Self-monitoring of blood glucose: psychological barriers and benefits (original) (raw)
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Self-management Education Program: The Case of Glycemic Control of Type 2 Diabetes
Oman Medical Journal
Objectives: Self-management education (SME) is recognized globally as a tool that enables patients to achieve optimal glucose control. While factors influencing the effectiveness of self-management interventions have been studied extensively, the impact of program length on clinical endpoints of patients diagnosed with diabetes is underdeveloped. This paper synthesized information from the existing literature to understand the effect of program length on glycated hemoglobin (HbA1C) in adults with type 2 diabetes mellitus. Methods: We searched Web of Science, PubMed, Scopus, MEDLINE, EMBASE, PsychINFO, and the Cochrane Central Register of Controlled Trials to identify relevant English language publications on diabetes selfmanagement education published between January 2000 and April 2019. Results: The review included 25 randomized controlled trials, with 64.0% reporting significant changes in HbA1C. The studies classified as long-term (lasting one year and above) were associated with...
Diabetology & metabolic syndrome, 2015
Self-monitoring of blood glucose (SMBG) has been recommended as a useful tool for improving glycemic control, but is still an underutilized strategy and most diabetic patients are not aware of the actions that must be taken in response to its results and do not adjust their treatment. The purpose of this study was to evaluate the effectiveness and safety of an educational program for insulin self-adjustment based on SMBG in poorly controlled patients with type 2 diabetes (T2DM). A prospective, randomized, controlled 12-week intervention study was conducted on poorly controlled insulin-requiring patients with T2DM. Twenty-three subjects were randomized to two educational programs: a 2-week basic program with guidance about SMBG and types and techniques of insulin administration (group A, n = 12) and a 6-week program including the basic one and additional instructions about self-titration of insulin doses according to a specific protocol (group B, n = 11). Patients were reviewed after...
Metabolic Control of Adults With Type 2 Diabetes Mellitus Through Education and Counseling
Journal of Nursing Scholarship, 2006
Purpose: To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care.Design: A quasi-experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylatedhemoglobin (HbA1c), psychosocial, and clinical variables.Findings: Results showed a significant decrease in HbA1c in the experimental group, as well as positive effects of self-care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self-care actions.Conclusions: The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self-care agency, adaptation, and barriers were predictors of self-care measures and level of HbA1c.
2005
Background: The benefit of Self-monitoring of Blood Glucose (SMBG) in people with non-insulin treated type 2 diabetes remains unclear with inconsistent evidence from randomised controlled trials fuelling the continued debate. Lack of a consistent finding has been attributed to variations in study population and design, including the SMBG intervention. There is a growing consensus that structured SMBG, whereby the person with diabetes and health care provider are educated to detect patterns of glycaemic abnormality and take appropriate action according to the blood glucose profiles, can prove beneficial in terms of lowering HbA1c and improving overall well-being. Despite this, many national health agencies continue to issue guidelines restricting the use of SMBG in non-insulin treated type 2 diabetes. Methods: The SMBG Study is a 12 month, multi-centre, randomised controlled trial in people with type 2 diabetes not on insulin therapy who have poor glycaemic control (HbA1c ≥58 mmol/mol / 7.5%). The participants will be randomised into three comparative groups: Group 1 will act as a control group and receive their usual diabetes care; Group 2 will undertake structured SMBG with clinical review every 3 months; Group 3 will undertake structured SMBG with additional monthly telecare support from a trained study nurse. A total of 450 participants will be recruited from 16 primary and secondary care sites across Wales and England. The primary outcome measure will be HbA1c at 12 months with secondary measures to include weight, BMI, total cholesterol and HbA1c levels at 3, 6, 9 and 12 months. Participant well-being and attitude towards SMBG will be monitored throughout the course of the study. Recruitment began in December 2012 with the last participant visit due in September 2016. Discussion: This study will attempt to answer the question of whether structured SMBG provides any benefits to people with poorly controlled type 2 diabetes who are not being treated with insulin. The data will also clarify whether the telecare support provides additional value. The overall acceptability of SMBG as a tool for self-management will be assessed.
Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2016
Background: Diabetes mellitus places an enormous burden upon both patients and countries' health systems. Integral to achieving control is patients assuming responsibility for their condition. Self-monitoring of blood glucose (SMBG) can serve as a powerful tool modifying lifestyle behaviour and can aid in achieving optimal control. Methods: This study assessed the effect on diabetes control in patients who received glucometers and education over 12 months. This data was analysed at baseline, 6 and 12 months. Results: Glycaemic control improved significantly between baseline, 6 and 12 months (HbA1c% 12.29 ± 3.17 vs. 11.16 ± 3.09 vs. ±10.68 ± 3.10, respectively). The number of patients achieving target glycaemic control increased substantially while the number of patients achieving target total cholesterol and triglyceride levels improved at six months. Mean HDL cholesterol increased significantly between baseline and 12 months (1.20 ± 0.42 vs. 1.31 ± 0.40, respectively; p-value 0.0095). The mean BMI of male patients in the study increased between 6 and 121 months (27.59 ± 6.42 vs. 31.90 ± 8.85, respectively, p = 0.0012) and between baseline and 12 months (27.64 ± 6.13 vs. 31.90 ± 8.85, respectively, p = 0.0012). Conclusion: This study demonstrated that the introduction of SMBG and patient education, within this resource-limited clinic setting, had beneficial effects on diabetes control; however, obesity remains an obstacle to optimal control.
Self-management profiles and metabolic outcomes in type 2 diabetes
Journal of Advanced Nursing, 2006
Self-management profiles and metabolic outcomes in type 2 diabetes Aim. This paper reports a study whose aims were (1) to examine whether it is possible to determine participants' self-management profiles using three open-ended questions about their self-perceived role in diabetes management; and (2) to analyse whether such self-management profiles have any bearing on haemoglobin A 1c levels. Background. The behavioural and educational aspects of self-management in type 2 diabetes have been the topic of a number of investigations. The individual's role in maintaining health and a satisfying everyday life with chronic conditions is increasingly becoming the focus of secondary prevention. Method. Participants (n ¼ 259) were recruited from those attending a year-long health educational programme for people with type 2 diabetes at Swedish pharmacies. A questionnaire was distributed 24 months after baseline. The health outcome, haemoglobin A 1c was measured on four occasions. Three open-ended questions were used to explore self-management profiles based on perceived role, goal, and need of support in treatment. Data were collected during the period 1997-2002. Findings. The following profiles of participants emerged: Disease Manager, Compliant, and Disheartened, with no initial differences in metabolic control. However, during the programme Disease Managers achieved good glycaemic control and succeeded in maintaining the reduction in their blood glucose for a longer period than those in other categories: their haemoglobin A 1c level was reduced by À0AE35 at 6 months (P ¼ 0AE000), À0AE30 at 12 months (P ¼ 0AE001), and À0AE28 at 24 months (P ¼ 0AE001) after baseline. Compliant participants had a good everyday routine and a À0AE18 reduction at 6 months (P ¼ 0AE028) but no statistically significant haemoglobin A 1c level reduction later. A smaller group of people, the Disheartened, reported difficulties in living with diabetes and did not succeed in decreasing their haemoglobin A 1c by statistically significant amounts. Conclusion. Healthcare professionals could use our three open-ended questions to assist in understanding people's views of their role in disease management so that health promotion and education can be tailored to individual needs.
Journal of Diabetes Science and Technology, 2011
Active study, (BMI) body mass index, (CI) confidence interval, (DiGEM) Diabetes Glycemic Education and Monitoring study, (FBS) fasting blood sugar, (HbA1c) hemoglobin A1c, (IEM) Institute of Endocrinology and Metabolism, (MBG) mean blood glucose, (MPP) mean postprandial blood glucose, (SD) standard deviation, (SMBG) self-monitoring of blood glucose, (T2DM) type 2 diabetes mellitus
Journal of diabetes research, 2014
To comprehensively evaluate the effect of a short-term diabetes self-management education (DSME) on metabolic markers and atherosclerotic parameters in patients with type 2 diabetes. 76 patients with type 2 diabetes were recruited in this study. They were divided into the intervention group (n = 36) and control group (n = 40). The patients in the intervention group received a 3-month intervention, including an 8-week education on self-management of diabetes mellitus and subsequent 4 weeks of practice of the self-management guidelines. The patients in the control group received standard advice on medical nutrition therapy. Metabolic markers, carotid intima-media thickness (CIMT), and carotid arterial stiffness (CAS) of the patients in both groups were assessed before and after the 3-month intervention. There was a significant reduction in hemoglobin A1c (HbA1c, -0.2 ± 0.56% versus 0.08 ± 0.741%; P < 0.05) and body weight (-1.19 ± 1.39 kg versus -0.61 ± 2.04 kg; P < 0.05) in the...