The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients - An urgent need for better educational strategies
The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients - An urgent need for better educational strategies
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DOI：
10.2337/diacare.24.11.1870
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发表时间：
2001-11-01
期刊：
影响因子：
16.2
通讯作者：
Nicolucci, A
中科院分区：
文献类型：
--
作者：
Franciosi, M;Pellegrini, F;Nicolucci, A
目的：自我血糖监测（SMBG）在2型糖尿病中的作用仍然存在争议。在一项全国性结果研究计划的框架下，我们调查了SMBG的频率及其与代谢控制和生活质量（QoL）的关系。研究设计和方法：该研究涉及3567名2型糖尿病患者，他们来自101家糖尿病门诊诊所和103名全科医生。患者完成了一份调查SMBG实践和生活质量（糖尿病相关压力、糖尿病健康困扰、糖尿病相关担忧和流行病学研究中心抑郁量表）的问卷。结果-可获得2,855名受试者（占整个研究人群的80%）的SMBG数据。总体而言，471名患者（17%）表示他们每天在家检测1次血糖水平，899名患者（31%）每周检测1次血糖水平，414名患者（14%）检测血液，而1071名患者（38%）表示从未进行过SMBG。在能够调整胰岛素剂量的受试者中，较高的SMBG频率与更好的代谢控制有关，而在所有其他患者中，无论何种治疗方式，都没有发现这种关系。多变量分析表明SMBG频率！在未接受胰岛素治疗的患者中，每天1 Lime与更高水平的痛苦、担忧和抑郁症状显著相关。结论：我们的研究结果表明，SMBG可以在改善代谢控制方面发挥重要作用，如果它是致力于促进患者自主性的更广泛教育策略的组成部分。在未接受胰岛素治疗的患者中，自我监测与较高的HbA（1c）水平和心理负担相关。我们的数据不支持将SMBG扩展到这一群体。
OBJECTIVE - The role of self-monitoring of blood glucose (SMBG) in type 2 diabetes is still a matter of debate. in the framework of a nationwide outcomes research program, we investigated the frequency of SMBG and its association with metabolic control and quality of life (QoL).RESEARCH DESIGN AND METHODS - The study involved 3,567 patients with type 2 diabetes who were recruited by 101 outpatient diabetes clinics and 103 general practitioners. Patients completed a questionnaire investigating SMBG practice and QoL (diabetes-related stress, diabetes health distress, diabetes-related worries, and Centers for Epidemiologic Studies-Depression scale).RESULTS - Data on SMBG were available for 2,855 subjects (80% of the entire study population). Overall, 471 patients (17%) stated that they tested their blood glucose levels at home I time per day, 899 patients (31%) tested their blood glucose levels : I time per week, and 414 patients (14%) tested their blood whereas 1,071 patients (38%) stated that the never practiced SMBG. A higher frequency of SMBG was associated with better, metabolic control among subjects who were able to adjust insulin doses, whereas no relationship was found in all other patients, irrespective of the kind of treatment. Multivariate analyses showed that an SMBG Frequency ! 1 Lime per day was significantly related to higher levels of distress, worries, and depressive symptoms in non-insulin-treated patients.CONCLUSIONS - our findings suggest that SMBG can have an important role in improving metabolic control if it is an integral part of a wider educational strategy devoted to the promotion of patient autonomy. In patients not treated with insulin, self-monitoring is associated with higher HbA(1c) levels and psychological burden. Our data do not support the extension of SMBG to this group.