The Burden of Structured Self-Monitoring of Blood Glucose on Diabetes-Specific Quality of Life and Locus of Control in Patients with Noninsulin-Treated Type 2 Diabetes: The PRISMA Study.
To evaluate whether structured self-monitoring of blood glucose (SMBG) is associated with changes in diabetes-specific quality of life (DSQoL) and locus of control (LOC) in patients with noninsulin-treated type 2 diabetes (T2DM).



In this analysis of the PRISMA (Prospective Randomized Trial on Intensive SMBG Management Added Value in Noninsulin-Treated T2DM Patients) Study psychosocial data, we evaluated the impact of 12 months of structured SMBG on the individual domains of DSQoL and LOC questionnaires, including the role of selected confounders.



The score for Satisfaction, Impact, and Worry domains (DSQoL) improved when compared with baseline, without significant differences between structured SMBG regimen (intervention group, n = 501) and active control group (n = 523). Scores for Internal, Chance, and Powerful Others domains (LOC) improved compared with baseline, with a significant between-group change in Chance (P = 0.0309). For DSQoL domain score, improvements were associated with higher number of SMBG measurements (P = 0.007), older age (P = 0.013), and male sex (P = 0.0133) for Satisfaction and with male sex (P < 0.0001) for Worry. Concerning LOC domain score, improvements were associated with longer diabetes duration (P = 0.0084) and younger age (P < 0.0001) for Chance and total number of SMBG measurements (P = 0.0036) for Internal, with the intervention group close to being significant (P = 0.06).



Our analysis demonstrates that in patients with noninsulin-treated T2DM, structured SMBG is not associated with a deterioration of quality of life and LOC, which is strongly predicted by demographics and diabetes-related variables. These findings should be considered when tailoring educational support to SMBG for these patients.
1 Department of Clinical and Experimental Medicine, Policlinico Universitario Gaetano Martino , Messina, Italy .
Giuseppina T
GT
Russo
2 Diabetes Research Institute, San Raffaele Scientific Institute , Milan, Italy .
Marina
M
Scavini
3 Medical Affairs, Roche Diagnostics S.p.A. , Monza, Italy .
Elena
E
Acmet
4 Section of Medical Statistics and Biometry G.A. Maccacaro, Department of Occupational Health Clinica del Lavoro L. Devoto, School of Medicine, University of Milan , Milan, Italy .
Erminio
E
Bonizzoni
2 Diabetes Research Institute, San Raffaele Scientific Institute , Milan, Italy .|5 San Raffaele Vita-Salute University , Milan, Italy .
Emanuele
E
Bosi
6 Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine , Bari, Italy .
Francesco
F
Giorgino
7 Division of Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Padova , Padova, Italy .
Antonio
A
Tiengo
1 Department of Clinical and Experimental Medicine, Policlinico Universitario Gaetano Martino , Messina, Italy .
Domenico
D
Cucinotta
D000328:Adult; D000367:Age Factors; D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors