Determinants of self‐monitoring of blood glucose in patients with Type 1 diabetes: a multi‐centre study in Brazil

• DOI: 10.1111/dme.12236
• Publication Date: 2013-05-30T14:10:41Z
• Authors: M. B. Gomes; L. R. M. Tannus; R. A. Cobas; A. S. M. Matheus; P. Dualib; A. T. Zucatti; C. Cani; A. D. Guedes; F. M. Santos; J. Sepulveda; M. Tolentino; M. C. Façanha; A. C. R. A. Faria; S. Lavigne; A. P. Montenegro; M. Rodacki; M. de Fatima Guedes; R. Szundy; M. M. Cordeiro; P. T. S. Santos; C. A. Negrato
• Keywords: Adult; Blood Glucose; Glycated Hemoglobin; Male; Analysis of Variance; Adolescent; Blood Glucose Self-Monitoring; 3. Good health; 03 medical and health sciences; Cross-Sectional Studies; Diabetes Mellitus, Type 1; 0302 clinical medicine; Patient Education as Topic; Socioeconomic Factors; Quality of Life; Humans; Hypoglycemic Agents; Insulin; Patient Compliance; Female; Brazil; Follow-Up Studies; Retrospective Studies

AbstractAimThe aim of this study was to determine the relationship between the daily frequency of self‐monitoring of blood glucose and glycaemic control, demographic and socio‐economic status in patients with Type 1 diabetes under routine clinical care in Brazil.MethodsThis was a cross‐sectional, multi‐centre study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data were obtained from 3176 patients, aged 22 ± 11.8 years, of whom 56.3% were female and 57.4% were Caucasian. The mean time since diabetes diagnosis was 11.7 ± 8.1 years.ResultsThe prevalence of self‐monitoring of blood glucose was 88.5%. There was a significant increase in self‐monitoring frequency associated with female gender, lower ages, more intensive diabetes management and higher socio‐economic status. A correlation between HbA1c levels and the daily frequency of self‐monitoring was observed (rs = –0.13; P = 0.001). The mean HbA1c levels were related to the daily frequency of self‐monitoring (P < 0.001) without additional benefit to patients who performed self‐monitoring more than four times daily (9.2, 11.2, 10.2,15.2 and 15% for one, two, three, four, five or more self‐monitoring tests daily, respectively; P < 0.0001).ConclusionsThe majority of our patients (88.5%) performed three or more self‐monitoring tests daily, with more frequent testing reported by females, younger patients, those on intensive insulin regimens and of higher socio‐economic status. No additional benefit was found in patients who performed self‐monitoring more than four times daily. The diabetes care team must improve patients' education regarding self‐monitoring of blood glucose and its benefits.