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Erschienen in: Acta Diabetologica 1/2016

01.02.2016 | Original Article

Frequency of self-monitoring blood glucose and attainment of HbA1c target values

verfasst von: Jorge F. Elgart, Lorena González, Mariana Prestes, Enzo Rucci, Juan J. Gagliardino

Erschienen in: Acta Diabetologica | Ausgabe 1/2016

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Abstract

Aims

Test strips for self-monitoring of blood glucose (SMBG) represent in Argentina, around 50 % of diabetes treatment cost; the frequency of their use is closely associated with hyperglycemia treatment. However, the favorable impact of SMBG on attainment of HbA1c goal in different treatment conditions remains controversial. We therefore attempted to estimate the relationship between use of SMBG test strips and degree of attainment of metabolic control in an institution of our social security subsector (SSS) in which provision is fully covered and submitted to a regular audit system.

Methods

Observational retrospective study using information of 657 patients with T2DM (period 2009–2010) from the database of the Diabetes and Other Cardiovascular Risk Factors Program (DICARO) of one institution of our SSS. DICARO provides—with an audit system—100 % coverage for all drugs and keeps records of clinical, metabolic and treatment data from every patient.

Results

The average monthly test strips/patient used for SMBG increased as a function of treatment intensification: Monotherapy with oral antidiabetic drugs (OAD) < combined OAD therapy < insulin treatment. In every condition, the number was larger in people with target HbA1c levels. Test strips represented the larger percentage of total prescription cost.

