Self-monitoring of blood glucose in a multiethnic population of rural older adults with diabetes.
The purpose of the study was to describe self-monitoring of blood glucose (SMBG) practices of 698 older adults with type 2 diabetes in the rural Southeast, to identify characteristics differentiating testers from nontesters, and to identify personal and support-related predictors of monitoring frequency.



The ELDER (Evaluating Long-term Diabetes Self-management Among Elderly Rural Adults) study was a population-based, cross-sectional survey of African American, Native American, and white Medicare recipients > or =65 years with diagnosed diabetes. Data were obtained through in-home interviews. Multiple logistic regression models were used to identify factors associated with SMBG and frequency of monitoring.



Seventy-seven percent of respondents practiced SMBG in the previous week; 40% tested every day in that week. No ethnic differences were seen. Significant independent predictors of any SMBG were medication regimen (taking oral agents or insulin with or without oral agents) and health care provider (HCP) recommendation to test. Among those monitoring, significant independent predictors of SMBG frequency were medication regimen, HCP recommendation to test, duration of diabetes, and receiving help with testing, which was negatively associated with monitoring frequency.



Among rural older persons with diabetes, HCP recommendation significantly affected practicing SMBG and SMBG frequency. These findings suggest points of intervention by diabetes educators with this vulnerable population. Further research is needed to determine how older adults use SMBG data in their self-care regimen.
Skelly
Anne H
AH
The School of Nursing, University of North Carolina at Chapel Hill (Dr Skelly)
Arcury
Thomas A
TA
The Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Arcury)
Snively
Beverly M
BM
The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
Bell
Ronny A
RA
The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
Smith
Shannon L
SL
The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
Wetmore
Lindsay K
LK
The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
Quandt
Sara A
SA
The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003431:Cross-Cultural Comparison; D003920:Diabetes Mellitus / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D012044:Regression Analysis; D012424:Rural Population; D012648:Self Care