucose in Non-Insulin Treated Type 2 Diabetes,” 2009.

[14]   H. Ishii, C. Bradley, A. Riazi, S. Barendse and K. Yamamoto, “Japanese Translation of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Its Evaluation,” Igaku-No-Ayumi, Vol. 192, No. 7, 2000, pp. 809-814.

[15]   C. Bradley, “The Well-being Questionnaire,” In: C. Bradley, Ed., Handbook of Psychology and Diabetes, Harwood Academic Publishers, Chur, 1994, pp. 89-109.

[16]   J. O. Prochaska and C. C. DiClemente, “Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change,” Journal of Consulting and Clinical Psychology, Vol. 51, No. 3, 1983, pp. 390-395. doi:10.1037/0022-006X.51.3.390

[17]   Y. Seino, K. Nanjo, N. Tajima, T. Kadowaki, A. Kashiwagi, E. Araki, C. Ito, N. Inagaki, Y. Iwamoto, M. Kasuga, T. Hanafusa, M. Haneda and K. Ueki, “Report of the Committee on the Classi?cation and Diagnostic Criteria of Diabetes Mellitus,” Diabetology International, Vol. No. 1, 2010, pp. 2-20.

[18]   Translation Supervisor by Y. Ikeda, “Life with Diabetes, Diabetes Class Perfect Guide,” Ishiyaku Shuppan, Tokyo, 2001, p. 60.

[19]   Japan Diabetes Society, “Food Exchange Lists Dietary Guidance for Persons with Diabetes,” Bunkodo Co., Ltd., Tokyo, 2008.

[20]   R. S. Beaser, Staff of the Joslin Diabetes Center, Planning Meals, “Joslin’s Diabetes Deskbook. A Guide for Primary Care Providers,” 2nd Edition Joslin’s Diabetes Center, 2007.

[21]   Japan Diabetes Society, “Guidance of Instruction in Dietary Therapy for Diabetes,” 2nd Edition, Bunkodo Co., Ltd, Tokyo, 2004, pp. 13-16.

[22]   Japan Diabetes Society, “Treatment Guide for Diabetes,” Bunkodo, Tokyo, 2012, pp. 43-45.

[23]   T. Shiraishi and A. Kawata, “Instruction Manual for Fatness and Obesity,” 2nd Edition, Ishiyaku Shuppan, Tokyo, 2001, pp. 29-45.

[24]   Y. Atusmi and K. Koide, “Make use of SMBG,” Nakayama Shoten, Tokyo, 2011, pp. 125.

[25]   L. M. Welschen, E. Bloemendal, G. Nijpels, J. M. Dekker, R. J. Heine, W. A. Stalman and L. M. Bouter, “SelfMonitoring of Blood Glucose in Patients with Type 2 Diabetes Who Are not Using Insulin,” Diabetes Care, Vol. 28, No. 6, 2005, pp. 1510-1517. doi:10.2337/diacare.28.6.1510