Conclusions

In our population, the type of hyperglycemia treatment was the main driver of test strip use for SMBG; in every condition tested, targeted HbA1c values were associated with greater strip use. Patient education and prescription audit may optimize its use and treatment outcomes.
Literatur
1.
2.
Zurück zum Zitat Klonoff DC, Blonde L, Cembrowski G, Coalition for Clinical Research-Self-Monitoring of Blood Glucose Scientific Board et al (2011) Consensus report: the current role of self-monitoring of blood glucose in non-insulin-treated type 2 diabetes. J Diabetes Sci Technol 5:1529–1548PubMedCentralCrossRefPubMed Klonoff DC, Blonde L, Cembrowski G, Coalition for Clinical Research-Self-Monitoring of Blood Glucose Scientific Board et al (2011) Consensus report: the current role of self-monitoring of blood glucose in non-insulin-treated type 2 diabetes. J Diabetes Sci Technol 5:1529–1548PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Virdi N, Daskiran M, Nigam S, Kozma C, Raja P (2012) The association of self-monitoring of blood glucose use with medication adherence and glycemic control in patients with type 2 diabetes initiating non-insulin treatment. Diabetes Technol Ther 14:790–798CrossRefPubMed Virdi N, Daskiran M, Nigam S, Kozma C, Raja P (2012) The association of self-monitoring of blood glucose use with medication adherence and glycemic control in patients with type 2 diabetes initiating non-insulin treatment. Diabetes Technol Ther 14:790–798CrossRefPubMed
4.
Zurück zum Zitat Fisher L, Polonsky WH, Parkin CG, Jelsovsky Z, Petersen B, Wagner RS (2012) The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes. Diabetes Res Clin Pract 96:149–155CrossRefPubMed Fisher L, Polonsky WH, Parkin CG, Jelsovsky Z, Petersen B, Wagner RS (2012) The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes. Diabetes Res Clin Pract 96:149–155CrossRefPubMed
5.
Zurück zum Zitat Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton A, Grzeszczak W, Harno K, Kempler P, Satman I, Vergès B (2011) Addressing schemes of self-monitoring of blood glucose in type 2 diabetes: a European perspective and expert recommendation. Diabetes Technol Ther 13:959–965CrossRefPubMed Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton A, Grzeszczak W, Harno K, Kempler P, Satman I, Vergès B (2011) Addressing schemes of self-monitoring of blood glucose in type 2 diabetes: a European perspective and expert recommendation. Diabetes Technol Ther 13:959–965CrossRefPubMed
6.
Zurück zum Zitat Blevins T (2013) Value and utility of self-monitoring of blood glucose in non-insulin-treated patients with type 2 diabetes mellitus. Postgrad Med 125(3):191–204CrossRefPubMed Blevins T (2013) Value and utility of self-monitoring of blood glucose in non-insulin-treated patients with type 2 diabetes mellitus. Postgrad Med 125(3):191–204CrossRefPubMed
7.
Zurück zum Zitat Malanda UL, Bot SD, Nijpels G (2013) Self-monitoring of blood glucose in noninsulin-using type 2 diabetic patients: it is time to face the evidence. Diabetes Care 36:176–178PubMedCentralCrossRefPubMed Malanda UL, Bot SD, Nijpels G (2013) Self-monitoring of blood glucose in noninsulin-using type 2 diabetic patients: it is time to face the evidence. Diabetes Care 36:176–178PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Parkin CG, Buskirk A, Hinnen DA, Axel-Schweitzer M (2012) Results that matter: structured vs. unstructured self-monitoring of blood glucose in type 2 diabetes. Diabetes Res Clin Pract 97:6–15CrossRefPubMed Parkin CG, Buskirk A, Hinnen DA, Axel-Schweitzer M (2012) Results that matter: structured vs. unstructured self-monitoring of blood glucose in type 2 diabetes. Diabetes Res Clin Pract 97:6–15CrossRefPubMed
9.
Zurück zum Zitat Benhalima K, Mathieu Ch (2012) The role of blood glucose monitoring in non-insulin treated type 2 diabetes: what is the evidence? Prim Care Diabetes 6:179–185CrossRefPubMed Benhalima K, Mathieu Ch (2012) The role of blood glucose monitoring in non-insulin treated type 2 diabetes: what is the evidence? Prim Care Diabetes 6:179–185CrossRefPubMed
10.
Zurück zum Zitat International Diabetes Federation Clinical Guidelines Taskforce and International SMBG Working Group (2009) Global guideline on self-monitoring of blood glucose in noninsulin treated type 2 diabetes. Accessed 1 March 2011 from www.idf.org International Diabetes Federation Clinical Guidelines Taskforce and International SMBG Working Group (2009) Global guideline on self-monitoring of blood glucose in noninsulin treated type 2 diabetes. Accessed 1 March 2011 from www.​idf.​org
11.
Zurück zum Zitat O’Kane MJ, Pickup J (2009) Self-monitoring of blood glucose in diabetes: is it worth it? Ann Clin Biochem 46(Pt 4):273–282CrossRefPubMed O’Kane MJ, Pickup J (2009) Self-monitoring of blood glucose in diabetes: is it worth it? Ann Clin Biochem 46(Pt 4):273–282CrossRefPubMed
12.
Zurück zum Zitat Tunis SL (2011) Cost effectiveness of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes and not on insulin: impact of modelling assumptions on recent Canadian findings. Appl Health Econ Health Policy 9(6):351–365CrossRefPubMed Tunis SL (2011) Cost effectiveness of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes and not on insulin: impact of modelling assumptions on recent Canadian findings. Appl Health Econ Health Policy 9(6):351–365CrossRefPubMed
13.
Zurück zum Zitat Caporale JE, Elgart JF, Gagliardino JJ (2011) The cost of diabetes care programs for type 2 diabetes in Argentina: a probabilistic sensitivity analysis. Prim Health Care Open Access 1:105 Caporale JE, Elgart JF, Gagliardino JJ (2011) The cost of diabetes care programs for type 2 diabetes in Argentina: a probabilistic sensitivity analysis. Prim Health Care Open Access 1:105
14.
Zurück zum Zitat Elgart JF, González L, Rucci E, Gagliardino JJ (2014) Self-monitoring of blood glucose: use, frequency drivers, and cost in Argentina. J Diabetes Sci Technol pii: 1932296814549993 Elgart JF, González L, Rucci E, Gagliardino JJ (2014) Self-monitoring of blood glucose: use, frequency drivers, and cost in Argentina. J Diabetes Sci Technol pii: 1932296814549993
15.
Zurück zum Zitat Cobas RA, Ferraz MB, Matheus AS, Tannus LR, Negrato CA, Antonio de Araujo L, Dib SA, Gomes MB, Brazilian Type 1 Diabetes Study Group (2013) The cost of type 1 diabetes: a nationwide multicentre study in Brazil. Bull World Health Organ 91(6):434–440PubMedCentralCrossRefPubMed Cobas RA, Ferraz MB, Matheus AS, Tannus LR, Negrato CA, Antonio de Araujo L, Dib SA, Gomes MB, Brazilian Type 1 Diabetes Study Group (2013) The cost of type 1 diabetes: a nationwide multicentre study in Brazil. Bull World Health Organ 91(6):434–440PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Gagliardino JJ, de la Hera M, Siri F, Grupo de Investigacion de la Red Qualidiab (2001) Evaluación de la calidad de la asistencia al paciente diabético en America Latina. Rev Panam Salud Publica/Pan Am J Public Health 10:309–317CrossRef Gagliardino JJ, de la Hera M, Siri F, Grupo de Investigacion de la Red Qualidiab (2001) Evaluación de la calidad de la asistencia al paciente diabético en America Latina. Rev Panam Salud Publica/Pan Am J Public Health 10:309–317CrossRef
17.
Zurück zum Zitat American Diabetes Association (2014) Standards of medical care in diabetes—2014. Diabetes Care 37(Suppl 1):S14–80. doi:10.2337/dc14-S014 American Diabetes Association (2014) Standards of medical care in diabetes—2014. Diabetes Care 37(Suppl 1):S14–80. doi:10.​2337/​dc14-S014
18.
Zurück zum Zitat Sanyal C, Graham SD, Cooke C, Sketris I, Frail DM, Flowerdew G (2008) The relationship between type of drug therapy and blood glucose self-monitoring test strips claimed by beneficiaries of the Seniors’ Pharmacare Program in Nova Scotia, Canada. BMC Health Serv Res 8:111–119PubMedCentralCrossRefPubMed Sanyal C, Graham SD, Cooke C, Sketris I, Frail DM, Flowerdew G (2008) The relationship between type of drug therapy and blood glucose self-monitoring test strips claimed by beneficiaries of the Seniors’ Pharmacare Program in Nova Scotia, Canada. BMC Health Serv Res 8:111–119PubMedCentralCrossRefPubMed
19.
Zurück zum Zitat Stratton IM, Adler AI, Neil HA et al (2002) Association of glycemia with macrovascular and microvascular complications of type 2 diabetes, (UKPDS 35) prospective observational study. BMJ 321:405–412CrossRef Stratton IM, Adler AI, Neil HA et al (2002) Association of glycemia with macrovascular and microvascular complications of type 2 diabetes, (UKPDS 35) prospective observational study. BMJ 321:405–412CrossRef
20.
Zurück zum Zitat Bosi E, Scavini M, Ceriello A, Cucinotta D, Tiengo A, Marino R, Bonizzoni E, Giorgino F, PRISMA Study Group (2013) Intensive structured self-monitoring of blood glucose and glycemic control in noninsulin-treated type 2 diabetes: the PRISMA randomized trial. Diabetes Care 36(10):2887–2894PubMedCentralCrossRefPubMed Bosi E, Scavini M, Ceriello A, Cucinotta D, Tiengo A, Marino R, Bonizzoni E, Giorgino F, PRISMA Study Group (2013) Intensive structured self-monitoring of blood glucose and glycemic control in noninsulin-treated type 2 diabetes: the PRISMA randomized trial. Diabetes Care 36(10):2887–2894PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Ruiz Gracia T, García de la Torre Lobo N, Durán Rodríguez Hervada A, Calle Pascual AL (2014) Structured SMBG in early management of T2DM: contributions from the St Carlos study. World J Diabetes 5(4):471–481PubMedCentralCrossRefPubMed Ruiz Gracia T, García de la Torre Lobo N, Durán Rodríguez Hervada A, Calle Pascual AL (2014) Structured SMBG in early management of T2DM: contributions from the St Carlos study. World J Diabetes 5(4):471–481PubMedCentralCrossRefPubMed
22.
Zurück zum Zitat Schnell O, Hanefeld M, Monnier L (2014) Self-monitoring of blood glucose: a prerequisite for diabetes management in outcome trials. J Diabetes Sci Technol 8(3):609–614PubMedCentralCrossRefPubMed Schnell O, Hanefeld M, Monnier L (2014) Self-monitoring of blood glucose: a prerequisite for diabetes management in outcome trials. J Diabetes Sci Technol 8(3):609–614PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Duran A, Martın P, Runkle I et al (2010) Benefits of self-monitoring blood glucose in the management of new-onset Type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2:203–211CrossRefPubMed Duran A, Martın P, Runkle I et al (2010) Benefits of self-monitoring blood glucose in the management of new-onset Type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. J Diabetes 2:203–211CrossRefPubMed
24.
Zurück zum Zitat Shiraiwa T, Takahara M, Kaneto H, Kaneto H, Miyatsuka T, Yamamoto K, Yoshiuchi K, Sakamoto K, Matsuoka TA, Matsuhisa M, Yamasaki Y, Shimomura I (2010) Efficacy of occasional self-monitoring of postprandial blood glucose levels in type 2 diabetic patients without insulin therapy. Diabetes Res Clin Pract 90:e91–e92CrossRefPubMed Shiraiwa T, Takahara M, Kaneto H, Kaneto H, Miyatsuka T, Yamamoto K, Yoshiuchi K, Sakamoto K, Matsuoka TA, Matsuhisa M, Yamasaki Y, Shimomura I (2010) Efficacy of occasional self-monitoring of postprandial blood glucose levels in type 2 diabetic patients without insulin therapy. Diabetes Res Clin Pract 90:e91–e92CrossRefPubMed
25.
Zurück zum Zitat Polonsky WH, Fisher L, Schikman CH, Hinnen DA, Parkin CG, Jelsovsky Z, Axel-Schweitzer M, Petersen B, Wagner RS et al (2011) A structured self-monitoring of blood glucose approach in type 2 diabetes encourages more frequent, intensive, and effective physician interventions: results from the STeP study. Diabetes Technol Ther 13:797–802CrossRefPubMed Polonsky WH, Fisher L, Schikman CH, Hinnen DA, Parkin CG, Jelsovsky Z, Axel-Schweitzer M, Petersen B, Wagner RS et al (2011) A structured self-monitoring of blood glucose approach in type 2 diabetes encourages more frequent, intensive, and effective physician interventions: results from the STeP study. Diabetes Technol Ther 13:797–802CrossRefPubMed
26.
Zurück zum Zitat Kempf K, Tankova T, Martin S (2013) ROSSO-in-praxi-international: long-term effects of self-monitoring of blood glucose on glucometabolic control in patients with type 2 diabetes mellitus not treated with insulin. Diabetes Technol Ther 15(1):89–96CrossRefPubMed Kempf K, Tankova T, Martin S (2013) ROSSO-in-praxi-international: long-term effects of self-monitoring of blood glucose on glucometabolic control in patients with type 2 diabetes mellitus not treated with insulin. Diabetes Technol Ther 15(1):89–96CrossRefPubMed
27.
Zurück zum Zitat Wang J, Zgibor J, Matthews JT, Charron-Prochownik D, Sereika SM, Siminerio L (2012) Self-monitoring of blood glucose is associated with problem-solving skills in hyperglycemia and hypoglycemia. Diabetes Educ 38(2):207–218CrossRefPubMed Wang J, Zgibor J, Matthews JT, Charron-Prochownik D, Sereika SM, Siminerio L (2012) Self-monitoring of blood glucose is associated with problem-solving skills in hyperglycemia and hypoglycemia. Diabetes Educ 38(2):207–218CrossRefPubMed
