Understanding the Profiles of Blood Glucose Monitoring Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Shandong, China

Figures & data

Table 1 The Characteristics of the Participants in Shandong Province, China (n = 2166)

Characteristics	N	%
Residence
Urban	1070	49.4
Rural	1096	50.6
Gender
Male	749	34.6
Female	1417	65.4
Age group, years
<65	1086	50.1
≥65	1080	49.9
Marital status
Married	1865	86.1
Unmarried or other status	301	13.9
Educational level
No formal education	711	32.8
Primary school	716	33.1
Junior school and above	739	34.1
Annual household income per capita, RMB Yuan
0~3000	542	25.0
3000~6000	541	25.0
6000~12,000	541	25.0
>12,000	542	25.0
Health insurance
Uninsured	56	2.6
URRBMI	1956	90.3
UEBMI	154	7.1
Duration of diabetes, years
<5	833	38.5
6~10	680	31.4
>10	653	30.2
Diabetes complication
No	1393	64.3
Yes	773	35.7
Blood glucose control status
FPG<7.0mmol/L	1240	57.2
FPG≥7.0mmol/L	926	42.8
Therapy regimen
Diet/excise	300	13.9
OHAs	1545	71.3
Insulin	321	14.8
Knowledge about blood glucose control
Poor	880	40.6
Good	1286	59.4
Attitude to blood glucose monitoring
Poor	155	7.2
Good	2011	92.8
Inpatient service in the past year
No	1920	88.6
Yes	246	11.4

Abbreviations: UEBMI, Urban Employees Basic Medical Insurance, including the Government Insurance Scheme (GIS); URRBMI, Urban and Rural Residents Basic Medical Insurance, a merged plan of Urban Resident Basic Medical Insurance (URBMI); NRCMI, New Rural Cooperative Medical Insurance; OHAs, oral hypoglycemic agents; FBG, fasting blood glucose.

Table 2 The Frequency of Blood Glucose Monitoring Among the Participants (n=2166)

Blood Glucose Monitoring	Frequency Distribution of Blood Glucose Monitoring per Month, n (%)				Mean±Sd
	Freq < 0.33	0.33 ≤ Freq < 2	2 ≤ Freq < 8	8 ≤ Freq
In primary health institutes	407 (18.8)	1452 (67.0)	303 (14)	4 (0.2)	0.84±1.05
In hospitals	2118 (97.8)	41 (1.9)	7 (0.3)	0 (0)	0.03±0.20
In retail pharmacies	1973 (91.1)	125 (5.8)	68 (3.1)	0 (0)	0.14±0.52
Self-monitoring at home	1621 (74.8)	148 (6.8)	275 (12.7)	122 (5.6)	1.76±7.56
Total	251 (11.6)	1190 (54.9)	586 (27.1)	139 (6.4)	2.77±7.65

Notes: Freq <0.33: less than once per quarter; 0.33≤ Freq <2: no less than once per quarter but less than twice a month; 2≤ Freq <8: no less than twice a month but less than twice a week; 8≤ Freq: no less than twice a week.

Abbreviation: Sd, standard deviation.

Table 3 Model Fit Statistics of the One- to Six-Class Latent Profile Analysis Models

No. of Classes	Log Likelihood	Degree of Freedom	BIC	AIC	LMRLR Testing the Null Hypothesis	P-value for LMRLR
1	−11,855.61	8	23,727.22	23,772.66	–	–
2	−11,268.72	13	22,563.45	22,637.29	Class 1 vs Class 2	0.00
3	−10,353.98	17	20,741.97	20,838.54	Class 2 vs Class 3	0.01
4	−9332.843	22	18,709.69	18,834.66	Class 3 vs Class 4	0.00
5	−7727.101	27	15,508.2	15,661.58	Class 4 vs Class 5	0.00
6	−9008.097	26	18,068.19	18,215.89	Class 5 vs Class 6	0.12

Notes: Bold text signifies the selected model, which was based on: 1) Bayesian information criterion was at the minimum; 2) Akaike information criterion was relatively small; 3) LMRLR indicated two-class model was the best-fitting model (LMRLR compares n versus n-1 class models and reject the null hypothesis that n-1 class fits the data better than n class model, if p<0.05).

Abbreviations: BIC, Bayesian information criterion; AIC, Akaike information criterion; LMRLR, Lo-Mendell-Rubin likelihood ratio tests.

Figure 1 The estimated item-response probabilities for blood glucose monitoring in each of the five latent classes.

Table 4 The Factors Associated with the Profiles of Blood Glucose Monitoring Among the Type 2 Diabetes Patients in Shandong Province, China

