A survey of blood glucose monitoring in patients with type 2 diabetes: are recommendations from health care professionals being followed?

Abstract

Objective:

To survey the self-reported use of self-monitoring of blood glucose (SMBG) among patients with type 2 diabetes (T2DM), both insulin users (IUs) and non-insulin users (NIUs), in the United States and to examine: how often patients test; what SMBG instructions patients report receiving from their health care providers (HCPs); how the frequency of testing conforms with reported HCP recommendations for testing; and what is done with the results of testing. Differences between IUs and NIUs were also investigated.

Methods:

A convenience sample of 886 T2DM participants at a series of one-day conferences across the United States completed a survey on current and recommended SMBG frequency, how SMBG results were used, and how HCPs reportedly talked about SMBG issues with the patient. IUs (65% of the sample) and NIUs (35%) were examined separately.

Results:

IUs and NIUs reported testing significantly less frequently than was recommended (in both cases, p < 0.001), with wide variations within both groups. Many IUs (42%) and NIUs (50%) did not bring SMBG data regularly to medical visits, and 54% of IUs and 56% of NIUs did not respond regularly to out-of-range SMBG readings. HCPs were generally supportive and responsive to SMBG data. More frequent SMBG was associated with more regular HCP attention to SMBG records, for IUs (p = 0.02) and NIUs (p = 0.004).

Conclusions:

Self-reported SMBG use is common in T2DM, though frequency is lower than HCP recommendations. Wide variations in actual and recommended SMBG were observed. HCP support for SMBG is reportedly common, and is associated with greater SMBG frequency. While SMBG data can be valuable, recommendations are often not followed and data often goes unused by both HCPs and patients.

Key words::

• Adherence
• Blood glucose monitoring
• Type 2 diabetes

Transparency

Declaration of funding

This study was supported by an unrestricted educational grant from Roche Diagnostics. The investigators had independent access and control of the data, and the authors have 100% responsibility for the manuscript and its content.

Declaration of financial/other relationships

W.H.P. has received fees for lectures, consulting and advisory board memberships from sanofi-aventis, Eli Lilly, Roche Diagnostics, Novo Nordisk, Abbott Diabetes Care, Animas and Amylin Pharmaceuticals, and unrestricted research grants from Roche Diagnostics. L.F. has received fees for lectures and consulting from Roche Diagnostics and has participated in advisory boards for Eli Lilly. D.H. has disclosed that she has no significant relationships with or financial interests in any commercial companies related to this study or article. S.V.E. has received fees for lectures, consulting and advisory board memberships from Eli Lilly, Novo Nordisk, Sanofi-Aventis, Abbott Diabetes Care, Dexcom, Johnson and Johnson, Merck and Amylin Pharmaceuticals.