Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database
Open accessAbstract
Abstract Objectives: To investigate patterns of self monitoring of blood glucose concentration in diabetic patients who use insulin and to determine whether frequency of self monitoring is related to glycaemic control. Setting: Diabetes database, Tayside, Scotland. Subjects: Patients resident in Tayside in 1993-5 who were using insulin and were registered on the database and diagnosed with insulin dependent (type 1) or non-insulin dependent (type 2) diabetes before 1993. Main outcome measures: Number of glucose monitoring reagent strips dispensed (reagent strip uptake) derived from records of prescriptions. First recorded haemoglobin A1c concentration in the study period, and reagent strips dispensed in the previous 6 months. Results: Among 807 patients with type 1 diabetes, 128 (16%) did not redeem any prescriptions for glucose monitoring reagent strips in the 3 year study period. Only 161 (20%) redeemed prescriptions for enough reagent strips to test glucose daily. The corresponding figures for the 790 patients with type 2 diabetes who used insulin were 162 (21%; no strips) and 131 (17%; daily tests). Reagent strip uptake was influenced both by age and by deprivation category. There was a direct relation between uptake and glycaemic control for 258 patients (with recorded haemoglobin A1c concentrations) with type 1 diabetes. In a linear regression model the decrease in haemoglobin A1c concentration for every extra 180 reagent strips dispensed was 0.7%. For the 290 patients with type 2 diabetes who used insulin there was no such relation. Conclusions: Self monitoring of blood glucose concentration is associated with improved glycaemic control in patients with type 1 diabetes. Regular self monitoring in patients with type 1 and type 2 diabetes is uncommon. Key messages Several studies have indicated the importance of self monitoring of blood glucose concentration for prevention of complications in patients with diabetes Uptake of reagent strips for self monitoring of blood glucose among diabetic patients who used insulin was low, with only 20% of patients with type 1 diabetes and 17% of those with type 2 diabetes obtaining enough strips to test blood glucose concentration once daily Reagent strip uptake depends on characteristics such as age and social deprivation category, and patient groups with low uptake should be identified and targeted There was a direct association between strip uptake in the previous 6 months and glycaemic control in patients with type 1 diabetes but not in those with type 2 diabetes
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Most evidence indicates that SMBG contributes to good glycemic control among type 1 and type 2 diabetic patients.
“Although most evidence indicates that SMBG contributes to good glycemic control among type 1 (4,5) and type 2 diabetic (6,7) patients, it remains uncertain whether SMBG use is efficacious in insulin-naïve type 2 diabetic patients.”
From Structured Self-Monitoring of Blood Glucose Significantly Reduces A1C Levels in Poorly Controlled, Noninsulin-Treated Type 2 Diabetes (2011) · cites this paper as [5]
The Blood glucose control section reports an association between self-monitoring and better control in patients with type 1 diabetes, but cautions that it may reflect other health behaviours rather than a causal effect. The same section reports no association in insulin-treated patients with type 2 diabetes. This paper therefore does not support the claim for both types or establish that monitoring contributes causally to good control. (LLM, conf=0.88)
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- Authors
- Evans, J. M. M., Newton, R. W., Ruta, D. A., MacDonald, T. M., Stevenson, R. J., & Morris, A. D.
- Affiliations
- Ninewells Hospital (GB)
- University of Dundee (GB)
- Corresponding author
- Evans, J. M M
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1999-07-10
- Volume
- 319
- Issue
- 7202
- Pages
- 83-86
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC28155
- OpenAlex
- W2100218801
- Cited by
- 283
- References
- 30
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 11 · 2017: 10 · 2016: 8 · 2015: 12 · 2014: 15 · 2013: 9 · 2012: 8
- FWCI
- 9.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Wellcome Trust (050212)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- self-monitoring of blood glucose, glycemic control, insulin therapy, type 1 diabetes, type 2 diabetes, HbA1c, social deprivation, age differences, diabetes complications prevention, prescription dispensing data, diabetes self-management education
- MeSH terms
- Age Factors, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Insulin, Patient Compliance, Reagent Kits, Diagnostic, Socioeconomic Factors, Blood Glucose Self-Monitoring, Databases, Factual
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