Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database.
OBJECTIVE
To investigate patterns of self monitoring of blood glucose concentration in diabetic patients who use insulin and to determine whether frequency of self monitoring is related to glycaemic control.


METHODS
Diabetes database, Tayside, Scotland.


METHODS
Patients resident in Tayside in 1993-5 who were using insulin and were registered on the database and diagnosed with insulin dependent (type 1) or non-insulin dependent (type 2) diabetes before 1993.


METHODS
Number of glucose monitoring reagent strips dispensed (reagent strip uptake) derived from records of prescriptions. First recorded haemoglobin A1c concentration in the study period, and reagent strips dispensed in the previous 6 months.


RESULTS
Among 807 patients with type 1 diabetes, 128 (16%) did not redeem any prescriptions for glucose monitoring reagent strips in the 3 year study period. Only 161 (20%) redeemed prescriptions for enough reagent strips to test glucose daily. The corresponding figures for the 790 patients with type 2 diabetes who used insulin were 162 (21%; no strips) and 131 (17%; daily tests). Reagent strip uptake was influenced both by age and by deprivation category. There was a direct relation between uptake and glycaemic control for 258 patients (with recorded haemoglobin A1c concentrations) with type 1 diabetes. In a linear regression model the decrease in haemoglobin A1c concentration for every extra 180 reagent strips dispensed was 0.7%. For the 290 patients with type 2 diabetes who used insulin there was no such relation.


CONCLUSIONS
Self monitoring of blood glucose concentration is associated with improved glycaemic control in patients with type 1 diabetes. Regular self monitoring in patients with type 1 and type 2 diabetes is uncommon.
Evans
J M
JM
Medicines Monitoring Unit, Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee DD1 9SY. josie@memo.dundee.ac.uk
Newton
R W
RW
Ruta
D A
DA
MacDonald
T M
TM
Stevenson
R J
RJ
Morris
A D
AD
D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D010349:Patient Compliance; D011933:Reagent Kits, Diagnostic; D012959:Socioeconomic Factors
D001786:Blood Glucose; D007328:Insulin; D011933:Reagent Kits, Diagnostic