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Frequency of self-monitoring blood glucose and attainment of HbA1c target values

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Abstract

Aims

Test strips for self-monitoring of blood glucose (SMBG) represent in Argentina, around 50 % of diabetes treatment cost; the frequency of their use is closely associated with hyperglycemia treatment. However, the favorable impact of SMBG on attainment of HbA1c goal in different treatment conditions remains controversial. We therefore attempted to estimate the relationship between use of SMBG test strips and degree of attainment of metabolic control in an institution of our social security subsector (SSS) in which provision is fully covered and submitted to a regular audit system.

Methods

Observational retrospective study using information of 657 patients with T2DM (period 2009–2010) from the database of the Diabetes and Other Cardiovascular Risk Factors Program (DICARO) of one institution of our SSS. DICARO provides—with an audit system—100 % coverage for all drugs and keeps records of clinical, metabolic and treatment data from every patient.

Results

The average monthly test strips/patient used for SMBG increased as a function of treatment intensification: Monotherapy with oral antidiabetic drugs (OAD) < combined OAD therapy < insulin treatment. In every condition, the number was larger in people with target HbA1c levels. Test strips represented the larger percentage of total prescription cost.

Conclusions

In our population, the type of hyperglycemia treatment was the main driver of test strip use for SMBG; in every condition tested, targeted HbA1c values were associated with greater strip use. Patient education and prescription audit may optimize its use and treatment outcomes.

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Acknowledgments

The authors greatly appreciate the contribution of the Obra Social de Trabajadores de Edificios de Renta y Horizontal (OSPERYH) authorities. JE, LG, MP and ER are member of the Health Economics Research Unit at CENEXA. LG and ER are research fellows of the National University of La Plata and CONICET, respectively. JJG is a member of the Research Career of CONICET.

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

For this type of study formal consent is not required.

Author information

Authors and Affiliations

  1. CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Médicas UNLP, 60 y 120, 1900, La Plata, Argentina

    Jorge F. Elgart, Lorena González, Mariana Prestes, Enzo Rucci & Juan J. Gagliardino

  2. Escuela de Economía de la Salud y Administración de Organizaciones de Salud, Facultad de Ciencias Económicas, Universidad Nacional de La Plata (UNLP), La Plata, Argentina

    Lorena González

  3. III-LIDI, Facultad de Informática, Universidad Nacional de La Plata (UNLP), La Plata, Argentina

    Enzo Rucci

Authors
  1. Jorge F. Elgart
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  2. Lorena González
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  3. Mariana Prestes
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  5. Juan J. Gagliardino
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Correspondence to Juan J. Gagliardino.

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Elgart, J.F., González, L., Prestes, M. et al. Frequency of self-monitoring blood glucose and attainment of HbA1c target values. Acta Diabetol 53, 57–62 (2016). https://doi.org/10.1007/s00592-015-0745-9

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  • DOI: https://doi.org/10.1007/s00592-015-0745-9

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