Self-glucose monitoring and glycaemic control at a tertiary care university hospital, Karachi, Pakistan.

Abstract

To explore the association between Self Monitoring of Blood Glucose (SMBG) levels and improved glycemic control (HbA1c level) among type 2 diabetic patients, receiving oral hypoglycaemic agents and insulin, and to ascertain the factors influencing SMBG.
Using Comparative cross sectional study design five hundred Type 2 diabetes patients through convenient sampling between 30-70 years were interviewed through a structured questionnaire in year 2006 and 2007 at AKUH Ambulatory setting. These 500 subjects were divided as 250 in case (doing SMBG) and 250 in control (not doing SMBG) groups.
We identified that HbA1c value was maintained at good and fair levels in case (56%) as compared to controls (p=0.002). There was a high association of SMBG with education level, as graduate and above were monitoring SMBG at high level as evident by (p=0.005). Furthermore, there was a high association of SMBG with duration of diabetes as subjects having diabetics more than 5 years were monitoring their blood glucose level at frequent intervals (p=0.001). In case, 96.8% subjects had knowledge about the target of fasting and random blood glucose in comparison to 91.6% subjects in controls. The frequency of blood sugar checking varied among all subjects in case group such as 55% checked their blood sugar occasionally, 26% monitored daily, and 13% twice a day and 3% checked their blood sugar before and after each meal. Conclusion: Self-monitoring of blood glucose levels was associated with clinically and statistically better glycaemic control regardless of diabetes type or therapy. Therefore, healthcare personnel must increase awareness on the importance of SMBG and strongly promote this practice among diabetic patients.