Hortensius J, Kleefstra N, Houweling S T, van der Bijl J J, Gans R O B, Bilo H J G
Diabetes Centre, Isala Clinics, Zwolle, the Netherlands.
Neth J Med. 2012 Aug;70(6):287-91.
Patients' adherence to guidelines regarding self-monitoring of blood glucose (SMBG) is limited. However, there are no previous reports about the recommendations that are given in clinical practice concerning SMBG. The aim of this study was to investigate what healthcare providers recommend to insulin-treated patients with diabetes regarding frequency and timing of SMBG.
In this cross-sectional descriptive study, primary care assistants, diabetes specialised nurses and doctors in the Netherlands were invited via e-mail to complete an internet survey.
A total of 980 (14%) professionals returned the questionnaire. Insulin pump users and patients with type 1 diabetes (T1DM) on 4 injections a day were advised to perform SMBG daily by 96% and 63% of the professionals, respectively. The majority of the professionals advised these patients to perform 3-4 measurements per day. There was less agreement on the timing (pre- and÷or postprandial). Patients with type 2 diabetes (T2DM) on four injections were advised to perform SMBG less frequently. There was a wide variation in recommendations that were given to patients with T2DM on less intensive insulin regimens.
This study investigated SMBG from a professional's perspective. A considerable and relevant variation in the recommendations about the number and timing of SMBG was observed. The most striking differences were found in patients with T2DM on less intensive insulin regimes, also with respect to the frequency of SMBG. Well-designed studies are necessary in order to give a more evidence-based advice on the basic frequency and timing of SMBG.
患者对血糖自我监测(SMBG)指南的依从性有限。然而,此前尚无关于临床实践中给予SMBG的建议的报道。本研究的目的是调查医疗保健提供者就SMBG的频率和时间向接受胰岛素治疗的糖尿病患者推荐了什么。
在这项横断面描述性研究中,通过电子邮件邀请荷兰的初级护理助理、糖尿病专科护士和医生完成一项网络调查。
共有980名(14%)专业人员返回了问卷。分别有96%和63%的专业人员建议胰岛素泵使用者和每日注射4次的1型糖尿病(T1DM)患者每天进行SMBG。大多数专业人员建议这些患者每天进行3 - 4次测量。在测量时间(餐前和/或餐后)方面的共识较少。对于每日注射4次的2型糖尿病(T2DM)患者,建议其进行SMBG的频率较低。对于胰岛素治疗方案强度较低的T2DM患者,所给予的建议存在很大差异。
本研究从专业人员的角度调查了SMBG。观察到关于SMBG的次数和时间的建议存在相当大且相关的差异。最显著的差异存在于胰岛素治疗方案强度较低的T2DM患者中,在SMBG频率方面也是如此。为了就SMBG的基本频率和时间给出更基于证据的建议,有必要进行精心设计的研究。