Self-monitoring of blood glucose in type 2 diabetic patients in China: current status and influential factors.
BACKGROUND
Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.


METHODS
In this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.


RESULTS
Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.


CONCLUSIONS
SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.
Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. Email: ylhxyy@163.com.
Li
L
Yuan
Department of Endocrinology, First Hospital of Peking University, Beijing 100034, China.
Xiaohui
X
Guo
Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
Zhenzhen
Z
Xiong
Department of Health Education, Jiangsu Province Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing, Jiangsu 210028, China.
Qingqing
Q
Lou
Nursing Department, Beijing Tsinghua Chang Gung Hospital of Tsinghua University, Beijing 100027, China.
Li
L
Shen
Department of Endocrinology, China-Japan Friendship Hospital, Beijing100029, China.
Fang
F
Zhao
Department of Internal Medicine, Southeast University Zhongda Hospital, Nanjing, Jiangsu 210009, China.
Zilin
Z
Sun
Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
Jianwei
J
Li
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data*; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose