Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study

Ong, Woon May; Chua, Siew Siang; Ng, Chirk Jenn

doi:10.2147/ppa.s57567

Cited by 100 publications

(72 citation statements)

References 34 publications

(71 reference statements)

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“…The finding that respondents with type 1 diabetes perceived more diabetes stigma than those with type 2 diabetes may be surprising, given previous research and public discussion focused on the stigma associated with type 2 diabetes (18,22,24,26–29). In type 2 diabetes, diabetes stigma increased with intensity of therapy.…”

Section: Discussionmentioning

confidence: 89%

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Stigma in People With Type 1 or Type 2 Diabetes

Liu

Brown

Folias³

et al. 2017

Clinical Diabetes

174

150

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IN BRIEF This study quantitatively measures diabetes stigma and its associated psychosocial impact in a large population of U.S. patients with type 1 or type 2 diabetes using an online survey sent to 12,000 people with diabetes. A majority of respondents with type 1 (76%) or type 2 (52%) diabetes reported that diabetes comes with stigma. Perceptions of stigma were significantly higher among respondents with type 1 diabetes than among those with type 2 diabetes, with the highest rate in parents of children with type 1 diabetes (83%) and the lowest rate in people with type 2 diabetes who did not use insulin (49%). Our results suggest that a disturbingly high percentage of people with diabetes experience stigma, particularly those with type 1 or type 2 diabetes who are on intensive insulin therapy. The experience of stigma disproportionately affects those with a higher BMI, higher A1C, and poorer self-reported blood glucose control, suggesting that those who need the most help are also the most affected by stigma.

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Section: Discussionmentioning

confidence: 89%

“…Most of the existing studies on diabetes stigma have focused on type 2 diabetes (18,22,24,26–29), with a minority addressing stigma in type 1 diabetes (18,30). Additionally, many of these studies were qualitative and derived from small population samples.…”

mentioning

confidence: 99%

Stigma in People With Type 1 or Type 2 Diabetes

Liu

Brown

Folias³

et al. 2017

Clinical Diabetes

174

150

View full text Add to dashboard Cite

show abstract

“…In group interactions, patients of various ages and employment statuses shared how they could understand their current physical changes according to different physical sensations. Physical perception should be used for early symptom identification, and the detection of these warning messages early before disease onset can be a reference for patients with diabetes to prevent disease onset [19]. Health-care professionals should also reflect on how to improve patients' self-observation from the clues to symptoms before onset to further reduce the frequency of acute onset.…”

Section: Diabetes Self-monitoring and Symptom Identificationmentioning

confidence: 99%

Self-management Experience of Middle-aged and Older Adults With Type 2 Diabetes: A Qualitative Study

Tai

Sun

2019

Asian Nursing Research

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Purpose: Diabetes mellitus has been either the fourth or fifth leading cause of death among Taiwanese adults during 1995e2015. Older adults with diabetes are at higher risk of developing diabetic macrovascular and micro-vascular complications. The purpose of this study explored the self-management experiences of middle-aged and older adults with diabetes through a focus group. Methods: Purposive sampling was used to recruit patients with diabetes from the metabolic outpatient clinics of medical centers and regional hospitals in Taiwan. Two focus groups, comprising a total of 23 participants, were employed to collect data, and group discussions were held a total of four times in an education room that was distant from clinical areas. Results: Three themes were generated from analysis of the collected data: (1) "listening to the voice of the body and observing physical changes," (2) "re-recognizing diabetes and challenges," and (3) "selfmanagement implementation dilemmas." This study provided new insights into the experiences of middle-aged and older adults in Taiwan regarding their self-management of diabetes. Conclusion: Healthcare teams should be involved in the self-management education of patients with diabetes as early as possible to reduce patients' anxiety and to develop more patient-centered, culturesensitive clinical skills. In addition to monitoring patients' self-management, healthcare professor should pay more attention to patients' successful adaptation to and coexistence with the disease.

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“…For participants on intensive insulin therapy, four or more blood glucose tests are required daily to safely and effectively adjust insulin doses. This is not always achieved because of the pain and inconvenience associated with this method of glucose testing [10, 11]. A tool that can support a more comprehensive assessment of glycemia is continuous glucose monitoring; however, current devices are costly, require repeated calibration, and are constantly attached to the patient, all key factors preventing widespread use.…”

Section: Introductionmentioning

confidence: 99%

Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-Treated Type 2 Diabetes: a Multicenter, Open-Label Randomized Controlled Trial

Hanaire²,

et al. 2016

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IntroductionGlycemic control in participants with insulin-treated diabetes remains challenging. We assessed safety and efficacy of new flash glucose-sensing technology to replace self-monitoring of blood glucose (SMBG).MethodsThis open-label randomized controlled study (ClinicalTrials.gov, NCT02082184) enrolled adults with type 2 diabetes on intensive insulin therapy from 26 European diabetes centers. Following 2 weeks of blinded sensor wear, 2:1 (intervention/control) randomization (centrally, using biased-coin minimization dependant on study center and insulin administration) was to control (SMBG) or intervention (glucose-sensing technology). Participants and investigators were not masked to group allocation. Primary outcome was difference in HbA1c at 6 months in the full analysis set. Prespecified secondary outcomes included time in hypoglycemia, effect of age, and patient satisfaction.ResultsParticipants (n = 224) were randomized (149 intervention, 75 controls). At 6 months, there was no difference in the change in HbA1c between intervention and controls: −3.1 ± 0.75 mmol/mol, [−0.29 ± 0.07% (mean ± SE)] and −3.4 ± 1.04 mmol/mol (−0.31 ± 0.09%) respectively; p = 0.8222. A difference was detected in participants aged <65 years [−5.7 ± 0.96 mmol/mol (−0.53 ± 0.09%) and −2.2 ± 1.31 mmol/mol (−0.20 ± 0.12%), respectively; p = 0.0301]. Time in hypoglycemia <3.9 mmol/L (70 mg/dL) reduced by 0.47 ± 0.13 h/day [mean ± SE (p = 0.0006)], and <3.1 mmol/L (55 mg/dL) reduced by 0.22 ± 0.07 h/day (p = 0.0014) for intervention participants compared with controls; reductions of 43% and 53%, respectively. SMBG frequency, similar at baseline, decreased in intervention participants from 3.8 ± 1.4 tests/day (mean ± SD) to 0.3 ± 0.7, remaining unchanged in controls. Treatment satisfaction was higher in intervention compared with controls (DTSQ 13.1 ± 0.50 (mean ± SE) and 9.0 ± 0.72, respectively; p < 0.0001). No serious adverse events or severe hypoglycemic events were reported related to sensor data use. Forty-two serious events [16 (10.7%) intervention participants, 12 (16.0%) controls] were not device-related. Six intervention participants reported nine adverse events for sensor-wear reactions (two severe, six moderate, one mild).ConclusionFlash glucose-sensing technology use in type 2 diabetes with intensive insulin therapy results in no difference in HbA1c change and reduced hypoglycemia, thus offering a safe, effective replacement for SMBG.Trial registrationClinicalTrials.gov identifier: NCT02082184.FundingAbbott Diabetes Care.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-016-0223-6) contains supplementary material, which is available to authorized users.

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Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study

Cited by 100 publications

References 34 publications

Stigma in People With Type 1 or Type 2 Diabetes

Stigma in People With Type 1 or Type 2 Diabetes

Self-management Experience of Middle-aged and Older Adults With Type 2 Diabetes: A Qualitative Study

Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-Treated Type 2 Diabetes: a Multicenter, Open-Label Randomized Controlled Trial

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