Self monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients' perspectives

Peel, Elizabeth; Douglas, Margaret; Lawton, Julia

doi:10.1136/bmj.39302.444572.de

Cited by 204 publications

(289 citation statements)

References 24 publications

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“…Indeed, the present study shows that patients who realize the importance of carrying out SMBG testing are more willing to share SMBG results with their physicians, and that patients realize the importance of carrying out SMBG testing and sharing SMBG results with their physicians more when physicians regularly check patients’ SMBG results to provide meaningful feedback. Previous studies have shown that appropriate SMBG use under instructions from healthcare professionals improved glycemic control and well‐being in type 1 diabetes patients16 and also in non‐insulin treated type 2 diabetes patients17, 18, whereas others have failed to show significant benefits19, 20. As the present study shows that physicians’ regular check of patients’ SMBG results affects patients’ attitude to SMBG use, sharing SMBG results between patients and healthcare professionals could play a critical role in making better use of SMBG to improve glycemic control in type 1 diabetes and type 2 diabetes patients.…”

Section: Discussionmentioning

confidence: 99%

Mental distress and health‐related quality of life among type 1 and type 2 diabetes patients using self‐monitoring of blood glucose: A cross‐sectional questionnaire study in Japan

Tanaka

Yabe

Murotani

et al. 2018

J of Diabetes Invest

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Aims/IntroductionThe present multicenter, cross‐sectional survey was initiated to evaluate self‐monitoring of blood glucose (SMBG)‐associated mental distress among patients with diabetes.Materials and MethodsThe survey was carried out in patients with type 1 diabetes and type 2 diabetes using SMBG recruited from 42 medical institutions. Profiles of Mood States 2 and diabetes therapy‐related quality of life questionnaires were used to evaluate mood status and health‐related quality of life. Two original questionnaires were also developed to evaluate SMBG ‘importance,’ ‘painfulness’ and ‘confidence’ among patients, and to evaluate physician attitudes to SMBG use.ResultsQuestionnaires from 517 type 1 diabetes and 1,648 type 2 diabetes patients showed that 46.0% of type 1 diabetes and 37.5% of type 2 diabetes patients reported ‘painfulness,’ and that these patients reporting ‘painfulness’ showed significantly higher Profiles of Mood States 2 scores, lower diabetes therapy‐related quality of life scores and higher glycated hemoglobin compared with those not reporting ‘painfulness,’ whereas the number of their daily SMBG tests were comparable. Patients reporting ‘painfulness’ also reported that SMBG use was significantly less important. Whether or not patients recognized the importance of SMBG use was well correlated with the frequency of physicians checking patient diaries.ConclusionsType 1 diabetes and type 2 diabetes patients reporting ‘painfulness’ in SMBG use had more mental distress, lower health‐related quality of life and higher glycated hemoglobin regardless of their number of daily SMBG tests. The importance of SMBG use was recognized less by patients experiencing pain, and the importance of SMBG use was recognized more in medical institutions in which physicians regularly checked SMBG diaries to provide meaningful feedback to patients in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Mental distress and health‐related quality of life among type 1 and type 2 diabetes patients using self‐monitoring of blood glucose: A cross‐sectional questionnaire study in Japan

Tanaka

Yabe

Murotani

et al. 2018

J of Diabetes Invest

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show abstract

“…It is reported that an SMBG frequency of ≥1 per day is related to higher levels of distress, worry, and depressive symptoms in insulin-naïve patients (Franciosi et al, 2001). Inexplicable readings can be distressing, resulting in a sense of personal "failure" with unexpected values of glucose levels (Peel et al, 2004). However, structured SMBG was not associated with deterioration of quality of life and locus of control (Russo et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial

Nishimura

Harashima

Fujita

et al. 2017

Journal of Diabetes and its Complications

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Aims:To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Methods:Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. Results:HbA1c levels were significantly decreased by 0.32% (3.50 mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94 kg and 6.8/4.7 mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Conclusions:Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions.

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“…In Nepal, it may also be important to consider if, and how much responsibility patients are willing to accept in managing their diabetes. Whilst self-monitoring can enhance patients’ self-management skills [12,13] and may have favourable outcomes, it can impose a burden affecting patients’ quality of life [12,13]. Before making recommendations for the health system to include a subsidised self-monitoring programme in Nepal, it is also imperative to explore self-monitoring practices in patients for whom self-monitoring is considered more useful, that is, patients with type 1 diabetes and those with T2D on insulin [2].…”

Section: Discussionmentioning

confidence: 99%

“…However, effective diabetes management through SMBG may be limited by a patient’s ability to interpret and act on the ‘abnormal’ home blood glucose readings [13], by the analytical quality of the instruments, and by a patient’s knowledge about the device and their understanding of its purpose [14]. Studies report that while some patients find self-monitoring useful, it can also cause discomfort and stress, particularly when readings are ‘high’ [12,13]. In 2010, a Cochrane review concluded that SMBG was of limited clinical usefulness and unlikely to be cost effective in patients with T2D managed on oral agents or lifestyle alone [15].…”

Section: Introductionmentioning

confidence: 99%

Blood glucose monitoring in type 2 diabetes – Nepalese patients’ opinions and experiences

Sapkota

Brien

Aslani

2017

Global Health Action

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Background: Blood glucose monitoring forms a vital component of diabetes care. Monitoring conducted at home using glucometers, and in laboratories by professionals, are two common methods of blood glucose monitoring in clinical practice. Objective: To investigate Nepalese patients’ perceptions and practices of blood glucose monitoring in diabetes. Methods: In-depth interviews were conducted with 48 Nepalese participants with type 2 diabetes in Sydney and Kathmandu. The interviews were audio-recorded, transcribed verbatim and thematically analysed. Results: In Australia, most participants perceived home monitoring as useful; and both home and laboratory monitoring were conducted at fairly regular intervals. In Nepal, only a small number conducted home monitoring and the laboratory method formed the primary method of day-to-day monitoring. The laboratory method was preferred due to easy access to laboratories, lack of faith in glucometers and perceptions that home monitoring is costlier. However, overall monitoring was irregular in Nepal. In addition to the healthcare system which enabled cheaper self-monitoring in Australia, Nepalese in Australia also tended to have a better understanding about the purpose of home monitoring. Conclusions: This study has highlighted the disparity in perceptions and practices related to blood glucose monitoring. Understanding the importance of blood glucose monitoring and access to affordable resources are critical facilitators for conducting regular monitoring. Both patient and health-system factors play a key role in ensuring continued diabetes monitoring and management.

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Self monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients' perspectives

Cited by 204 publications

References 24 publications

Mental distress and health‐related quality of life among type 1 and type 2 diabetes patients using self‐monitoring of blood glucose: A cross‐sectional questionnaire study in Japan

Mental distress and health‐related quality of life among type 1 and type 2 diabetes patients using self‐monitoring of blood glucose: A cross‐sectional questionnaire study in Japan

Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial

Blood glucose monitoring in type 2 diabetes – Nepalese patients’ opinions and experiences

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