Self-monitoring among non-insulin treated patients with type 2 diabetes mellitus: Patients' behavioural responses to readings and associations with glycaemic control

Aim: To investigate self-monitoring of blood glucose (SMBG) behaviour among non-insulin treated patients with type 2 diabetes mellitus, and to evaluate associations with glycaemic control.

Methods: Eligible patients in 23 GP practices in Tayside, Scotland, were identified (18-75 years, no insulin treatment, SMBG reagent strips dispensed in 2009). Consenting patients were administered questionnaires addressing SMBG behaviour: these primary data were record-linked to clinical data (including HbA1c) from a validated population-based diabetes clinical information system, then anonymised.

Results: Among 629 eligible patients, 207 were interviewed and analysed. Mean SMBG reagent strips dispensed in 12 months was 268. In response to a perceived high test result, 80 (38.8%) patients took no action or simply checked later with most of them (61.3%) indicating they did not know what action to take. Of the 126 (61.2%) patients who took some action, 101 made changes to diet, 12 increased physical activity, 10 made changes to medication and 12 mad a HCP appointment. A high score on a Diabetes Knowledge Test was a statistically significant predictor of taking action (odds ratio: 2.07). However, neither taking action nor increased SMBG frequency was associated with improved glycaemic control.

Conclusions: Responding to SMBG test results and increased testing frequency were not associated with improved glycaemic control in the short-term. There is a lack of knowledge surrounding SMBG in non-insulin treated patients.