Preventing Type II Diabetes Mellitus through Self-Monitoring of Blood Glucose And Nutritional Education – A Pilot Study

Introduction Over 720 million individuals are estimated to have pre-diabetes worldwide. Experts expect this number to continue increasing with no immediate end in sight. Socioeconomic barriers and limited healthcare access have a significant impact on the diagnosis and clinical management of pre-diabetes. Studies show that blood glucose monitoring can improve HbA1C in patients with poorly controlled type II diabetes. However, researchers have not explored this as a possible intervention in patients with pre-diabetes. The purpose of this study is to demonstrate that blood glucose self-monitoring and nutritional education can limit progression toward type II diabetes mellitus in patients with pre-diabetes. Materials and Methods This pilot study occurred at a South Texas family medicine clinic serving an economically disadvantaged, under-resourced, predominantly Hispanic community. Twenty-five adult patients (ages 38-69) with pre-diabetes were enrolled. The intervention consisted of a 30-minute nutritional session, followed by a 10-minute session where patients were given a glucometer and educated on self-monitoring. HbA1C (%) and BMI (kg/m2) were measured at baseline and 12 months post-intervention. Results Mean HbA1C and BMI measures pre-intervention were 5.94% and 36.2 kg/m^2, respectively. Wilcoxon matched-pairs signed-ranks tests of the pre-and post-intervention measures indicated an overall HbA1c decrease of 0.183% (P=0.001) and a BMI decrease of 1.35 kg/m^2 (P=0.054). Nonzero confidence intervals provide supporting evidence of a meaningful reduction in both measures. Importantly, none of the patients who completed the study progressed toward type II diabetes. Furthermore, 39% (n=9) of patients experienced an HbA1c decrease below the pre-diabetes threshold of 5.7%. The remaining patients (n=14) remained within a pre-diabetes range based on HbA1c measures. Conclusions This study revealed the significant role of blood glucose self-monitoring and nutritional education in limiting the progression toward type II diabetes. Providing glucometers and dietary/lifestyle education to patients with pre-diabetes shows substantial potential for mitigating preexisting barriers that challenge a healthy lifestyle and diabetic control.