The ROSSO Study

#1 11-08-2006, 10:13 PM

This was probably discussed while I was wandering. The Roche
Accu-chek newsletter last week mentioned this study, but I'm
too cheap to pay for the full version.

At last some research of the subject, albeit still limited:
http://tinyurl.com/ycp9cl or
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum

"Self-monitoring of blood glucose in type 2 diabetes and
long-term outcome: an epidemiological cohort study.

* Martin S,
* Schneider B,
* Heinemann L,
* Lodwig V,
* Kurth HJ,
* Kolb H,
* Scherbaum WA.

German Diabetes Clinic, German Diabetes Centre at the
Heinrich-Heine-University, Dusseldorf, Auf'm Hennekamp 65,
40225 Dusseldorf, Germany.

AIMS/HYPOTHESIS: The aim of this study was to obtain
epidemiological data on self-monitoring of blood glucose
(SMBG) in type 2 diabetes and to investigate the
relationship of SMBG with disease-related morbidity and
mortality.

METHODS: The German multicentre Retrolective Study
'Self-monitoring of Blood Glucose and Outcome in Patients
with Type 2 Diabetes' (ROSSO) followed 3,268 patients from
diagnosis of type 2 diabetes between 1995 and 1999 until the
end of 2003. Endpoints were diabetes-related morbidity
(non-fatal myocardial infarction, stroke, foot amputation,
blindness or haemodialysis) and all-cause mortality. SMBG
was defined as self-measurement of blood glucose for at
least 1 year.

RESULTS: During a mean follow-up period of 6.5 years, 1,479
patients (45.3%) began SMBG prior to an endpoint and an
additional 64 patients started SMBG after a non-fatal
endpoint. Interestingly, many patients used SMBG while being
treated with diet or oral hypoglycaemic drugs (808 of 2,515,
32%). At baseline, the SMBG cohort had higher mean fasting
blood glucose levels than the non-SMBG cohort (p<0.001),
suggesting that insufficient metabolic control was one
reason for initiating SMBG. This was associated with a
higher rate of microvascular endpoints. However, the total
rate of non-fatal events, micro- and macrovascular, was
lower in the SMBG group than in the non-SMBG group (7.2 vs
10.4%, p=0.002). A similar difference was found for the rate
of fatal events (2.7 vs 4.6%, p=0.004). Cox regression
analysis identified SMBG as an independent predictor of
morbidity and mortality, with adjusted hazard ratios of 0.68
(95% CI 0.51-0.91, p=0.009) and 0.49 (95% CI 0.31-0.78,
p=0.003), respectively. A better outcome for both endpoints
was also observed in the SMBG cohort when only those
patients who were not receiving insulin were analysed.

CONCLUSIONS/INTERPRETATION: SMBG was associated with
decreased diabetes-related morbidity and all-cause mortality
in type 2 diabetes, and this association remained in a
subgroup of patients who were not receiving insulin therapy.

SMBG may be associated with a healthier lifestyle and/or
better disease management."

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Florence

#2 11-08-2006, 10:14 PM

"This was probably discussed while I was wandering. The Roche
Accu-chek newsletter last week mentioned this study, but I'm
too cheap to pay for the full version.

At last some research of the subject, albeit still limited:
http://tinyurl.com/ycp9cl or"

I looked at the full article, it is good. One conclusion of note in the
discussion section was that more testing likely allowed more direct use
of results to adjust diet and exercise programs as part of empowering
patients.

#3 11-08-2006, 10:14 PM

"Alan S" <loralgtweightandcarbs@gmail.com> wrote in message
news:86gbk21n5nr54afas789t17khtlokgq54n@4ax.com...
> This was probably discussed while I was wandering. The Roche
> Accu-chek newsletter last week mentioned this study, but I'm
> too cheap to pay for the full version.
>
> At last some research of the subject, albeit still limited:
> http://tinyurl.com/ycp9cl or
> http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum
>
> "Self-monitoring of blood glucose in type 2 diabetes and
> long-term outcome: an epidemiological cohort study.
>
> * Martin S,
> * Schneider B,
> * Heinemann L,
> * Lodwig V,
> * Kurth HJ,
> * Kolb H,
> * Scherbaum WA.
>
> German Diabetes Clinic, German Diabetes Centre at the
> Heinrich-Heine-University, Dusseldorf, Auf'm Hennekamp 65,
> 40225 Dusseldorf, Germany.

Hi Alan, here are some quotes :

Introduction

Since the first description of regular self-monitoring of blood glucose
(SMBG) [1, 2] there has been a longstanding controversy among diabetologists
as to whether, and to what extent, patients with type 2 diabetes should
perform self-monitoring [3, 4]. Several studies that evaluated the influence
of SMBG on glycaemic control support the usefulness of SMBG for these
patients [5-11]; how-ever, other studies do not [12-16]. A position
statement from the American Diabetes Association recommends daily blood
glucose self-measurement for pharmacologically (insulin or oral
hypoglycaemic drugs) treated patients with type 2 diabetes [17]. Two
meta-analyses recently evaluated published randomised trials: Sarol et al.
[18] found eight randomised controlled trials on SMBG in noninsulin-
receiving patients with type 2 diabetes, while Welschen et al. [19]
identified six. Both meta-analyses concluded that multi-component treatment
strategies produced significantly greater reductions in HbA1c levels when
SMBG was included. The arguments for and against SMBG in patients with type
2 diabetes were recently summarised [20, 21]. Unfortunately, none of the
prospective studies was extended over a period of several years, precluding
analysis of clinical endpoints. In routine patient care, the metabolic
control of type 2 diabetes patients performing SMBG was worse than in
patients not using SMBG, which seems to reflect the more serious disease
stage of patients who undertake SMBG [22]. Nevertheless, the possibly
healthier lifestyle and better treatment regimen of patients performing SMBG
may reduce the risk of diabetic complications. Therefore, the Retrolective
Study 'Self-monitoring of Blood Glucose and Outcome in Patients with Type 2
Diabetes' (ROSSO) was designed to document patients from diagnosis for a
period of several years to obtain data on the use of SMBG and the occurrence
of diabetes-related morbidity and allcause mortality.

In conclusion, the results of this retrospective cohort study demonstrate
that SMBG is a marker of better clinical outcome. The differences between
the SMBG and non- SMBG groups remained after adjustment for patients' or
doctors' characteristics and when non-insulin-receiving

hth
Gys

#4 11-08-2006, 10:14 PM

On Tue, 31 Oct 2006 00:22:14 +0100, "GysdeJongh"
<jongh711@planet.nl> wrote:

>
>"Alan S" <loralgtweightandcarbs@gmail.com> wrote in message
>news:86gbk21n5nr54afas789t17khtlokgq54n@4ax.com.. .
>> This was probably discussed while I was wandering. The Roche
>> Accu-chek newsletter last week mentioned this study, but I'm
>> too cheap to pay for the full version.
>>
>> At last some research of the subject, albeit still limited:
>> http://tinyurl.com/ycp9cl or
>> http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum
>>
>> "Self-monitoring of blood glucose in type 2 diabetes and
>> long-term outcome: an epidemiological cohort study.
>>
>> * Martin S,
>> * Schneider B,
>> * Heinemann L,
>> * Lodwig V,
>> * Kurth HJ,
>> * Kolb H,
>> * Scherbaum WA.
>>
>> German Diabetes Clinic, German Diabetes Centre at the
>> Heinrich-Heine-University, Dusseldorf, Auf'm Hennekamp 65,
>> 40225 Dusseldorf, Germany.
>
>
>Hi Alan, here are some quotes :
>
>Introduction
>
>Since the first description of regular self-monitoring of blood glucose
>(SMBG) [1, 2] there has been a longstanding controversy among diabetologists
>as to whether, and to what extent, patients with type 2 diabetes should
>perform self-monitoring [3, 4]. Several studies that evaluated the influence
>of SMBG on glycaemic control support the usefulness of SMBG for these
>patients [5-11]; how-ever, other studies do not [12-16]. A position
>statement from the American Diabetes Association recommends daily blood
>glucose self-measurement for pharmacologically (insulin or oral
>hypoglycaemic drugs) treated patients with type 2 diabetes [17]. Two
>meta-analyses recently evaluated published randomised trials: Sarol et al.
>[18] found eight randomised controlled trials on SMBG in noninsulin-
>receiving patients with type 2 diabetes, while Welschen et al. [19]
>identified six. Both meta-analyses concluded that multi-component treatment
>strategies produced significantly greater reductions in HbA1c levels when
>SMBG was included. The arguments for and against SMBG in patients with type
>2 diabetes were recently summarised [20, 21]. Unfortunately, none of the
>prospective studies was extended over a period of several years, precluding
>analysis of clinical endpoints. In routine patient care, the metabolic
>control of type 2 diabetes patients performing SMBG was worse than in
>patients not using SMBG, which seems to reflect the more serious disease
>stage of patients who undertake SMBG [22]. Nevertheless, the possibly
>healthier lifestyle and better treatment regimen of patients performing SMBG
>may reduce the risk of diabetic complications. Therefore, the Retrolective
>Study 'Self-monitoring of Blood Glucose and Outcome in Patients with Type 2
>Diabetes' (ROSSO) was designed to document patients from diagnosis for a
>period of several years to obtain data on the use of SMBG and the occurrence
>of diabetes-related morbidity and allcause mortality.
>
>
>
>In conclusion, the results of this retrospective cohort study demonstrate
>that SMBG is a marker of better clinical outcome. The differences between
>the SMBG and non- SMBG groups remained after adjustment for patients' or
>doctors' characteristics and when non-insulin-receiving
>
>hth
>Gys
>
Thanks Gys

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Tuscany, Radicofani, Lake Bolsena