title: Self Monitoring of Blood Glucose Among Patients with Type 2 Diabetes Mellitus in Eastern Nigeria: Need for Multi-strategic Interventions.
abstract: BACKGROUND
  Self Monitoring of Blood Glucose (SMBG) is a useful adjunct to lifestyle modification and medications for optimal management of type 2 Diabetes Mellitus (DM). This study was aimed at evaluating the practice, cost and associations of SMBG in subjects with type 2 DM in Enugu, Nigeria.
  
  
  METHODS
  In a cross-sectional survey conducted at the diabetes clinic in three hospitals, 366 type 2 diabetic subjects aged 18-65 years were consecutively interviewed. Socio-demographic and clinical information were documented and glycated hemoglobin was performed for all the participants.
  
  
  RESULTS
  A total of 318 subjects with mean age of 49.0 ± 9.4 years completed the study. 304 subjects (95.6%) reported that they were aware of SMBG and 60.7% practiced SMBG at frequencies ranging from ≥ 1/day (7.9%), ≥ 1/week (26.1%) or < 1/week (26.7%). 39.3% of the respondents did not perform any SMBG. Lack of finance was the predominant reason for not performing any SMBG. The median monthly cost of performing SMBG excluding the cost of meters was N2,000 (USD 6.7) per patient, amounting to annual societal cost of N37.8 billion (USD 126 million). Significant associates of performing any SMBG were longer DM duration, previous participation in diabetes education, insulin treatment and infrequent hospitalization.
  
  
  CONCLUSIONS
  Despite high awareness, SMBG practice is grossly inadequate and is associated with a huge economic burden that may be unsustainable in a resource-poor country like Nigeria. Measures aimed at reducing the cost of glucometers and strips, and improving diabetes education are recommended.
authors.affiliation: Department of Internal Medicine, Enugu State University of Science and Technology, Enugu, Nigeria.
authors.forename: Ejiofor T
authors.initials: ET
authors.lastname: Ugwu
authors.affiliation: Department of Internal Medicine, Enugu State University of Science and Technology, Enugu, Nigeria.
authors.forename: Casmir J G
authors.initials: CJG
authors.lastname: Orjioke
authors.affiliation: Department of Internal Medicine, University of Nigeria Nsukka, Nsukka, Nigeria.
authors.forename: Ekenechukwu E
authors.initials: EE
authors.lastname: Young
mesh_terms: D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000191:economics* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009549:Nigeria; D012044:Regression Analysis; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Awareness; Nigeria; blood glucose; cost; diabetes mellitus; self-monitoring