Perspectives of patients with non‐insulin‐treated type 2 diabetes on self‐monitoring of blood glucose: A qualitative study

Chen, Chen-Mei; Hung, Li-Chen; Chen, Yang-Lin; Yeh, Mei Chang

doi:10.1111/jocn.14227

Cited by 11 publications

(13 citation statements)

References 36 publications

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“…While insulin users were more likely to focus on using SMBG to adjust for the insulin doses, non-insulin users were more likely to focus on using SMBG to modify their lifestyles (habits and diets) which may be more variable based on daily activities. 3,6 The HbA1c benefits brought by increased SMBG observed in this study were in line with the SMBG targets recommended by international guidelines. According to the American Diabetes Association guideline, one additional SMBG test per day can reduce HbA1c level for 0.2% in patients with type 1 diabetes, and for patients with type 2 diabetes, SMBG is expected to reduce HbA1c by 0.25%-0.3% at 6 months.…”

Section: Discussionsupporting

confidence: 89%

“…One potential explanation for the inconsistence over 12 months is the different purposes of performing SMBG in insulin users and non‐users. While insulin users were more likely to focus on using SMBG to adjust for the insulin doses, non‐insulin users were more likely to focus on using SMBG to modify their lifestyles (habits and diets) which may be more variable based on daily activities …”

Section: Discussionmentioning

confidence: 99%

“…Self‐monitoring of blood glucose (SMBG) has been accepted as an integral component of diabetes management . SMBG allows diabetic patients to become aware of their glycaemic levels, facilitating them to adjust diets and medication to improve their glycaemic control . When used appropriately, SMBG can help to reduce the risk of hypo‐ and hyperglycaemia …”

Section: Introductionmentioning

confidence: 99%

“…1 SMBG allows diabetic patients to become aware of their glycaemic levels, facilitating them to adjust diets and medication to improve their glycaemic control. [2][3][4] When used appropriately, SMBG can help to reduce the risk of hypoand hyperglycaemia. 2,5,6 Self-monitoring of blood glucose is considered beneficial to the management of type 1 diabetes (T1D) and insulin-treated type 2 diabetes (T2D).…”

mentioning

confidence: 99%

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Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Tan

Lee

2019

Int J Clin Pract

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Aims International diabetes guidelines have not established the frequencies of self‐monitoring of blood glucose in patients with type 2 diabetes (T2D) who do not use insulin. The present study aimed to assess the impact of self‐monitoring of blood glucose (SMBG) frequencies on the glucose control and other outcomes in non‐insulin‐treated patients with T2D. Methods A literature search was performed in four databases. Randomised controlled trials with ≥6‐month follow‐up duration that compared the impact of different frequencies of SMBG on glycated haemoglobin A1c (HbA1c) were included. Studies with abstract only or reported effects of SMBG as a secondary outcome were excluded. Results Of the 1557 studies identified, 12 RCTs with a total of 3350 patients were analysed. Overall, performing SMBG for 8 to 14 times per week was correlated with a better HbA1c control at 6 months (MD −0.46%, 95% CI −0.54 to −0.39) and 12 months (MD −0.20%, 95% CI −0.29 to −0.11). However, up to seven measurements of SMBG per week did not significantly affect glycaemic control. In addition, performing SMBG between 8 and 14 times per week was also associated with improved BMI (MD −0.46, 95% CI −0.84 to −0.08). When the results of SMBG were applied to adjust diabetes medication, a significant reduction in HbA1c levels was observed in the intervention arm compared to the control arm. Conclusions Eight to 14 measurements of SMBG per week were associated with an improved glycaemic control and a reduced BMI in patients with T2D not using insulin.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Tan

Lee

2019

Int J Clin Pract

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“…Sets of hypothetical self‐monitored blood glucose results were used to elicit descriptions of how the participants interpreted the values and the actions they would take if the values were their own. Chen, Hung, Chen, and Yeh (2018) found that some individuals use their blood glucose values to understand the relationship between their lifestyle and their blood glucose levels. Three sets of blood glucose data in both a line chart and table format were presented one at a time to the participant.…”

Section: Methodsmentioning

confidence: 99%

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Despins

Wakefield

2020

Journal of Clinical Nursing

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Aims and objectives To describe individuals' with type 2 diabetes mellitus sense‐making of blood glucose data and other influences impacting self‐management behaviour. Background Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self‐management regimens is an ongoing healthcare challenge. Examining individuals’ sense‐making processes can advance staff knowledge of and improve diabetes self‐management behaviour. Design A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self‐management decisions. Methods Sixteen one‐on‐one interviews with adults diagnosed with type 2 diabetes mellitus using a semi‐structured interview guide were conducted from March–May 2018. An inductive–deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self‐Management was used. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in completing this paper. Results Three main themes described participants’ type 2 diabetes mellitus sense‐making and influences on self‐management decisions: classifying blood glucose data, building mental models and making self‐management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. Conclusion Individuals use self‐monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyse the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycaemic data and influences on diabetes self‐management behaviour with periodic reassessment of this understanding can guide the healthcare team in optimising collaborative individualised care plans. Relevance to clinical practice Nurses must assess sense‐making processes in self‐management decisions. Periodic “refresher” diabetes education may be needed for individuals with type 2 diabetes mellitus.

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Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study

Gallagher

Tan³

et al. 2021

J Am Coll Clin Pharm

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IntroductionEpidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes.ObjectivesThe objective of this study was to evaluate the impact of team‐based pharmaceutical care on glycemic control, self‐care, diabetes‐dependent quality of life, and productivity loss in patients with long‐standing diabetes (≥5 years).MethodsThis was a prospective, multicenter, randomized, controlled study. Patients with a glycosylated hemoglobin (HbA1c) > 7%, long‐standing diabetes defined as having a disease duration of at least 5 years, and polypharmacy defined as taking 5 or more chronic medications were included in the study. Patients in the intervention arm received team‐based pharmaceutical care regularly while patients in the control arm received physician‐centered care. Patients' humanistic outcomes were followed for 6 months.ResultsA total of 248 patients (126 intervention and 122 control) were included in the study. In addition to improved glycemic control observed in the intervention arm (mean difference: 0.44%, P = .003, 95% confidence interval: [0.15, 0.73]), the intervention arm showed significant improvements in overall self‐care level (+0.36, 95% confidence interval: [0.01, 0.72], P = .045) and self‐monitoring of blood glucose (+1.87, 95% confidence interval: [1.00, 2.99], P < .001) compared with the control arm. There were no significant differences in the changes in diabetes‐associated quality of life and overall work impairment between the two arms. A significant difference in activity impairment (affected productivity in regular unpaid activity) between the two arms was found, with 43.3% impairment having occurred in the control group vs 27.9% in the intervention group (P = .047).ConclusionTeam‐based pharmaceutical care significantly improved overall self‐care and glycemia without deteriorating quality of life and incurring productivity loss. Our findings highlighted the value of team‐based pharmaceutical care in managing diabetes‐experienced patients.

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Perspectives of patients with non‐insulin‐treated type 2 diabetes on self‐monitoring of blood glucose: A qualitative study

Abstract: Healthcare professionals should reinforce patients' knowledge on appropriate responses to high and low blood glucose levels, intervene appropriately, discuss self-monitoring of blood glucose results with patients and track these results.

Cited by 11 publications

References 36 publications

Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Evaluating the impact of self‐monitoring of blood glucose frequencies on glucose control in patients with type 2 diabetes who do not use insulin: A systematic review and meta‐analysis

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study

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