Tanenbaum M L, Leventhal H, Breland J Y, Yu J, Walker E A, Gonzalez J S
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ.
Diabet Med. 2015 Nov;32(11):1504-12. doi: 10.1111/dme.12745. Epub 2015 Apr 11.
To clarify the role of self-monitoring of blood glucose (SMBG) in the self-management of Type 2 diabetes from the patient's perspective, using in-depth interviews with non-insulin-treated adults to investigate how they learned to manage their diabetes effectively and whether SMBG played a significant role in this process.
Individual interviews were conducted with 14 non-insulin-treated adults with Type 2 diabetes who had significantly improved their glycaemic control [64% women; 50% black; 21% Hispanic; mean age 60 years; mean HbA(1c) concentration 43 mmol/mol (6.1%)]. Interviews were transcribed and analysed by a coding team, applying the concept of illness coherence from the Common Sense Model of Self-Regulation.
The majority of participants relied on SMBG to evaluate their self-management efforts. Key themes included: adopting an experimental approach; experiencing 'a-ha' moments; provider-assisted problem-solving; using SMBG and other feedback to evaluate when their efforts were working; and normalizing diabetes-specific behaviour changes as being healthy for everyone.
Our qualitative data are consistent with the argument that SMBG, if implemented appropriately with enough education and provider access, can be a powerful tool for non-insulin-treated adults with Type 2 diabetes to monitor their self-management. Establishing sufficient conditions for illness coherence to develop while individuals are learning to use SMBG could increase their sense of personal control in managing a complex and demanding illness.
从患者角度阐明自我血糖监测（SMBG）在2型糖尿病自我管理中的作用，通过对非胰岛素治疗的成年人进行深入访谈，调查他们如何学会有效管理糖尿病，以及SMBG在此过程中是否发挥了重要作用。
对14名非胰岛素治疗的2型糖尿病成年人进行了个体访谈，这些患者的血糖控制有显著改善[64%为女性；50%为黑人；21%为西班牙裔；平均年龄60岁；平均糖化血红蛋白（HbA1c）浓度为43 mmol/mol（6.1%）]。访谈内容由一个编码团队进行转录和分析，应用自我调节常识模型中的疾病连贯性概念。
大多数参与者依靠自我血糖监测来评估他们的自我管理努力。关键主题包括：采用实验方法；经历“顿悟”时刻；在医疗服务提供者协助下解决问题；利用自我血糖监测和其他反馈来评估他们的努力何时有效；以及将特定于糖尿病的行为改变正常化，认为对每个人都有益健康。
我们的定性数据与以下观点一致，即如果在有足够教育和医疗服务提供者支持的情况下适当实施，自我血糖监测可以成为非胰岛素治疗的2型糖尿病成年人监测自我管理的有力工具。在个体学习使用自我血糖监测时，建立足够的条件以促进疾病连贯性的发展，可以增强他们在管理复杂且要求高的疾病时的个人控制感。
