title: Determinants of self-monitoring of blood glucose in patients with Type 1 diabetes: a multi-centre study in Brazil.
abstract: OBJECTIVE
  The aim of this study was to determine the relationship between the daily frequency of self-monitoring of blood glucose and glycaemic control, demographic and socio-economic status in patients with Type 1 diabetes under routine clinical care in Brazil.
  
  
  METHODS
  This was a cross-sectional, multi-centre study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data were obtained from 3176 patients, aged 22 ± 11.8 years, of whom 56.3% were female and 57.4% were Caucasian. The mean time since diabetes diagnosis was 11.7 ± 8.1 years.
  
  
  RESULTS
  The prevalence of self-monitoring of blood glucose was 88.5%. There was a significant increase in self-monitoring frequency associated with female gender, lower ages, more intensive diabetes management and higher socio-economic status. A correlation between HbA(1c) levels and the daily frequency of self-monitoring was observed (r(s) = -0.13; P = 0.001). The mean HbA1c levels were related to the daily frequency of self-monitoring (P < 0.001) without additional benefit to patients who performed self-monitoring more than four times daily (9.2, 11.2, 10.2,15.2 and 15% for one, two, three, four, five or more self-monitoring tests daily, respectively; P < 0.0001).
  
  
  CONCLUSIONS
  The majority of our patients (88.5%) performed three or more self-monitoring tests daily, with more frequent testing reported by females, younger patients, those on intensive insulin regimens and of higher socio-economic status. No additional benefit was found in patients who performed self-monitoring more than four times daily. The diabetes care team must improve patients' education regarding self-monitoring of blood glucose and its benefits.
authors.affiliation: Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, São Paulo, Brazil.
authors.forename: M B
authors.initials: MB
authors.lastname: Gomes
authors.forename: L R M
authors.initials: LR
authors.lastname: Tannus
authors.forename: R A
authors.initials: RA
authors.lastname: Cobas
authors.forename: A S M
authors.initials: AS
authors.lastname: Matheus
authors.forename: P
authors.initials: P
authors.lastname: Dualib
authors.forename: A T
authors.initials: AT
authors.lastname: Zucatti
authors.forename: C
authors.initials: C
authors.lastname: Cani
authors.forename: A D
authors.initials: AD
authors.lastname: Guedes
authors.forename: F M
authors.initials: FM
authors.lastname: Santos
authors.forename: J
authors.initials: J
authors.lastname: Sepulveda
authors.forename: M
authors.initials: M
authors.lastname: Tolentino
authors.forename: M C
authors.initials: MC
authors.lastname: Façanha
authors.forename: A C R A
authors.initials: AC
authors.lastname: Faria
authors.forename: S
authors.initials: S
authors.lastname: Lavigne
authors.forename: A P
authors.initials: AP
authors.lastname: Montenegro
authors.forename: M
authors.initials: M
authors.lastname: Rodacki
authors.forename: M
authors.initials: M
authors.lastname: de Fatima Guedes
authors.forename: R
authors.initials: R
authors.lastname: Szundy
authors.forename: M M
authors.initials: MM
authors.lastname: Cordeiro
authors.forename: P T S
authors.initials: PT
authors.lastname: Santos
authors.forename: C A
authors.initials: CA
authors.lastname: Negrato
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human