Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. Email:
Department of Endocrinology, First Hospital of Peking University, Beijing 100034, China.
Chin Med J (Engl). 2014;127(2):201-7.
Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.
In this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.
Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.
SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.
对于 2 型糖尿病（T2D）患者而言，自我血糖监测（SMBG）至关重要，然而诸多文化、经济和健康因素都会降低 SMBG 的依从性。目前关于 SMBG 依从性的研究主要来自美国和欧洲，其结果是否适用于亚洲地区尚不清楚。本研究旨在评估中国 T2D 患者的 SMBG 现状，并分析可能影响 SMBG 的人口统计学和糖尿病相关特征。
本多中心、横断面研究纳入了来自中国 29 个省 50 家医疗中心的 5953 例 T2D 患者，他们填写了一份标准化问卷，内容包括人口统计学特征、教育程度、职业、收入、生活方式危险因素、糖尿病病程、慢性并发症以及 SMBG 频率。受访者还被问及过去 6 个月内是否检查过糖化血红蛋白（HbA1c）。血糖、HbA1c 的最近值来自于病历记录。
仅 1130 例（18.98%）患者按照推荐频率进行 SMBG，而 4823 例（81.02%）患者未进行 SMBG。实际上，近 2105 例（35.36%）患者报告从未进行过 SMBG。在接受胰岛素治疗的 3661 例患者亚组中，仅有 266 例（7.27%）患者至少每天进行一次 SMBG，而 1210 例（33.05%）患者从未进行过 SMBG。相比之下，2292 例接受饮食/运动治疗或口服降糖药治疗的患者中，有 895 例（39.05%）患者从未进行过 SMBG。多变量 Logistic 回归确定了与 SMBG 依从性相关的几个因素：女性、较高的教育水平、较高的收入、较长的 T2D 病程以及 SMBG 教育。
中国 T2D 患者的 SMBG 依从性低于发达国家。多个因素影响 SMBG 依从性：性别、教育水平、收入、T2D 病程、治疗方案以及 SMBG 教育的接触。
