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Lewes, March 7 2006 |
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ROSSO - New study on self-monitoring of blood glucose
Newly published data shows self-monitoring in type 2 diabetes is associated with reducing serious and potentially long-term complications
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A new study shows that self-monitoring of blood glucose is clearly correlated with improved life expectancy and reduced long-term complications in people with type 2 diabetes. The RetrOlective Study: Self-monitoring of blood glucose and Outcome in people with type 2 diabetes (ROSSO) shows that people with type 2 diabetes who self-monitor have a 51% lower risk of death and a 32% lower risk of complications like heart attack, stroke, blindness and amputation.1
The end of 2005 and the beginning of 2006 saw this highly acclaimed study published in the Journal of Diabetes Nursing (authored by Nurse Consultant, Debbie Hicks)2 and the influential clinical journal Diabetologia1. The study compared people who self-monitor their blood glucose with those who do not. It found that people who practised self-monitoring were more aware of their blood glucose levels and sought advice sooner from their health care professional when their levels were outside the target range.
Indeed, there is a growing body of evidence to support the benefit of SMBG and just prior to ROSSO being published, the prominent Cochrane Collaboration3 highlighted the value of SMBG in people with diabetes. Welchen et al4, Sarol et al5 and Moore and McQuay6 all add to this recent accumulation of evidence and new guidelines from the International Diabetes Federation (IDF) have also been drawn up which support the use of self-monitoring of blood glucose in type 2 diabetes.7
About the study
The ROSSO study, conducted at the renowned German Diabetes Centre, Düsseldorf, collected data from 3268 people with type 2 diabetes. The research panel involved in the study stated that patients who monitored their blood glucose levels were more aware of their optimum levels and more inclined to alert their physician when they were outside their range. This would then lead to more frequent adjustments in medication. Debbie Hicks, Nurse Consultant in Diabetes and author of the review in the Journal of Diabetes Nursing said “Without the ability to self-monitor their blood glucose, people with diabetes may not be aware of increased blood glucose levels until they experience overt symptoms such as a hypoglycaemic episode. Persistently high levels of blood glucose can contribute to long-term complications such as heart attack, stroke and eye damage or even death”
Moreover, Debbie Hicks’ article goes on to explain that people who self-monitor are more likely to experiment with their diet enabling them to learn how certain foods influence their blood glucose levels and assess the effect of physical activity on blood glucose levels.
ROSSO also highlights the importance of patient education alongside regular blood glucose monitoring, so that results can be interpreted and acted upon. From this year, all Primary Care Organisations in England and Wales must, by law, provide people with diabetes with structured patient education.8
Patient education is further supported by the UK-wide consensus on SMBG by Owens et al.9 This provides healthcare professionals with a robust framework about when to use SMBG in people with type 1 or type 2 diabetes. It stresses the importance of patient education and healthcare professional guidance in effective SMBG.
It is hoped that this newly increasing evidence for SMBG will help to ensure that people with type 2 diabetes have access to self-monitoring. Then, in tandem with good diabetes education, they can interpret and act on their blood glucose results to achieve optimal self-management.
Notes to Editors
The ROSSO study has been funded by an unrestricted grant from Roche Diagnostics
References
1. Martin S, Schneider B, Heinemann L, Lodwig V, Kurth H-J, Kolb H, Scherbaum W A: Self-monitoring of blood gucose in type 2 diabetes and long-term outcome: an epidemiological cohort study. Diabetologia (2006) 49: 271-278
2. Hicks D (2005). Is it worth monitoring blood glucose levels in type 2 diabetes? Journal of Diabetes Nursing; Vol 9: 369-372
3. Welschen LMC, Bloemendal E, Nijpels G et al (2005). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. The Cochrane Library 2005, Issue 4
4. Welschen L, Bloemendal E, Nijpels G et al (2005). Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin. Diabetes Care; 28 (6): 1510-1517
5. Sarol J, Nemencio A, Nicodemus J, Tan K et al (2005). Self-monitoring of blood glucose as part of a multi-component therapy among non-insulin requiring type 2 diabetes patients: a meta-analysis (1966-2004). Current Medical Research and Opinions ; 21(2):173-183.
6. Moore A, McQuay H (2005). Is blood glucose self-monitoring worthwhile in type 2 diabetes? Banolier at www.jr2.ox.ac.uk/bandolier/band134/b134-4.html
7. International Diabetes Federation (IDF) Clinical Guidelines Task Force (2005) Global Guidelines for type 2 Diabetes. IDF, Brussels
8. NICE Guidance on the the use of patient-education models for diabetes. Technology Appraisal number 60: www.nice.org.uk/page.aspx?o=68326
9. Owens D, Barnett AH, Pickup J et al. (2005) The continuing debate on self-monitoring of blood glucose. Diabetes and Primary Care 2005; 6(1): 9-21
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