Incorporating Results into Diabetes Self-care Plan rather than Frequency of Glycemic Monitoring Improves Glycemic Control in Insulin-treated Subjects with Type 2 Diabetes Mellitus

Ejiofor Theophilus Ugwu

Abstract


Background: Although most professional guidelines recommend self-monitoring of blood glucose (SMBG) in insulin-treated subjects with type 2 diabetes mellitus (T2DM), emphasis is often laid on the frequency rather than incorporating the results into diabetes self-care plan. It is unclear how these influence long term glycemic control.

Aim: to evaluate the relationship between SMBG frequency, ability to incorporate results into improved self-care and long term glycemic control.

Methods: 75 insulin-treated T2DM patients aged 18-65 years were interviewed to ascertain whether they practiced SMBG, testing frequency and ability to utilize SMBG results to adjust lifestyle and insulin dosage. Glycated hemoglobin (HbA1c) was measured in all the participants.

Results: The mean (SD) age and mean (SD) duration of diabetes were respectively 49.1 (8.9) and 5.6 (3.2) years. Glycemic control was generally poor [mean (SD) HbA1c 8.4 (1.9) %]. 71 subjects (94.7%) practiced SMBG. However, only 33.3% tested at a frequency of at least once daily. Previous participation in diabetes education (P <0.001) and ability to adjust insulin using SMBG results (P 0.03) were significantly associated with higher SMBG frequency. Among SMBG performers, ability to engage in SMBG-guided self titration of insulin dosage but not SMBG frequency was significantly associated with lower HbA1c.

Conclusion: The study suggests that SMBG frequency is less influential on long-term glycemic control than incorporating the results into improved self-care practices.


Keywords


Self monitoring; blood glucose; glycemic control; type 2 diabetes mellitus; insulin; Nigeria

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References


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