Frequency of Blood Glucose Monitoring in Relation to Glycemic Control in Patients With Type 2 Diabetes

Abstract

OBJECTIVE—The aim of the study was to investigate the relationship between blood glucose level, measured as HbA1c, and frequency of self-monitoring in patients with type 2 diabetes. Daily self-monitoring is believed to be important for patients treated with insulin or oral agents to detect asymptomatic hypoglycemia and to guide patient and provider behavior toward reaching blood glucose goals. RESEARCH DESIGN AND METHODS—A national sample of patients with type 2 diabetes was studied in the third National Health and Nutrition Examination Survey. Data on therapy for diabetes, frequency of self-monitoring of blood glucose, and HbA1c values were obtained by structured questionnaires and by clinical and laboratory assessments. RESULTS—According to the data, 29% of patients treated with insulin, 65% treated with oral agents, and 80% treated with diet alone had never monitored their blood glucose or monitored it less than once per month. Self-monitoring at least once per day was practiced by 39% of those taking insulin and 5–6% of those treated with oral agents or diet alone. For all patients combined, the proportion of patients who tested their blood glucose increased with an increasing HbA1c value. However, when examined by diabetes therapy category, there was little relationship between HbA1c value and the proportion testing at least once per day or the proportion testing at least once per week. CONCLUSIONS—In this cross-sectional study of patients with type 2 diabetes, the increase in frequency of self-monitoring of blood glucose with increasing HbA1c value was associated with the higher proportion of insulin-treated patients in higher HbA1c categories. Within diabetes therapy categories, the frequency of self-monitoring was not related to glycemic control, as measured by HbA1c level.

Perceived diabetes status is independently associated with glucose monitoring behaviour among type 2 diabetes mellitus patients

“…This association too, did not change considerably when adjusted for disease severity and the personal objectives of selfmonitoring. The observed importance of clinical status and personal objectives is confirmed by previous studies [6][7][8][9]15,16].…”

“…We adjusted for potential confounders that have been associated with test strip use in previous studies: age, gender, duration of diabetes, type of glucose lowering treatment, self-reported HbA1c, complications and self-reported hypoglycemic events [6][7][8][9]15]. In the second analysis, the study population was restricted to patients who reported performing SMBG.…”

“…One of the key elements of self-management is selfmonitoring of blood glucose (SMBG) [4]. Factors related to the frequency of self-monitoring are use of insuline and experiencing hypoglycemic events [5][6][7][8][9]. In practice, personal objectives of self-monitoring are strongly correlated with the way type 1 and type 2 diabetes is treated.…”

Future Perspectives in Glucose Monitoring Sensors

“…however, SMBG is still too invasive, time-consuming, and cumbersome to be universally undertaken with sufficient frequency and at the same time be compatible with the daily activities of children and adults alike. [31][32][33] Poor adherence to glucose monitoring determines an elevated risk for diabetes complications. continuous and noninvasive technology is therefore warranted.…”

Adherence to Glycemic Monitoring in Diabetes

“…[1][2][3] Unfortunately, there is evidence that patients with diabetes do not always complete glucose monitoring as frequently as prescribed. [4][5][6][7][8][9][10] Multiple barriers may exist to effective blood glucose monitoring. [10][11][12][13] However, there are also a few promising behavioral interventions which have specifically targeted blood glucose monitoring, particularly in patients with T1DM.…”