Self-monitoring of blood glucose improved glycemic control and the 10-year coronary heart disease risk profile of female type 2 diabetes patients in Trinidad and Tobago

Background and Aim: The risk of death from coronary heart disease (CHD) in women with diabetes is more than three times that of non-diabetic women. We assessed the difference in CHD risk levels of Afro-Caribbean diabetic women provided with facilities for self-monitoring of blood glucose and their counterparts without such facilities Materials and Methods: Forty-nine patients who never used gluco-meters were studied as intervention (23) and control (26) groups. The intervention group was trained on self-monitoring of blood glucose. At baseline, BP, anthropometric indices, and fasting blood glucose of all patients were measured. Subsequently, the intervention patients were provided with gluco-meters, testing strips, and advised to self-monitor fasting and postprandial blood glucose every other day for 6 months. CHD risk was determined with the United Kingdom Prospective Diabetes Study risk engine calculator. Results: The age, duration of diagnosis of diabetes, BP, and anthropometric indices were similar in the two groups (all, P>0.05). The majority of the patients were unemployed or retired with only primary education. After 3 months, the HbA(1c) levels of the control patients did not change (8.3 +/- 0.4% vs. 7.8 +/- 0.4%, P>0.05) whereas the HbA(1c) levels of the intervention patients reduced significantly from the baseline at 3 (9.2 +/- 0.4% vs. 7.4 +/- 0.3%, P<0.001) and 6 (9.2 +/- 0.4% vs. 7.3 +/- 0.3%, P<0.001) months. The 10-year CHD risk level of the intervention group was remarkably reduced from the baseline level after 6 months (7.4 +/- 1.3% vs. 4.5 +/- 0.9%) of the study. Conclusion: Provision of facilities for self-monitoring of blood glucose in Afro-Caribbean women with type 2 diabetes improves both their glycemic control and CHD risk profile.