Assessment of compliance to self monitoring of blood glucose in type 2 diabetic patients and level of implementation of Polish Diabetes Association Recommendation for general practitioners
2018
Introduction. Self monitoring of blood glucose is one of basic elements of effective diabetes treatment. Due to proper self monitoring of blood glucose adequate modification of diabetes treatment — fulfilling criteria of good glycemic control — is possible. Effective treatment enables prevention of late diabetic complications — a cause of disability or death in diabetic population. Material and methods. 765 type 2 diabetic patients (above 18 yrs) treated with both oral hypoglycaemic drugs or insulin in different schemes were observed (mean age: 64.5 ± 10.9 yrs). Therapy was in line with general standards of treatment, medication choice was based on indications and previous independent physician decision. Patients were given glucometer ContourPlus and were taught how to use it and how often measurement had to be taken (on the basis of Polish Diabetes Association Recommendation for 2016). After 3 months (± 2 weeks) assessment of compliance to self monitoring of blood glucose was performed. Additionally, level of implementation of Polish Diabetes Association Recommendation for general practitioners, functionality of glucometer and usefulness of “second chance” measurement were evaluated. Results. 440 participants completely fulfilled recommendations (65.1%) of general practitioner (investigator) regarding self monitoring documentation (type of documentation provided: glucometer, glucose monitoring diary). In investigators opinion, 315 patients (below 50%) were conscientiously compliant to self monitoring of blood glucose based on Polish Diabetes Association Recommendations. In general practice for about 68.0% of patients (n = 506) Polish Diabetes Association Recommendations for self blood glucose monitoring were implemented. Based on investigators opinion the most important features of glucometers which determine effectiveness of self monitoring of glucose are: simplicity, high capacity memory, accuracy and precision of measurement, evaluation of mean glucose in general and mean pre-/after meal. 67.7% patients (n = 451) regarded possibility of “second chance” measurement in glucometer ContourPlus as useful in daily self monitoring of blood glucose. Conclusions. Discrepancy between Polish Diabetes Association Recommendations of self blood glucose monitoring and its realization by type 2 diabetic patients, carried out by general practitioners, was observed. Effective glucose monitoring is dependent on tight cooperation between doctor and patient.
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