ABSTRACT
<p><b>BACKGROUND</b>The debate over the overall benefits of self-monitoring of blood glucose in type 2 diabetes patients is still continuing. We aimed to assess the difference in glycaemic control and coronary heart disease (CHD) risk levels of experimental type 2 diabetes patients provided with facilities for self-monitoring blood glucose and their counterparts without such facilities.</p><p><b>METHODS</b>Sixty-one patients who had no prior experience in using glucometers were studied as intervention (n = 30) and control (n = 31) groups. The intervention group was trained in self-monitoring of blood glucose and documentation. Baseline blood glucose and fasting blood glucose were measured and the intervention patients were provided with glucometers and advised to self-monitor their fasting and postprandial blood glucose over six months. The 10-year CHD risk levels were determined with the United Kingdom Prospective Diabetes Study-derived risk engine calculator.</p><p><b>RESULTS</b>The age and diabetes duration were similar in the two groups (P > 0.05). The majority of the patients were unemployed or retired females with only a primary level education. After 3 months, the haemogolbin A 1C (HbA 1c) levels of the control patients remained unchanged ((7.8 ± 0.3)% vs. (7.9 ± 0.4)%, P > 0.05) whereas the HbA 1c levels of the intervention patients were significantly reduced from the baseline at three ((9.6 ± 0.3)% vs. (7.8 ± 0.3)%, P < 0.001) and six ((9.2 ± 0.4)% vs. (7.5 ± 0.3)%, P < 0.001) months. Interestingly, while the 10-year CHD risk level of the control group remained unchanged after three months, that of the intervention group was remarkably reduced at three and six months from the baseline level ((7.4 ± 1.3)% vs. (4.5 ± 0.9)%, P = 0.056).</p><p><b>CONCLUSION</b>Self-monitoring of blood glucose in type 2 diabetes patients significantly improved glycaemic control and the CHD risk profile, suggesting that type 2 diabetes patients will potentially benefit from inclusion of glucose meters and testing strips in their health-care package.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Blood Glucose , Metabolism , Blood Glucose Self-Monitoring , Methods , Coronary Disease , Diabetes Mellitus, Type 2 , Blood , Metabolism , Fasting , Blood , Postprandial Period , PhysiologyABSTRACT
BACKGROUND AND OBJECTIVE: Studies suggest that the link between postprandial hyperglycaemia and cardiovascular risk in type 2 diabetes mellitus might be related to postprandial hypertriglyceridaemia and the increased levels of the highly atherogenic small and dense low density lipoprotein (LDL) particles. In this study we therefore aimed to determine which of the three popular carbohydrate foods has the highest potential of increasing postprandial triglyceride levels in type 2 diabetic patients and in healthy non diabetic individuals. METHODS: All subjects were studied on three different occasions seven days apart after an overnight fast. On each day of study, anthropometric indices were measured and after collecting fasting blood sample, subjects consumed bread, roti or rice within 10 min and water taken as wished. Subsequently, 7 ml of venous blood samples were collected at 60, 90, 120 and 150 min for insulin, glucose and lipids determinations. RESULTS: The diabetic and non diabetic healthy subjects had similar baseline body mass index, insulin, triglyceride, total and LDL-cholesterol. The mean percentage triglyceride increase after ingestion of the test foods was highest with bread and lowest with rice irrespective of diabetic status or ethnicity, and despite similar baseline triglyceride, insulin and body mass index levels, the diabetic patients of East Indian origin had comparatively higher incremental triglyceride levels for the three test foods than those of African origin. INTERPRETATION AND CONCLUSION: Contrary to anecdotal perception, the commercially prepared whole wheat bread has the highest propensity to induce hypertriglyceridaemia especially among diabetic patients of East Indian origin.