Lecomte P, Romon I, Fosse S, Simon D, Fagot-Campagna A
Unité d'endocrinologie et métabolisme, CHRU Bretonneau, Tours, France.
Diabetes Metab. 2008 Jun;34(3):219-26. doi: 10.1016/j.diabet.2007.11.005. Epub 2008 Mar 17.
To describe the practice of self-monitoring blood glucose (SMBG) testing and to determine factors linked to SMBG in people with diabetes living in France.
The 2001 Entred study, a French national survey of people being treated for diabetes, is based on a representative sample of 10,000 adults who claimed reimbursement for oral hypoglycaemic agents and/or insulin in October to December 2001 and who were randomly extracted from the database of the major National Health Insurance System. A questionnaire was mailed to all these people and was returned by 36% of them, who were then classified into three groups: type 1 diabetes (T1D, N=235); type 2 diabetes treated with insulin (iT2D, N=635); and type 2 diabetes treated with oral hypoglycaemic agents (oT2D, N=2689). Factors associated with SMBG were analyzed using logistic regression models with a step-by-step forward approach.
HbA(1c) was greater than or equal to 8% in 42% of people with T1D, 48% of those with iT2D and 21% of those with oTD2. Almost all of those treated with insulin performed SMBG. The frequency of self-monitoring was higher in T1D than in iT2D. In T1D, 58% of people reported they took at least three tests a day, as recommended in guidelines, which was more frequent in those who knew what HbA(1c) meant and in women. In iT2D, 74% reported that they took at least two tests a day, as recommended, and it was more frequent in those who knew what HbA(1c) meant, who reported at least one severe hypoglycaemic episode in 2001 and who received dietary advice from their practitioner. In oT2D, 38% reported using SMBG (six tests a week on average), even though no official recommendation had been provided for these patients. SMBG was also more frequent in patients being treated with multiple oral hypoglycaemic agents, in those who benefited from a waiver of co-payment due to a chronic disease and in those, who had visited a diabetes specialist in 2001, reported they knew what HbA(1c) meant, received dietary advice and reported at least one severe hypoglycaemic episode in 2001 and/or a history of diabetes complications.
In France, as per the official recommendations, almost all people on insulin treatment use a SMBG device while, overall, their glucose control remains poor. More than one-third of those with oT2D regularly perform SMBG. In only 3% of people, the regular use of SMBG does not appear to be related to any special needs or events (such as insulin treatment, occurrence of severe hypoglycaemia or chronic complications).
描述自我血糖监测（SMBG）测试的情况，并确定与法国糖尿病患者自我血糖监测相关的因素。
2001年的Entred研究是一项针对法国糖尿病患者的全国性调查，基于10000名成年人的代表性样本，这些成年人在2001年10月至12月期间报销了口服降糖药和/或胰岛素费用，并且是从主要国家医疗保险系统的数据库中随机抽取的。向所有这些人邮寄了一份问卷，36%的人回复了问卷，这些人随后被分为三组：1型糖尿病（T1D，N = 235）；接受胰岛素治疗的2型糖尿病（iT2D，N = 635）；接受口服降糖药治疗的2型糖尿病（oT2D，N = 2689）。使用逐步向前法的逻辑回归模型分析与自我血糖监测相关的因素。
42%的T1D患者、48%的iT2D患者和21%的oTD2患者糖化血红蛋白（HbA1c）大于或等于8%。几乎所有接受胰岛素治疗的患者都进行自我血糖监测。T1D患者自我监测的频率高于iT2D患者。在T1D患者中，58%的人报告他们按照指南建议每天至少进行三次测试，在知道HbA1c含义的人和女性中更频繁。在iT2D患者中，74%的人报告他们按照建议每天至少进行两次测试，在知道HbA1c含义的人、报告在2001年至少有一次严重低血糖发作的人以及接受医生饮食建议的人中更频繁。在oT2D患者中，38%的人报告使用自我血糖监测（平均每周六次测试），尽管尚未为这些患者提供官方建议。在接受多种口服降糖药治疗的患者、因慢性病而享受免共同支付待遇的患者以及在2001年看过糖尿病专科医生、报告知道HbA1c含义、接受饮食建议并报告在2001年至少有一次严重低血糖发作和/或有糖尿病并发症病史的患者中，自我血糖监测也更频繁。
在法国，根据官方建议，几乎所有接受胰岛素治疗的人都使用自我血糖监测设备，然而总体而言，他们的血糖控制仍然很差。超过三分之一的oT2D患者定期进行自我血糖监测。只有3%的人，自我血糖监测的常规使用似乎与任何特殊需求或事件（如胰岛素治疗、严重低血糖的发生或慢性并发症）无关。
