ArticleDiabetes care2013
Changes in A1C levels are significantly associated with changes in levels of the cardiovascular risk biomarker hs-CRP: results from the SteP study.
Article in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 21 citations in OpenAlex.
- Relationship Between Systemic Inflammation and Glycemic Control in Firefighters.Journal of functional morphology and kinesiology · 2025Article
- Inflammatory Trajectory of Type 2 Diabetes: Novel Opportunities for Early and Late Treatment.Cells · 2024Review
- Associations of Serum Cytokines, Growth Factors, and High-Sensitivity C-Reactive Protein Levels in Patients with Major Depression with and without Type 2 Diabetes Mellitus: An Explanatory Investigation.Neuropsychiatric disease and treatment · 2022Article
- The Importance of Patient and Family Engagement, the Needs for Self-Monitoring of Blood Glucose (SMBG) - Our Perspectives Learned Through a Story of SMBG Assistive Devices Made by a Husband of the Patient with Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- Effects of glucose control on arterial stiffness in patients with type 2 diabetes mellitus and hypertension: An observational study.The Journal of international medical research · 2018Observational
- Associations among glycemic excursions, glycated hemoglobin and high-sensitivity C-reactive protein in patients with poorly controlled type 2 diabetes mellitus.Experimental and therapeutic medicine · 2015Article
- Use of an integrated strip-free blood glucose monitoring system increases frequency of self-monitoring and improves glycemic control: Results from the ExAct study.Journal of clinical & translational endocrinology · 2014Article
- Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2014Article
- Self-monitoring of blood glucose: a prerequisite for diabetes management in outcome trials.Journal of diabetes science and technology · 2014Article
- Effects of long-term testosterone therapy on patients with "diabesity": results of observational studies of pooled analyses in obese hypogonadal men with type 2 diabetes.International journal of endocrinology · 2014Article
- Higher accuracy of self-monitoring of blood glucose in insulin-treated patients in Germany: clinical and economical aspects.Journal of diabetes science and technology · 2013Article
- Urinary leukotriene E4 is associated with renal function but not with endothelial function in type 2 diabetes.Disease markers · 2013Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveThe effect of therapeutic strategies on cardiovascular (CV) disease can be evaluated by monitoring changes in CV risk biomarkers. This study investigated the effect of a structured self-monitoring of blood glucose (SMBG) protocol and the resulting improvements in glycemic control on changes in high-sensitivity C-reactive protein (hs-CRP) in insulin-naïve patients with type 2 diabetes. RESEARCH DESIGN AND
methodsThe Structured Testing Program (STeP) study was a prospective, cluster-randomized, multicenter trial in which 483 poorly controlled, insulin-naïve patients with type 2 diabetes were randomized to active control (ACG) or structured testing (STG) that included quarterly structured SMBG. Changes in A1C, hs-CRP, and glycemic variability (STG subjects only) were measured at baseline and quarterly.
resultsReductions in geometric mean hs-CRP values were significantly greater in the STG group at months 3 (P = 0.005), 6 (P = 0.0003), and 12 (P = 0.04) than in the ACG group. STG patients at high CV risk (>3 mg/L) showed significantly greater reductions in hs-CRP levels than ACG patients at high CV risk: -3.64 mg/dL (95% CI -4.21 to -3.06) versus -2.18 mg/dL (-2.93 to -1.43), respectively (P = 0.002). There was a strong correlation between reductions in hs-CRP and A1C in both groups: standardized coefficient (β) was 0.25 for the entire cohort (P < 0.0001), 0.31 for STG (P < 0.0001), and 0.16 for ACG (P = 0.02).
conclusionsReductions in hs-CRP level are associated with reductions in A1C but not reductions in lipids or glycemic variability. Comprehensive structured SMBG-based interventions that lower A1C may translate into improvements in CV risk, as evidenced by levels of the biomarker hs-CRP.
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