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. 2017 Apr 6;5(1):e000342.
doi: 10.1136/bmjdrc-2016-000342. eCollection 2017.

Adherence of self-monitoring of blood glucose in persons with type 1 diabetes in Sweden

Peter Moström  1 , Elsa Ahlén  2   3   4 , Henrik Imberg  5   6 , Per-Olof Hansson  4 , Marcus Lind  3   4
Affiliations

Adherence of self-monitoring of blood glucose in persons with type 1 diabetes in Sweden

Peter Moström et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: The primary aim was to evaluate the extent to which persons with type 1 diabetes perform self-monitoring of blood glucose (SMBG) according to guidelines. Secondary objectives were to investigate predictors for good SMBG adherence, reasons for non-adherence, and association between SMBG frequency and hemoglobin A1c (HbA1c).

Methods: This was a survey-based cross-sectional study. Questionnaires were sent out to 600 random patients at five sites. Patients were included if they were diagnosed with type 1 diabetes and ≥18 years old and excluded if they were currently using continuous glucose monitoring (CGM). Analysis of data was performed separately for the three sites where the answer frequency was ≥70%.

Results: In total, 138 of 314 study participants, 43.9% (95% CI 38.5% to 49.4%) performed SMBG ≥4 times per day. For the three clinics where ≥70% of surveyed patients were included in the analysis, results were similar, 41.3% (95% CI 34.7% to 47.8%). Top three reported reasons for not performing more frequent SMBG were lack of time, not remembering, and self-consciousness. Frequency of SMBG was associated with HbA1c levels (p<0.0001). 30% of patients believed that ≤3 SMBG/day was recommended by healthcare providers.

Conclusions: Less than 50% of patients in Sweden follow guidelines of SMBG ≥4 times per day, despite glucose meters and strips being generally available at no cost. This indicates a need for further support in performing SMBG and increased availability of other tools for glucose monitoring.

Keywords: Blood Glucose Monitoring; Compliance/Adherence; Frequency; HbA1.

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Conflict of interest statement

Competing interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ML reports receiving honoraria or having been a consultant for AstraZeneca, Eli Lilly, Medtronic, Novo Nordisk, and Pfizer and grant support from AstraZeneca, Dexcom, Novo Nordisk, and Pfizer. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Distribution of number of daily SMBG last 30 days. (B) HbA1c as function of daily SMBG. HbA1c, hemoglobin A1c; SMBG, self-monitoring of blood glucose.
See this image and copyright information in PMC

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