Center for Value-Based Care Research, Cleveland Clinic, 9500 Euclid Avenue, G10, Cleveland, OH, 44195, USA.
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
J Gen Intern Med. 2022 May;37(7):1673-1679. doi: 10.1007/s11606-021-07047-2. Epub 2021 Aug 13.
Professional societies have recommended against use of self-monitoring blood glucose (SMBG) in non-insulin-treated type 2 diabetes (NITT2D) to control blood sugar levels, but patients are still monitoring.
To understand patients' motivation to monitor their blood sugar, and whether they would stop if their physician suggested it.
Cross-sectional in-person and electronic survey conducted between 2018 and 2020.
Adults with type 2 diabetes not using insulin who self-monitor their blood sugar.
The survey included questions about frequency and reason for using SMBG, and the impact of SMBG on quality of life and worry. It also asked, "If your doctor said you could stop checking your blood sugar, would you?" We categorized patients based on whether they would stop. To identify the characteristics independently associated with desire to stop SMBG, we performed a logistic regression using backward stepwise selection.
We received 458 responses. The common reasons for using SMBG included the doctor wanted the patient to check (67%), desire to see the number (65%), and desire to see if their medications were working (61%). Forty-eight percent of respondents stated that using SMBG reduced their worry about their diabetes and 61% said it increased their quality of life. Fifty percent would stop using SMBG if given permission. In the regression model, respondents who said that they check their blood sugar levels because "I was told to" were more likely to want to stop (AOR: 1.69, 95%CI: 1.11, 2.58). Those that used SMBG due to habit and to understand their diabetes better had lower odds of wanting to stop (AOR: 0.33, 95%CI: 0.18-0.62; AOR: 0.60, 95%CI: 0.39-0.93, respectively).
Primary care physicians should discuss patients' reasons for using SMBG and offer them the option of discontinuing.
专业协会建议非胰岛素治疗 2 型糖尿病（NITT2D）患者不要使用自我监测血糖（SMBG）来控制血糖水平，但患者仍在进行监测。
了解患者监测血糖的动机，以及如果医生建议他们停止监测，他们是否会停止。
在 2018 年至 2020 年期间进行的横断面现场和电子调查。
未使用胰岛素且自我监测血糖的 2 型糖尿病成人患者。
该调查包括有关 SMBG 频率和原因的问题，以及 SMBG 对生活质量和担忧的影响。它还询问：“如果您的医生说您可以停止检查血糖，您会吗？”我们根据患者是否会停止监测，将患者进行分类。为了确定与停止 SMBG 愿望相关的特征，我们使用向后逐步选择进行了逻辑回归。
我们收到了 458 份回复。使用 SMBG 的常见原因包括医生希望患者检查（67%）、想看数值（65%）和想看药物是否有效（61%）。48%的受访者表示，使用 SMBG 减少了他们对糖尿病的担忧，61%的受访者表示它提高了他们的生活质量。如果得到允许，50%的患者会停止使用 SMBG。在回归模型中，回答“因为我被告知”而检查血糖的受访者更有可能想要停止（OR：1.69，95%CI：1.11，2.58）。那些因为习惯和更好地了解自己的糖尿病而使用 SMBG 的人停止的可能性较小（OR：0.33，95%CI：0.18-0.62；OR：0.60，95%CI：0.39-0.93）。
初级保健医生应讨论患者使用 SMBG 的原因，并为他们提供停止使用的选择。
