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Perspectives in care
Adherence of self-monitoring of blood glucose in persons with type 1 diabetes in Sweden
  1. Peter Moström1,
  2. Elsa Ahlén2,3,4,
  3. Henrik Imberg5,6,
  4. Per-Olof Hansson4,
  5. Marcus Lind3,4
  1. 1Department of Internal Medicine, Alingsås Lasarett, Alingsås, Sweden
  2. 2Department of Medicine, Värnamo Hospital, Värnamo, Sweden
  3. 3Department of Medicine, NU Hospital Group, Uddevalla, Sweden
  4. 4Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  5. 5Statistiska Konsultgruppen, Gothenburg, Sweden
  6. 6Department of Mathematical Sciences, Chalmers University of Technology and the University of Gothenburg, Gothenburg, Sweden
  1. Correspondence to Dr Marcus Lind; lind.marcus{at}telia.com

Abstract

Objective The primary aim was to evaluate the extent to which persons with type 1 diabetes perform self-monitoring of blood glucose (SMBG) according to guidelines. Secondary objectives were to investigate predictors for good SMBG adherence, reasons for non-adherence, and association between SMBG frequency and hemoglobin A1c (HbA1c).

Methods This was a survey-based cross-sectional study. Questionnaires were sent out to 600 random patients at five sites. Patients were included if they were diagnosed with type 1 diabetes and ≥18 years old and excluded if they were currently using continuous glucose monitoring (CGM). Analysis of data was performed separately for the three sites where the answer frequency was ≥70%.

Results In total, 138 of 314 study participants, 43.9% (95% CI 38.5% to 49.4%) performed SMBG ≥4 times per day. For the three clinics where ≥70% of surveyed patients were included in the analysis, results were similar, 41.3% (95% CI 34.7% to 47.8%). Top three reported reasons for not performing more frequent SMBG were lack of time, not remembering, and self-consciousness. Frequency of SMBG was associated with HbA1c levels (p<0.0001). 30% of patients believed that ≤3 SMBG/day was recommended by healthcare providers.

Conclusions Less than 50% of patients in Sweden follow guidelines of SMBG ≥4 times per day, despite glucose meters and strips being generally available at no cost. This indicates a need for further support in performing SMBG and increased availability of other tools for glucose monitoring.

  • Blood Glucose Monitoring
  • HbA1
  • Compliance/Adherence
  • Frequency

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000342

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    Footnotes

    • Contributors ML and PM designed the study and are the guarantors of this work. HI performed all statistical analysis. All authors participated in interpreting and discussing the results. PM, EA, and ML wrote a first draft of the manuscript and the supplement. All other authors reviewed and revised the manuscript.

    • Funding This study was supported by grants from the Region Västra Götaland, the Swedish State (ALF grant) and the Novo Nordisk Foundation.

    • Competing interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ML reports receiving honoraria or having been a consultant for AstraZeneca, Eli Lilly, Medtronic, Novo Nordisk, and Pfizer and grant support from AstraZeneca, Dexcom, Novo Nordisk, and Pfizer. All other authors declare no conflicts of interest.

    • Patient consent Obtained.

    • Ethics approval The regional ethical committee in Gothenburg, Sweden.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.