28.
Zurück zum Zitat Chen R, Cheadle A, Johnson D, Duran B (2014) US Trends in Receipt of Appropriate Diabetes Clinical and Self-care From 2001 to 2010 and Racial/Ethnic Disparities in Care. Diabetes Educ pii: 0145721714546721. [Epub ahead of print] Chen R, Cheadle A, Johnson D, Duran B (2014) US Trends in Receipt of Appropriate Diabetes Clinical and Self-care From 2001 to 2010 and Racial/Ethnic Disparities in Care. Diabetes Educ pii: 0145721714546721. [Epub ahead of print]
29.
Zurück zum Zitat Clar C, Barnard K, Cummins E, Royle P, Waugh N, Aberdeen Health Technology Assessment Group (2010) Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess 14(12):1–140CrossRef Clar C, Barnard K, Cummins E, Royle P, Waugh N, Aberdeen Health Technology Assessment Group (2010) Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess 14(12):1–140CrossRef
30.
Zurück zum Zitat Choudhary P, Genovese S, Reach G (2013) Blood glucose pattern management in diabetes: creating order from disorder. J Diabetes Sci Technol 7(6):1575–1584PubMedCentralPubMed Choudhary P, Genovese S, Reach G (2013) Blood glucose pattern management in diabetes: creating order from disorder. J Diabetes Sci Technol 7(6):1575–1584PubMedCentralPubMed
31.
Zurück zum Zitat González L, Elgart JF, Calvo H, Gagliardino JJ (2013) Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina. Clinicoecon Outcomes Res 5:337–345PubMedCentralCrossRefPubMed González L, Elgart JF, Calvo H, Gagliardino JJ (2013) Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina. Clinicoecon Outcomes Res 5:337–345PubMedCentralCrossRefPubMed
32.
Zurück zum Zitat Gagliardino JJ, Etchegoyen G, PEDNID-LA Research Group (2001) A model education program for people with type 2 diabetes: a cooperative Latin American implementation study (PEDNID-LA). Diabetes Care 24:1001–1007CrossRefPubMed Gagliardino JJ, Etchegoyen G, PEDNID-LA Research Group (2001) A model education program for people with type 2 diabetes: a cooperative Latin American implementation study (PEDNID-LA). Diabetes Care 24:1001–1007CrossRefPubMed
33.
Zurück zum Zitat Gagliardino JJ, Lapertosa S, Pfirter G, Villagra M, Caporale JE, Gonzalez CD, Elgart J, González L, Cernadas C, Rucci E, Clark C, PRODIACOR (2013) Clinical, metabolic and psychological outcomes and treatment costs of a prospective randomized trial based on different educational strategies to improve diabetes care (PRODIACOR). Diabet Med 30(9):1102–1111CrossRefPubMed Gagliardino JJ, Lapertosa S, Pfirter G, Villagra M, Caporale JE, Gonzalez CD, Elgart J, González L, Cernadas C, Rucci E, Clark C, PRODIACOR (2013) Clinical, metabolic and psychological outcomes and treatment costs of a prospective randomized trial based on different educational strategies to improve diabetes care (PRODIACOR). Diabet Med 30(9):1102–1111CrossRefPubMed
34.
Zurück zum Zitat Evans JM, Mackison D, Emslie-Smith A, Lawton J (2012) Self-monitoring of blood glucose in Type 2 diabetes: cross-sectional analyses in 1993, 1999 and 2009. Diabet Med 29:792–795CrossRefPubMed Evans JM, Mackison D, Emslie-Smith A, Lawton J (2012) Self-monitoring of blood glucose in Type 2 diabetes: cross-sectional analyses in 1993, 1999 and 2009. Diabet Med 29:792–795CrossRefPubMed
35.
Zurück zum Zitat Kesavadev J, Sadikot S, Wangnoo S, Kannampilly J, Saboo B, Aravind SR, Kalra S, Makkar BM, Maji D, Saikia M, Anjana RM, Rajput R, Singh SK, Shah S, Dhruv U, Vishwanathan V (2014) Consensus guidelines for glycemic monitoring in type 1/type 2 & GDM. Diabetes Metab Syndr 8(3):187–195CrossRefPubMed Kesavadev J, Sadikot S, Wangnoo S, Kannampilly J, Saboo B, Aravind SR, Kalra S, Makkar BM, Maji D, Saikia M, Anjana RM, Rajput R, Singh SK, Shah S, Dhruv U, Vishwanathan V (2014) Consensus guidelines for glycemic monitoring in type 1/type 2 & GDM. Diabetes Metab Syndr 8(3):187–195CrossRefPubMed
Metadaten
Titel
Frequency of self-monitoring blood glucose and attainment of HbA1c target values
verfasst von
Jorge F. Elgart
Lorena González
Mariana Prestes
Enzo Rucci
Juan J. Gagliardino
Publikationsdatum
01.02.2016
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 1/2016
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-015-0745-9

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