Cuevas Heather E, Brown Sharon A, García Alexandra A, Winter Mary, Brown Adama, Hanis Craig L
1 School of Nursing, The University of Texas at Austin , Austin, Texas.
Diabetes Technol Ther. 2015 Feb;17(2):105-11. doi: 10.1089/dia.2014.0147. Epub 2014 Oct 7.
The purpose was to describe patterns of home self-monitoring of blood glucose (SMBG) in Mexican Americans with type 2 diabetes mellitus enrolled in a diabetes self-management education protocol. Research questions were as follows: (1) What were the patterns and rates of home glucose self-monitoring over the 6-month course of the study? (2) What were the differences in monitoring rates between experimental and control groups? (3) What were the relationships between rates of monitoring and glycosylated hemoglobin (A1C), gender, and years with diabetes?
We used a randomized (by group) repeated-measures pretest/posttest control group design. Glucometer data from an experimental group (diabetes self-management education plus nurse case management) and a comparison group (diabetes self-management education only) were analyzed. Data were collected at baseline and at 3 and 6 months.
Overall average SMBG rates were low. Experimental and control group monitoring levels were not significantly different. More females than males never monitored glucose values, but more females than males checked at least one time per week. Those participants who checked their glucose levels more than once per week had diabetes for a longer period of time. Rates of monitoring were not strongly associated with A1C levels at 3 and 6 months, but at 6 months A1C levels were statistically significantly different based on whether or not individuals monitored their glucose levels (P=0.03, n=71).
SMBG rates were low in this study despite SMBG education and access to free glucometers and test strips. The lower rates of SMBG may reflect the effects of unexpected environmental challenges, but exact causes remain unclear. Reasons for low rates of SMBG need to be explored further, especially in underserved communities.
目的是描述参与糖尿病自我管理教育方案的墨西哥裔2型糖尿病患者的家庭血糖自我监测（SMBG）模式。研究问题如下：（1）在为期6个月的研究过程中，家庭血糖自我监测的模式和频率是怎样的？（2）实验组和对照组在监测频率上有何差异？（3）监测频率与糖化血红蛋白（A1C）、性别以及糖尿病病程之间有何关系？
我们采用了随机（分组）重复测量的前测/后测对照组设计。对实验组（糖尿病自我管理教育加护士个案管理）和对照组（仅糖尿病自我管理教育）的血糖仪数据进行了分析。在基线、3个月和6个月时收集数据。
总体平均SMBG频率较低。实验组和对照组的监测水平无显著差异。从未监测过血糖值的女性多于男性，但每周至少检查一次的女性多于男性。每周检查血糖水平超过一次的参与者患糖尿病的时间更长。在3个月和6个月时，监测频率与A1C水平的相关性不强，但在6个月时，根据个体是否监测血糖水平，A1C水平在统计学上有显著差异（P = 0.03，n = 71）。
尽管进行了SMBG教育且可获得免费血糖仪和试纸，但本研究中的SMBG频率较低。较低的SMBG频率可能反映了意外环境挑战的影响，但确切原因尚不清楚。SMBG频率较低的原因需要进一步探索，尤其是在服务不足的社区。
