Self-monitoring of blood glucose levels and glycemic control: The Northern California Kaiser Permanente Diabetes Registry
Self-monitoring of blood glucose levels and glycemic control: The Northern California Kaiser Permanente Diabetes Registry
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DOI：
10.1016/s0002-9343(01)00742-2
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发表时间：
2001-07-01
影响因子：
5.9
通讯作者：
Selby, JV
中科院分区：
文献类型：
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作者：
Karter, AJ;Ackerson, LM;Selby, JV
目的：我们试图评估自我监测血糖水平对改善血糖控制的有效性。 对象和方法：采用队列设计来评估自我监测频率（1996 年平均每日血糖仪条使用率）与 1997 年测量的首次糖化血红蛋白 (HbA(1c)) 水平之间的关系。研究样本包括 24,312 名成年糖尿病患者，他们属于一个大型群体的成员模型，管理式医疗组织。我们估计了按美国糖尿病协会推荐的频率进行自我监测的患者与按 A 监测频率进行自我监测的患者相比，HbA(1c) 水平之间的差异。模型根据年龄、性别、种族、教育、职业、收入、糖尿病病程、药物补充依从性、门诊预约“缺席”率、年度眼科检查出勤率、非药物（饮食和运动）糖尿病治疗的使用、吸烟、饮酒、住院和急诊室就诊以及每日胰岛素次数进行了调整结果：1 型糖尿病患者（每天大于或等于 3 次）和接受药物治疗的 2 型糖尿病患者（至少每天一次）的自我监测与较低的 HbA(1c) 水平相关（I 型糖尿病患者降低 1.0 个百分点，2 型糖尿病患者降低 0.6 个百分点），而监测频率较低的患者则较低（P
PURPOSE: We sought to evaluate the effectiveness of self-monitoring blood glucose levels to improve glycemic control.SUBJECTS AND METHODS: A cohort design was used to assess the relation between self-monitoring frequency (1996 average daily glucometer strip utilization) and the first glycosylated hemoglobin (HbA(1c)) level measured in 1997, The study sample included 24,312 adult patients with diabetes who were members of a large, group model, managed care organization. We estimated the difference between HbA(1c) levels in patients who self-monitored at frequencies recommended by the American Diabetes Association compared with those who monitored less frequently or not at A. Models were adjusted for age, sex, race, education, occupation, income, duration of diabetes, medication refill adherence, clinic appointment "no show" rate, annual eye exam attendance, use of nonpharmacological (diet and exercise) diabetes therapy, smoking, alcohol consumption, hospitalization and emergency room visits, and the number of daily insulin injections.RESULTS: Self-monitoring among patients with type 1 diabetes (greater than or equal to3 times daily) and pharmacologically treated type 2 diabetes (at least daily) was associated with lower HbA(1c) levels ( 1.0 percentage points lower in type I diabetes and 0.6 points lower in type 2 diabetes) than was less frequent monitoring (P