Glucose self-monitoring in primary care: a survey of current practice.
BACKGROUND
The role of long-term glycaemic control in minimizing long-term complications of diabetes mellitus is evidence-based and national guidelines recommend a target glycosylated haemoglobin level of approximately 7%. Although the role of self-monitoring blood and urine glucose is less well defined, this activity consumes vast National Health Service (NHS) resources.


OBJECTIVE
The aims of this study were to (i) determine the current practice of glucose self-monitoring in primary care, (ii) determine any changes to therapy made as a result and (iii) compare monitoring and frequency of monitoring in those patients using insulin with those patients taking oral hypoglycaemic agents.


METHODS
Postal questionnaire to 311 patients using insulin or oral hypoglycaemic agents identified from three general practices.


RESULTS
The response rate was 59.8% (186/311), with the majority of responding patients (n = 158, 87.3%) performing self-monitoring. The patients using insulin were more likely to be self-monitoring than those taking oral therapy (chi(2), P < 0.001, d.f. = 1). The majority of patients who self-monitored and were using insulin (n = 45, 61.1%) altered the dose of insulin if a reading was beyond their target range. However, the majority of patients who self-monitored and were taking oral therapy (n = 48, 68.6%) took no action at all.


CONCLUSIONS
Blood glucose self-monitoring was common in those treated with insulin or oral hypoglycaemics, although those using insulin were more likely to self-monitor. Notably many patients, particularly those on oral therapy, took no action based on the results of self-monitoring.
Stewart
D
D
School of Pharmacy, The Robert Gordon University, Aberdeen AB10 1GG, Scotland, UK. d.stewart@rgu.ac.uk
McCaig
D
D
Davie
A
A
Juroszek
L
L
Blackwood
L
L
Findlay
N
N
McCarthy
S
S
D000284:Administration, Oral; D000368:Aged; D001294:Attitude to Health; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000706:statistics & numerical data; D003625:Data Collection; D019317:Evidence-Based Medicine / Q000379:methods; D006029:Glycosuria; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011320:Primary Health Care; D011795:Surveys and Questionnaires
D007004:Hypoglycemic Agents; D007328:Insulin