Characteristics	Low Frequency, (%, Row)	High Frequency, (%, Row)					COR, 95% CI	AOR, 95% CI
		Total	High Frequency in Hospitals	High Frequency in Primary Health Institutes	High Frequency in Pharmacies	High Frequency in Self-Monitoring
Residence
Urban	898 (83.9)	172 (16.1)	16 (1.5)	82 (7.7)	52 (4.9)	22 (2.1)	1	1
Rural	1011 (92.2)	85 (7.8)	12 (1.1)	51 (4.7)	15 (1.4)	7 (0.6)	0.44 (0.33~0.58)**	0.47 (0.35~0.63)**
Gender
Male	652 (87.0)	97 (13.0)	13 (1.7)	40 (5.3)	30 (4.0)	14 (1.9)	1	1
Female	1257 (88.7)	160 (11.3)	15 (1.1)	93 (6.6)	37 (2.6)	15 (1.1)	0.82 (0.63~1.07)	0.86 (0.65~1.15)
Age group, years
<65	946 (87.1)	140 (12.9)	17 (1.6)	78 (7.2)	29 (2.7)	16 (1.5)	1	1
≥65	963 (89.2)	117 (10.8)	11 (1.0)	55 (5.1)	38 (3.5)	13 (1.2)	0.86 (0.65~1.12)	0.96 (0.71~1.30)
Marital status
Others	261 (86.7)	40 (13.3)	5 (1.7)	21 (7.0)	9 (3.0)	5 (1.7)	1	1
Married	1648 (88.4)	217 (11.6)	23 (1.2)	112 (6.0)	58 (3.1)	24 (1.3)	0.86 (0.60~1.23)	0.71 (0.49~1.04)
Educational level
No formal education	633 (89.0)	78 (11.0)	8 (1.1)	49 (6.9)	16 (2.3)	5 (0.7)	1	1
Primary school	648 (90.5)	68 (9.5)	5 (0.7)	33 (4.6)	22 (3.1)	8 (1.1)	0.85 (0.60~1.20)	0.73 (0.51~1.05)
Junior school and above	628 (85.0)	111 (15.0)	15 (2.0)	51 (6.9)	29 (3.9)	16 (2.2)	1.43 (1.05~1.96)*	1.00 (0.68~1.47)
Annual household income, RMB Yuan
0~3000	496 (91.5)	46 (8.5)	4 (0.7)	31 (5.7)	6 (1.1)	5 (0.9)	1	1
3000~6000	478 (88.4)	63 (11.6)	8 (1.5)	33 (6.1)	16 (3.0)	6 (1.1)	1.42 (0.95~2.12)	1.36 (0.90~2.04)
6000~12,000	480 (88.7)	61 (11.3)	7 (1.3)	33 (6.1)	13 (2.4)	8 (1.5)	1.37 (0.92~2.05)	1.27 (0.84~1.92)
>12,000	455 (83.9)	87 (16.1)	9 (1.7)	36 (6.6)	32 (5.9)	10 (1.8)	2.06 (1.41~3.01)**	1.58 (1.04~2.41)*
Health insurance
Uninsured	50 (89.3)	6 (10.7)	0	4 (7.1)	2 (3.6)	0	1	1
URRBMI	1743 (89.1)	213 (10.9)	21 (1.1)	118 (6.0)	50 (2.6)	24 (1.2)	1.02 (0.43~2.40)	0.96 (0.40~2.31)
UEBMI	116 (75.3)	38 (24.7)	7 (4.5)	11 (7.1)	15 (9.7)	5 (3.2)	2.73 (1.09~6.87)*	1.86 (0.71~4.91)
Duration of diabetes, years
<5	753 (90.4)	80 (9.6)	5 (0.6)	44 (5.3)	23 (2.8)	8 (1.0)	1	1
6~10	598 (87.9)	82 (12.1)	7 (1.0)	48 (7.1)	18 (2.6)	9 (1.3)	1.29 (0.93~1.79)	1.21 (0.86~1.70)
>10	558 (85.5)	95 (14.5)	16 (2.5)	41 (6.3)	26 (4.0)	12 (1.8)	1.60 (1.17~2.20)**	1.38 (0.96~1.98)
Diabetes comorbidity
No	1246 (89.4)	147 (10.6)	13 (0.9)	86 (6.2)	33 (2.4)	15 (1.1)	1	1
Yes	663 (85.8)	110 (14.2)	15 (1.9)	47 (6.1)	34 (4.4)	14 (1.8)	1.41 (1.08~1.83)*	1.37 (1.03~1.82)*
Blood glucose control status
FPG:<7.0mmol/L	1094 (88.2)	146 (11.8)	20 (1.6)	76 (6.1)	35 (2.8)	15 (1.2)	1	1
FPG:≥7.0mmol/L	815 (88.0)	111 (12.0)	8 (0.9)	57 (6.2)	32 (3.5)	14 (1.5)	1.02 (0.78~1.33)	0.97 (0.63~1.50)
Therapy regimen
Diet/excise	269 (89.7)	31 (10.3)	4 (1.3)	18 (6)	8 (2.7)	1 (0.3)	1	1
OAD	1365 (88.3)	180 (11.7)	17 (1.1)	96 (6.2)	48 (3.1)	19 (1.2)	1.14 (0.76~1.71)	1.14 (0.86~1.51)
Insulin	275 (85.7)	46 (14.3)	7 (2.2)	19 (5.9)	11 (3.4)	9 (2.8)	1.45 (0.89~2.36)	1.33 (0.88~1.99)
Knowledge about PFG target
Poor	804 (91.4)	76 (8.6)	4 (0.5)	51 (5.8)	15 (1.7)	6 (0.7)	1	1
Good	1105 (85.9)	181 (14.1)	24 (1.9)	82 (6.4)	52 (4)	23 (1.8)	1.73 (1.31~2.30)**	1.59 (1.17~2.16)**
Utilization of inpatient services
No	1702 (88.6)	218 (11.4)	19 (1)	115 (6.0)	60 (3.1)	24 (1.3)	1	1
Yes	207 (84.1)	39 (15.9)	9 (3.7)	18 (7.3)	7 (2.8)	5 (2.0)	1.47 (1.02~2.13)*	0.93 (0.53~1.65)

Notes: **P<0.001; *P<0.05.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; UEBMI, Urban Employees Basic Medical Insurance; URRBMI, Urban and Rural Residents Basic Medical Insurance; OHAs, oral hypoglycemic agents; FBG, fasting blood glucose.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; UEBMI, Urban Employees Basic Medical Insurance; URRBMI, Urban and Rural Residents Basic Medical Insurance; OHAs, oral hypoglycemic agents; FBG, fasting blood glucose.