Perceptions of blood glucose self-monitoring for non-insulin treated type 2 diabetes: a qualitative interview study

Background: Self-monitoring of blood glucose (SMBG) is thought to empower patients to manage diabetes, however research suggests it may not be beneficial or cost-effective for those with non-insulin treated type 2 diabetes (NITT2D). Empirical studies have used self-regulation theories to conceptualise SMBG but theoretical approaches are largely absent in qualitative investigations. This study used the Common-Sense Model to explore patient and healthcare professional (HCP) perspectives on SMBG for NITT2D. Method: Nineteen participants (14 patients with NITT2D; 5 HCPs) took part in semi-structured qualitative interviews following a topic guide informed by the Common-Sense Model. Interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis. Results: “The challenge of glucose control” was identified as a central theme to four interrelated sub-themes. Patients described how “interpreting and responding to bodily signals and monitoring results” triggered thoughts and emotions that influenced their behaviour. “The role of monitoring in patients’ lives” was multi-layered, though certain patients felt self-monitoring was inessential. Accounts suggested a balancing act in “the roles and responsibilities of patients and HCPs”, with both facing competing tasks and goals. Health professionals stressed “appropriate testing”, suggesting that monitoring results must inform decision-making for patients to derive benefits. Conclusion. Patients and HCPs generally perceived self-monitoring as useful, though this varied depending on patients’ treatment regimens. Health professionals expressed concerns about appropriate testing, emphasising that self-monitoring must be linked with education to change behaviour. Findings support the importance of emotional and cognitive processes in self-monitoring and suggest the utility of the Common-Sense Model to examine SMBG.