'Urine testing is a waste of time': newly diagnosed Type 2 diabetes patients' perceptions of self-monitoring.
OBJECTIVE
To date, there is no convincing evidence that non-insulin treated patients who undertake self-blood glucose monitoring (SBGM) have better glycaemic control than those who test their urine. This has led to a recommendation that non-insulin dependent patients undertake urine testing, which is the cheaper option. This recommendation does not take account of patients' experiences and views. This study explores the respective merits of urine testing and SBGM from the perspectives of newly diagnosed patients with Type 2 diabetes.


METHODS
Qualitative study using repeat in-depth interviews with 40 patients. Patients were interviewed three times at 6-monthly intervals over 1 year. Patients were recruited from hospital clinics and general practices in Lothian, Scotland. The study was informed by grounded theory, which involves concurrent data collection and analysis.


RESULTS
Patients reported strongly negative views of urine testing, particularly when they compared it with SBGM. Patients perceived urine testing as less convenient, less hygienic and less accurate than SBGM. Most patients assumed that blood glucose meters were given to those with a more advanced or serious form of diabetes. This could have implications for how they thought about their own disease. Patients often interpreted negative urine results as indicating that they could not have diabetes.


CONCLUSIONS
Professionals should be aware of the meanings and understandings patients attach to the receipt and use of different types of self-monitoring equipment. Guidelines that promote the use of consistent criteria for equipment allocation are required. The manner in which negative urine results are conveyed needs to be reconsidered.
Research Unit in Health, Behaviour and Change, School of Clinical Sciences and Community Health, College of Medicine and Veterinary Medicine, The University of Edinburgh Medical School, Edinburgh, UK. J.Lawton@ed.ac.uk
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Lawton
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Peel
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Douglas
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Parry
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000523:psychology / Q000652:urine; D005260:Female; D006029:Glycosuria / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*