EPIDEMIOLOGY AND DETERMINANTS OF BLOOD-GLUCOSE SELF-MONITORING IN CLINICAL-PRACTICE

The aim of this study was to describe the epidemiology of self-monitor ing of blood glucose and to identify specific characteristics of those subgoups of diabetic patients treated with insulin that are most like ly to monitor their blood glucose according to medical recommendations . Data were collected on 1384 insulin-treated patients, enrolled from 35 diabetic outpatient clinics and 49 general practitioners' offices b etween December 1993 and June 1994. Seventeen Italian regions out of 2 0 were included in the study. Our data show that 418 (31%) diabetic pa tients treated with insulin had never practised blood glucose self-mon itoring. Tn addition, only 242 patients (18.2%) self-monitored their g lycemia with a mean frequency of at least once a day (29.7% among insu lin-dependent diabetes mellitus (IDDM) and 13.9% among insulin-treated non-insulin-dependent diabetes mellitus (NIDDM-IT) patients). Patient s' characteristics associated with a higher probability of practising blood glucose self-monitoring were age below 50 years, being treated a t a diabetic outpatient clinic, hypertension, need of three or more in sulin injections per day, history of hypoglycemic episodes, ability to self-manage insulin doses. Our study calls for vigorous efforts aimed at promoting the incorporation of clearly-defined educational program s at each level of carl, in order to improve the motivation and self-c are of diabetic patients. Furthermore, studies are necessary to identi fy subgroups of diabetic patients that truly need to self-monitor bloo d glycemia, and to assess the efficacy of the practice of self-monitor ing of brood glucose in improving metabolic control and reducing acute and long-term diabetic complications. Copyright (C) 1996 Elsevier Sci ence Ireland Ltd.