Testing versus guessing blood glucose values: impact on self-care behaviors in type 2 diabetes

Abstract

Objective:

To assess differences between estimated blood glucose values and those measured on a blood glucose meter and the impact on self-care behavior in type 2 diabetes.

Research design and methods:

Subjects ≥18 years with type 2 diabetes (N = 297) attending a Taking Control of Your Diabetes conference were asked questions about diabetes management and to estimate their current blood glucose. Study staff tested subjects’ blood glucose on a meter. After seeing the result, subjects were again asked questions on diabetes management.

Clinical trial registration:

NCT01453413.

Main outcome measure:

The percentage of subject blood glucose estimations that were outside ISO 15197:2003 accuracy criteria (>±15 mg/dL or >±20% of meter glucose values).

Results:

Nearly half (46%) of subjects estimated blood glucose values outside ISO 15197:2003 accuracy criteria. Time since last blood glucose test, time since last meal, testing frequency, and A1C did not have an effect on differences between estimated blood glucose values and meter results. In the questionnaire before blood glucose testing, most subjects strongly agreed, agreed, or neither agreed nor disagreed that ‘I make decisions about my diabetes, such as my food intake or my insulin dose even when I do not test my blood sugar’ (71%) and ‘My body tells me without testing if my blood sugar is low or high’ (77%). After blood glucose testing, 99% of subjects strongly agreed, agreed, or neither agreed nor disagreed that ‘Knowing my blood sugar by checking could help me make different diabetes decisions’.

Conclusions:

Self-monitoring of blood glucose is an important component of diabetes self-management. Testing rather than guessing blood glucose values is important to obtain accurate results and inform people with type 2 diabetes to make effective, appropriate diabetes management decisions. A potential limitation of this study is that the subject population may not be representative of the general population of people with diabetes; however, the conference setting may attract a more motivated population, which could underestimate the magnitude of the results.

Keywords::

• Diabetes management
• Self-care behaviors
• Self-monitoring of blood glucose
• TCOYD
• Type 2 diabetes mellitus

Transparency

Declaration of funding

This study was supported by Bayer HealthCare LLC, Diabetes Care, Whippany, NJ, USA.

Declaration of financial/other relationships

J.P. and S.V.E. have disclosed that they have received research support from Bayer HealthCare LLC, Diabetes Care. N.D. and S.P. have disclosed that they are full-time employees of Bayer HealthCare LLC, Diabetes Care. P.S., H.C.S., and J.L.P. have disclosed that they were full-time employees for Bayer HealthCare LLC, Diabetes Care at the time this study was conducted.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Medical writing assistance was provided by Allison Michaelis PhD of MedErgy, Yardley, PA, USA, and was supported by Bayer HealthCare LLC, Diabetes Care. We would like to thank the TCOYD staff and Carmine Greene, of Bayer, for their contributions to the study. We would also like to thank Jimm Greer for his contribution to the study and his assistance with the manuscript.

Previous presentation: These data were previously presented in part in oral and abstract form at the 21st Annual Scientific & Clinical Congress of the American Association of Clinical Endocrinologists (AACE), 23–27 May 2012, Philadelphia, PA, USA; at the 72nd Scientific Sessions of the American Diabetes Association (ADA), 8–12 June 2012, Philadelphia, PA, USA; at the Annual Meeting of the American Association of Diabetes Educators (AADE), 1–4 August 2012, Indianapolis, IN, USA; at the 48th Annual Meeting of the European Association for the Study of Diabetes (EASD), 1–5 October 2012, Berlin, Germany; at the 15th Annual Canadian Diabetes Association (CDA)/Canadian Society of Endocrinology and Metabolism (CSEM) Professional Conference and Annual Meeting, 10–13 October 2012, Vancouver, British Columbia, Canada; and at the 12th Annual Meeting of the Diabetes Technology Society (DTS), 8–10 November 2012, Bethesda, MD, USA.