Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants.
Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants.
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DOI：
10.2337/dc12-1770
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发表时间：
2013-07
期刊：
影响因子：
16.2
通讯作者：
T1D Exchange Clinic Network
中科院分区：
文献类型：
--
作者：
Miller KM;Beck RW;Bergenstal RM;Goland RS;Haller MJ;McGill JB;Rodriguez H;Simmons JH;Hirsch IB;T1D Exchange Clinic Network
尽管有大量证据表明，1型糖尿病患者经常自我监测血糖（SMBG）是有益的，但某些保险公司限制了他们提供的试纸数量。T1D Exchange诊所登记研究的大型数据库提供了一个机会，可以在广泛的儿童和成人年龄范围内评价每日SMBG测量次数与HbA1c水平之间的关系。该分析包括20，555名T1D Exchange临床登记研究中的1型糖尿病患者，年龄≥1岁，未使用动态血糖监测仪（11，641名年龄小于18岁，8，914名年龄≥ 18岁）。在调整潜在混杂变量后，使用一般线性模型评估SMBG测量次数与HbA1c水平之间的相关性。每日SMBG测量次数较多与非西班牙裔白色人种、保险范围、较高家庭收入和使用胰岛素泵输注胰岛素相关（每个因素P < 0.001）。调整这些因素后，每天SMBG测量次数越多，HbA1c水平越低（调整后P < 0.001），所有年龄组以及胰岛素泵和注射使用者均存在相关性。SMBG频率较高与HbA1c水平较低之间存在强相关性。对于保险公司来说，重要的是要考虑减少对每月提供的试纸数量的限制可能会改善某些1型糖尿病患者的血糖控制。
Despite substantial evidence of the benefit of frequent self-monitoring of blood glucose (SMBG) in type 1 diabetes, certain insurers limit the number of test strips that they will provide. The large database of the T1D Exchange clinic registry provided an opportunity to evaluate the relationship between the number of SMBG measurements per day and HbA1c levels across a wide age range of children and adults. The analysis included 20,555 participants in the T1D Exchange clinic registry with type 1 diabetes ≥1 year and not using a continuous glucose monitor (11,641 younger than age 18 years and 8,914 18 years old or older). General linear models were used to assess the association between the number of SMBG measurements and HbA1c levels after adjusting for potential confounding variables. A higher number of SMBG measurements per day were associated with non-Hispanic white race, insurance coverage, higher household income, and use of an insulin pump for insulin delivery (P < 0.001 for each factor). After adjusting for these factors, a higher number of SMBG measurements per day was strongly associated with a lower HbA1c level (adjusted P < 0.001), with the association being present in all age-groups and in both insulin pump and injection users. There is a strong association between higher SMBG frequency and lower HbA1c levels. It is important for insurers to consider that reducing restrictions on the number of test strips provided per month may lead to improved glycemic control for some patients with type 1 diabetes.