Randomized trial of fructosamine home monitoring in patients with diabetes.

CONTEXT Recognition of the importance of glycemic control in type 2 diabetes has generated interest in developing ways to improve such control. Levels of fructosamine, 1-amino-1-deoxyfructose, are highly correlated with those of hemoglobin A1c (HbA1c) and can be monitored in the home. DESIGN Randomized trial. PARTICIPANTS 140 adult patients with HbA1c values of 8% or greater were recruited to the trial through referral from physicians and a direct mailing to potentially eligible persons. INTERVENTION Weekly home fructosamine monitoring in addition to daily glucose monitoring. Control patients monitored daily glucose only. Both groups of patients were contacted regularly by telephone and were given the same instructions on diet and exercise. OUTCOME Measures of glycemic control 3 and 6 months after randomization. RESULTS No significant difference was found between the two groups in the mean absolute decrease of HbA1c levels at 3 months (0.5% in the fructosamine group vs. 0.8% in the control group; P > 0.2), and the difference favored the control group at 6 months (0.7% fructosamine vs. 1.2% control; P = 0.04). Both groups had a statistically significant improvement in glycemic control. CONCLUSIONS The addition of home fructosamine monitoring to routine glucose monitoring did not improve glycemic control.