Relationship between metabolic control and self-monitoring of blood glucose in insulin-treated patients with diabetes mellitus

Abstract Objective To assess the relationship between metabolic control (MC) and frequency of self-monitoring of blood glucose (SMBG) in insulin-treated patients with type 1 (T1DM) and type 2 (T2DM) diabetes mellitus, and to analyze the factors associated to MC. Materials and methods A multicenter, cross-sectional, observational study was conducted in which endocrinologists enrolled diabetic patients treated with insulin who used a glucometer. The cut-off value for MC was HbA 1c  ≤ 7%. Grade of acceptance of the glucometer was assessed using a visual analogue scale (VAS). Results A total of 341 patients (53.5% males) with a mean age (SD) 52.8 (16.3) years, mean HbA 1c of 7.69% (1.25) and 128 (37.5%) with T1DM and 211 (61.9%) with T2DM were evaluable. SMBG was done by 86.1% at least once weekly. No relationship was seen between MC and SMBG ( p  = 0.678) in the overall sample or in the T1DM ( p  = 0.940) or T2DM ( p  = 0.343) subgroups. In the logistic regression model, hyperglycemic episodes (Exp-b [risk] 1.794, p  = 0.022), falsely elevated HbA 1c values (Exp-b 3.182, p  = 0.005), and VAS (Exp-b 1.269, p  = 0.008) were associated to poor MC in the total sample. Hyperglycemic episodes (Exp-b 2.538, p  = 0.004), falsely elevated HbA 1c values (Exp-b 3.125, p  = 0.012), and VAS (Exp-b 1.316, p  = 0.026) were associated to poor MC in the T2DM subgroup, while body mass index (Exp-b 1.143, p  = 0.046) was associated to poor MC in the T1DM subgroup. Conclusions In this retrospective, non-controlled study on patients with DM treated with insulin who used a glucometer, no relationship was seen between the degree of metabolic control and frequency of use of the glucometer.