The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients - An urgent need for better educational strategies
M. Franciosi et al., The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients - An urgent need for better educational strategies, DIABET CARE, 24(11), 2001, pp. 1870-1877
OBJECTIVE - The role of self-monitoring of blood glucose (SMBG) in type 2 d
iabetes is still a matter of debate. in the framework of a nationwide outco
mes research program, we investigated the frequency of SMBG and its associa
tion with metabolic control and quality of life (QoL).
RESEARCH DESIGN AND METHODS - The study involved 3,567 patients with type 2
diabetes who were recruited by 101 outpatient diabetes clinics and 103 gen
eral practitioners. Patients completed a questionnaire investigating SMBG p
ractice and QoL (diabetes-related stress, diabetes health distress, diabete
s-related worries, and Centers for Epidemiologic Studies-Depression scale).
RESULTS - Data on SMBG were available for 2,855 subjects (80% of the entire
study population). Overall, 471 patients (17%) stated that they tested the
ir blood glucose levels at home I time per day, 899 patients (31%) tested t
heir blood glucose levels : I time per week, and 414 patients (14%) tested
their blood whereas 1,071 patients (38%) stated that the never practiced SM
BG. A higher frequency of SMBG was associated with better, metabolic contro
l among subjects who were able to adjust insulin doses, whereas no relation
ship was found in all other patients, irrespective of the kind of treatment
. Multivariate analyses showed that an SMBG Frequency ! 1 Lime per day was
significantly related to higher levels of distress, worries, and depressive
symptoms in non-insulin-treated patients.
CONCLUSIONS - our findings suggest that SMBG can have an important role in
improving metabolic control if it is an integral part of a wider educationa
l strategy devoted to the promotion of patient autonomy. In patients not tr
eated with insulin, self-monitoring is associated with higher HbA(1c) level
s and psychological burden. Our data do not support the extension of SMBG t
o this group.