The STeP Study: Harnessing The Power of One Of The Oldest Tools In The Shed

While we’re willing to bet that most people with diabetes think that blood glucose meters are an important tool, there is surprisingly little scientific evidence examining how this device really affects type 2 diabetes care. Partly because of the dearth of data, in both Europe and America reimbursement for strips is getting more difficult if you don’t take insulin. Dr. William Polonsky from the University of California at San Diego has been working on this issue with the Structured Testing Protocol (STeP) study, which investigated the benefits of structured blood glucose monitoring for people with type 2 diabetes not using insulin. The STeP study was sponsored by Roche, the makers of the Accu-Chek 360° View tool, a simple pencil-and-paper glucose-tracking system available for free download on its website. The tool is used to record blood glucose levels seven times daily (immediately before and two hours after each meal, and before bed) for three consecutive days. Great job to Dr. Polonsky and to Roche for creating a tool that can be used with any blood glucose monitoring system.

The participants in the STeP study were on average 56 years old, had been diagnosed with type 2 diabetes for just under eight years, had a mean A1c of 8.9%, and were not using insulin at the start of the study. All participants (483 people) were given a free glucose meter and test strips and were told to visit their primary care doctor at the start of the study and at 1, 3, 6, 9, and 12 months after the study began. Approximately half of the participants were further instructed to use the Accu-Chek 360° View tool prior to visits with their doctor. The participants who used the system were able to achieve significant improvements in A1c when compared to patients who did not use the paper-based tool; A1c reductions ranged from 0.3% (when all users are considered) to 0.5% (when only the patients who faithfully followed the directions set out in the study are considered). These improvements may seem modest, but they are impressive considering that the FDA uses a minimum of 0.5% A1c improvement as a benchmark to judge the efficacy for all new diabetes drugs. Notably, the data suggest that patients using the Accu-Chek 360° View tool were more likely to change treatment and therapy routines over the course of the study – that is certainly a positive if you’re trying to reach an A1c target or maintain one. –JS