The impact of limited and strategic blood glucose monitoring on metabolic control in a type 1 diabetes clinic in Central India

Caroline S. Zuijdwijk, Sharad Pendsey, James Ron, Graham D. Ogle, Amisha Agarwal, Nick Barrowman, Seema Chalkhore, Sanket Pendsey, Alexandra Ahmet

Research output: Contribution to journalArticlepeer-review


Background: Self-monitoring of blood glucose (SMBG) is an essential component of type 1 diabetes (T1D) management and typically involves several daily tests. However, due to high cost, SMBG supplies are often unavailable in low-resource settings. This study assessed whether the use of two SMBG tests per day improves glycemic control, measured by a change in HbA1c, in youth with T1D followed at the DREAM Trust (DT) in Nagpur, India. Methods: Single-site prospective cohort study of youth ≤ 23 years of age with T1D ≥ 1 year followed by DT, who were provided with SMBG meters and two test strips per day. Patients received education regarding SMBG and how to respond to blood glucose values and trends. They were followed every 3 months with HbA1c and questionnaires for a total of 21 months. Results: HbA1c declined significantly from 10.2 ± 2.5% (88 ± 4 mmol/mol) at baseline to 9.5 ± 2.4% (80 ± 3 mmol/mol) at 21 months (p < 0.001). In univariable analysis, change in HbA1c was associated with adherence to insulin dosing, number of patient education sessions, household income, and holding a below the poverty line certificate. In multivariable analysis, only adherence to insulin dosing was a significant predictor for a decrease in HbA1c. There was no increase in diabetes-related acute complications. Conclusions: The use of two SMBG test strips per day for the management of T1D in a low-resource setting was safe, and over the 21 months following its introduction, there was a clinically and statistically significant decrease in HbA1c.

Original languageEnglish (US)
Pages (from-to)578-584
Number of pages7
JournalInternational Journal of Diabetes in Developing Countries
Issue number4
StatePublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020, Research Society for Study of Diabetes in India.


  • Blood glucose self-monitoring
  • Diabetes mellitus, type 1
  • Glycated hemoglobin A1c
  • Insulin
  • Poverty


Dive into the research topics of 'The impact of limited and strategic blood glucose monitoring on metabolic control in a type 1 diabetes clinic in Central India'. Together they form a unique fingerprint.

Cite this