Advertisement

The impact of provision of self-monitoring of blood glucose supplies on self-care activities among patients with uncontrolled Type 2 diabetes mellitus: A prospective study

Published:October 08, 2019DOI:https://doi.org/10.1016/j.diabres.2019.107873

      Highlights

      • This study investigated the impact of providing self-monitoring of blood glucose (SMBG) supplies on self-care among patients with uncontrolled T2DM.
      • The provision of SMBG supplies was effective in increasing both SMBG performance and the frequency at which it was performed.
      • The improvement in SMBG was directly associated with the improvement in overall self-care.
      • The elimination of cost barriers through free provision of SMBG supplies may have been a major reason for the improvement in SMBG and subsequently self-care practice.

      Abstract

      Aims

      Self-monitoring of blood glucose (SMBG) is an important self-care activity for patients with Type 2 diabetes mellitus (T2DM) to achieve glycaemic control. The aim of this study was to evaluate the impact of providing SMBG supplies on self-care among patients with uncontrolled T2DM.

      Methods

      This was a six-month, prospective study conducted in two primary care institutions. Patients ≥21 years old with uncontrolled T2DM (HbA1c > 7.0%) and polypharmacy (≥5 chronic medications) were included. All participants were given a free blood glucometer, test strips, and lancets, and were invited to consult pharmacists to learn about SMBG. The Summary of Diabetes Self-Care Activities questionnaire was administered at baseline and at six months.

      Results

      A total of 167 patients were recruited and 150 (89.8%) completed the study. At six months, significant improvements from baseline were observed for overall self-care (+0.58, p = 0.008), glycemic control (−0.41%, p < 0.001) and all specific self-care activities. The mean change in the SMBG score in all the participants was found to have a strong positive correlation with the mean change in the overall self-care score (rs = 0.580, p = 0.01).

