Background: The cost of test strips for self monitoring of B-glucose (SMBG) has increased dramatically. However, the efficacy of SMBG for patients with type 2 diabetes has been questioned.
Aim: The aim of this work was to study the association between glycaemic control and SMBG in patients with type 2 diabetes and their opinions and habits of SMBG.
Method: A study was conducted at 18 primary health care centres (PHCC) where all patients with diabetes type 2 were surveyed (n= 6495). Age, gender, treatment category, and HbA1c were registered. Patients were categorised as users of SMBG if test strips had been prescribed within the last year. Users of SMBG (n=533) were telephone interviewed about the last time SMBG was used, the number of test-strips used the last week, the reason and value for SMBG, and strategy if unsatisfactory value.
Results: The treatment categories; diet only (32%), oral agents (37%) and insulin (31%), were similarly distributed at all PHCCs. Mean HbA1c (6.0%) was different in patients with oral agents at the PHCC with the highest frequency of SMBG users compared to the PHCC with the middle (6.8%, p<0.001) and to PHCC with the lowest (6.4%, p= 0.03) number of users. At one PHCC, users of SMBG with insulin treatment had higher HbA1c than non-users (7.0% vs 6.1%, p= 0.03). At two PHCCs, SMBG users with diet only, had higher HbA1c than non-users (5.5% vs 5.2% p=0.04, 6.8% vs 6.9% p=0.01). At one PHC non-users had higher HbA1c (6.4% vs 6.0%). The patients used 0-42 test-strips during the week prior to the interview. Reassurance was the main reason for using SMBG, and on a scale of 1 to10 the mean value was 7.5. Over 75% of the patients stated that self-modification of treatment was important but one third did not know what to do if the test-strip showed unsatisfactory value.
Conclusions: The results showed that the use of SMBG was inconsistently associated with glycaemic control. This study lends support for clear guidelines and optimal use of test-strips with focus on the patient as a person with individual needs.