      Conclusions

      Provision of SMBG supplies was effective in improving self-care among patients with uncontrolled T2DM, including non-insulin-treated patients.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Diabetes Research and Clinical Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aade
        AADE7 self-care behaviors.
        Diab Educ. 2008; 3: 445-449
        • Boren S.A.
        AADE7TM self-care Behaviors: systematic reviews.
        Diab Educ. 2007; 6: 866-871
        • Goh S.Y.
        • Ang S.B.
        • Bee Y.M.
        • Chen Y.T.
        • Gardner D.S.
        • Ho E.T.
        • et al.
        Ministry of Health Clinical Practice guidelines: diabetes mellitus.
        Singapore Med J. 2014; 6: 334-347
        • Shrivastava S.R.
        • Shrivastava P.S.
        • Ramasamy J.
        Role of self-care in management of diabetes mellitus.
        J Diab Metab Disord. 2013; 1: 14
        • Tan C.C.L.
        • Cheng K.K.F.
        • Sum C.F.
        • Shew J.S.H.
        • Holydard E.
        • Wang W.
        Perceptions of diabetes self-care management among older singaporeans with type 2 diabetes: a qualitative study.
        J Nurs Res. 2018; 4: 242-249
        • Mogre V.
        • Johnson N.A.
        • Tzelepis F.
        • Paul C.
        Barriers to diabetic self-care: a qualitative study of patients' and healthcare providers' perspectives.
        J Clin Nurs. 2019; 11–12: 2296-2308
        • Chowdhury S.
        • Ji L.
        • Suwanwalaikorn S.
        • Yu N.C.
        • Tan E.K.
        Practical approaches for self-monitoring of blood glucose: an Asia-Pacific perspective.
        Curr Med Res Opin. 2015; 3: 461-476
        • Pugliese G.
        • Zanuso S.
        • Alessi E.
        • Simonelli P.
        • Fallucca S.
        • Fallucca F.
        • et al.
        Self glucose monitoring and physical exercise in diabetes.
        Diab Metab Res Rev. 2009; : S11-S17
        • American Diabetes A.
        Standards of medical care in diabetes–2014.
        Diab Care. 2014; : S14-S80
        • Lee J.Y.
        • Tsou K.
        • Lim J.
        • Koh F.
        • Ong S.
        • Wong S.
        “Symptom-based insulin adjustment for glucose normalization” (SIGN) algorithm: a pilot study.
        Diab Technol Ther. 2012; 12: 1145-1148
        • Silva D.D.
        • Bosco A.A.
        An, educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study.
        Diab Metab Syndr. 2015; : 2
        • Rossi M.C.
        • Lucisano G.
        • Funnell M.
        • Pintaudi B.
        • Bulotta A.
        • Gentile S.
        • et al.
        Interplay among patient empowerment and clinical and person-centered outcomes in type 2 diabetes. The BENCH-D study.
        Patient Educ Couns. 2015; 9: 1142-1149
        • Chan J.C.
        • Gagliardino J.J.
        • Baik S.H.
        • Chantelot J.M.
        • Ferreira S.R.
        • Hancu N.
        • et al.
        Multifaceted determinants for achieving glycemic control: the International Diabetes Management Practice Study (IDMPS).
        Diab Care. 2009; 2: 227-233
        • Harashima S.
        • Fukushima T.
        • Sasaki M.
        • Nishi Y.
        • Fujimoto S.
        • Ogura M.
        • et al.
        Self-monitoring of blood glucose (SMBG) improves glycaemic control in oral hypoglycaemic agent (OHA)-treated type 2 diabetes (SMBG-OHA study).
        Diab Metab Res Rev. 2013; 1: 77-84
        • Zhu H.
        • Zhu Y.
        • Leung S.W.
        Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials.
        BMJ Open. 2016; 9: e010524
        • Tham K.Y.
        • Ong J.J.
        • Tan D.K.
        • How K.Y.
        How much do diabetic patients know about diabetes mellitus and its complications?.
        Ann Acad Med Singapore. 2004; 4: 503-509
        • Farhan S.A.
        • Shaikh A.T.
        • Zia M.
        • Kahara B.R.
        • Muneer R.
        • Rehman M.
        • et al.
        Prevalence and predictors of home use of glucometers in diabetic patients.
        Cureus. 2017; 6: e1330
        • Ismail M.
        • Teng C.L.
        • Omar M.
        • Ho B.K.
        • Kusiar Z.
        • Hasim R.
        Usage of glucometer is associated with improved glycaemic control in type 2 diabetes mellitus patients in Malaysian public primary care clinics: an open-label, randomised controlled trial.
        Singapore Med J. 2013; 7: 391-395
        • Hortensius J.
        • Kars M.C.
        • Wierenga W.S.
        • Kleefstra N.
        • Bilo H.J.
        • van der Bijl J.J.
        Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study.
        BMC Public Health. 2012; : 167
        • Raoufi A.M.
        • Tang X.
        • Jing Z.
        • Zhang X.
        • Xu Q.
        • Zhou C.
        Blood glucose monitoring and its determinants in diabetic patients: a cross-sectional study in Shandong, China.
        Diab Ther. 2018; 5: 2055-2066
        • Ong W.M.
        • Chua S.S.
        • Ng C.J.
        Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study.
        Patient Pref Adhe. 2014; : 237-246
        • Czupryniak L.
        • Barkai L.
        • Bolgarska S.
        • Bronisz A.
        • Broz J.
        • Cypryk K.
        • et al.
        Self-monitoring of blood glucose in diabetes: from evidence to clinical reality in Central and Eastern Europe–recommendations from the international Central-Eastern European expert group.
        Diab Technol Ther. 2014; 7: 460-475
        • Jin S.M.
        • Baek J.H.
        • Suh S.
        • Jung C.H.
        • Lee W.J.
        • Park C.Y.
        • et al.
        Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes: a prospective cohort study.
        J Diab Investig. 2018; 9: 549-557
        • Wishah R.A.
        • Al-Khawaldeh O.A.
        • Albsoul A.M.
        Impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes: randomized controlled trial.
        Diab Metab Syndr. 2015; 4: 271-276
        • Freckmann G.
        • Baumstark A.
        • Schmid C.
        • Pleus S.
        • Link M.
        • Haug C.
        Evaluation of 12 blood glucose monitoring systems for self-testing: system accuracy and measurement reproducibility.
        Diab Technol Ther. 2014; 2: 113-122
        • Lu Y.
        • Xu J.
        • Zhao W.
        • Han H.R.
        Measuring self-care in persons with type 2 diabetes: a systematic review.
        Eval Health Prof. 2016; 2: 131-184
        • Jalaludin M.
        • Fuziah M.
        • Hong J.
        • Mohamad Adam B.
        • Jamaiyah H.
        Reliability and validity of the revised summary of diabetes self-care activities (SDSCA) for Malaysian children and adolescents.
        Malays Fam Phys. 2012; 2–3: 10-20
        • Cheng L.
        • Leung D.Y.P.
        • Wu Y.N.
        • Sit J.W.H.
        • Yang M.Y.
        • Li X.M.
        Psychometric properties of the modified personal diabetes questionnaire among Chinese patients with type 2 diabetes.
        Eval Health Prof. 2018; 1: 3-24
        • Toobert D.J.
        • Hampson S.E.
        • Glasgow R.E.
        The summary of diabetes self-care activities measure: results from 7 studies and a revised scale.
        Diab Care. 2000; 7: 943-950
        • Koponen A.M.
        • Simonsen N.
        • Suominen S.
        How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care? A self-determination theory perspective.
        Health Psychol Open. 2019; 1 (2055102919854977)
        • Laaksonen M.
        • Talala K.
        • Martelin T.
        • Rahkonen O.
        • Roos E.
        • Helakorpi S.
        • et al.
        Health behaviours as explanations for educational level differences in cardiovascular and all-cause mortality: a follow-up of 60 000 men and women over 23 years.
        Eur J Public Health. 2008; 1: 38-43
        • Walker R.J.
        • Gebregziabher M.
        • Martin-Harris B.
        • Egede L.E.
        Relationship between social determinants of health and processes and outcomes in adults with type 2 diabetes: validation of a conceptual framework.
        BMC Endocr Disord. 2014; : 82
        • Yu H.
        • Li Q.
        • Zhang M.
        • Liu F.
        • Pan J.
        • Tu Y.
        • et al.
        Decreased leptin is associated with alterations in thyroid-stimulating hormone levels after Roux-en-Y gastric bypass surgery in obese euthyroid patients with type 2 diabetes.
        Obes Facts. 2019; 3: 272-280
        • Shanaki M.
        • Fadaei R.
        • Moradi N.
        • Emamgholipour S.
        • Poustchi H.
        The circulating CTRP13 in type 2 diabetes and non-alcoholic fatty liver patients.
        PLoS ONE. 2016; 12: e0168082
        • Fakhrzadeh H.
        • Sharifi F.
        • Alizadeh M.
        • Arzaghi S.M.
        • Tajallizade-Khoob Y.
        • Tootee A.
        • et al.
        Relationship between insulin resistance and subclinical atherosclerosis in individuals with and without type 2 diabetes mellitus.
        J Diab Metab Disord. 2015; : 41
        • Havele S.A.
        • Pfoh E.R.
        • Yan C.
        • Misra-Hebert A.D.
        • Le P.
        • Rothberg M.B.
        Physicians' views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin.
        Ann Fam Med. 2018; 4: 349-352
        • Young L.A.
        • Buse J.B.
        • Weaver M.A.
        • Vu M.B.
        • Mitchell C.M.
        • Blakeney T.
        • et al.
        Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial.
        JAMA Intern Med. 2017; 7: 920-929
        • Bonomo K.
        • De Salve A.
        • Fiora E.
        • Mularoni E.
        • Massucco P.
        • Poy P.
        • et al.
        Evaluation of a simple policy for pre- and post-prandial blood glucose self-monitoring in people with type 2 diabetes not on insulin.
        Diab Res Clin Pract. 2010; 2: 246-251
        • Chen C.M.
        • Hung L.C.
        • Chen Y.L.
        • Yeh M.C.
        Perspectives of patients with non-insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study.
        J Clin Nurs. 2018; 7–8: 1673-1683
        • Tanenbaum M.L.
        • Leventhal H.
        • Breland J.Y.
        • Yu J.
        • Walker E.A.
        • Gonzalez J.S.
        Successful self-management among non-insulin-treated adults with Type 2 diabetes: a self-regulation perspective.
        Diab Med. 2015; 11: 1504-1512
        • Norris S.L.
        • Lau J.
        • Smith S.J.
        • Schmid C.H.
        • Engelgau M.M.
        Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control.
        Diab Care. 2002; 7: 1159-1171
        • Soprovich A.L.
        • Sharma V.
        • Tjosvold L.
        • Eurich D.T.
        • Johnson J.A.
        Systematic review of community pharmacy-based and pharmacist-led foot care interventions for adults with type 2 diabetes.
        Can Pharm J (Ott). 2019; 2: 109-116
        • O’Kane M.J.
        • Bunting B.
        • Copeland M.
        • Coates V.E.
        • Group E.s.
        Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial.
        BMJ. 2008; 7654: 1174-1177
        • Zgibor J.C.
        • Simmons D.
        Barriers to blood glucose monitoring in a multiethnic community.
        Diab Care. 2002; 10: 1772-1777