School of Public Health, Shantou University, Shantou, China.
Shantou University Medical College, Shantou, China.
Front Endocrinol (Lausanne). 2023 Jun 27;14:1111565. doi: 10.3389/fendo.2023.1111565. eCollection 2023.
Self-monitoring of blood glucose (SMBG) plays a vital role in the maintenance of blood glucose with type 2 diabetes mellitus(T2DM) and pre-diabetes patients. The study was intended to describe the current status of SMBG with T2DM and pre-diabetes patients in grassroots communities, explore the relationship between SMBG frequency and blood glucose level and apply information-motivation-behavior(IMB) model to analyze the potential influencing factors of SMBG compliance based on electronic questionnaires.
A cross-sectional study was conducted with 1388 T2DM and pre-diabetes patients who completed electronic questionnaires composed of demographics and IMB model content. Chi-square test, Mann-Whitney U test and multivariable logistic regression model analysis were utilized to explore deeply causes of SMBG compliance.
The results of this study showed that among 1388 T2DM patients, only 26.2% (363/1388) patients reached SMBG standard, indicating low compliance with SMBG. Given that SMBG is one of the individual predictors of type 2 risk in prediabetes patients, this result suggests that the SMBG compliance rate needs to be improved. Patients with fixed occupation (OR=1.989, =0.035), BMI in normal range (OR=1.336, =0.049), smoking habit(OR=1.492, =0.019), understanding SMBG frequency (OR=1.825, <0.001), understanding control goal of blood glucose (OR=1.414, <0.001), knowing all the functions of the blood glucose meter (OR=1.923, <0.001), buying a blood glucose meter/test paper conveniently(OR=2.329, =0.047), taking supplementary measurement when forgetting blood glucose test(OR=2.044, =0.005), rotating all the fingers when measuring blood glucose (OR=1.616, <0.001) and less pain at the needling site(OR=2.114, <0.001)were independently promoting factors of adherence to SMBG. However, the lack of accessibility and convenience of blood glucose meter or heavy financial burden were blocking factors of adherence to SMBG. Moreover, there were still bottlenecks such as lack of health care knowledge and needle pricking pain.
This study verified the practicability of applying IMB model to SMBG with T2DM and pre-diabetes patients. Adherence to SMBG still remained to improved, and putting more emphasis in improvement of individual information, motivation and behavioral skills with patients might be beneficial to maintain better adherence to SMBG in long-term routine of diabetes self-management.
自我血糖监测（SMBG）在 2 型糖尿病（T2DM）和糖尿病前期患者的血糖控制中起着至关重要的作用。本研究旨在描述基层社区 T2DM 和糖尿病前期患者 SMBG 的现状，探讨 SMBG 频率与血糖水平的关系，并基于电子问卷应用信息-动机-行为（IMB）模型分析 SMBG 依从性的潜在影响因素。
采用横断面研究方法，对完成包含人口统计学和 IMB 模型内容的电子问卷的 1388 例 T2DM 和糖尿病前期患者进行调查。采用卡方检验、Mann-Whitney U 检验和多变量逻辑回归模型分析深入探讨 SMBG 依从性的原因。
本研究结果显示，在 1388 例 T2DM 患者中，仅 26.2%（363/1388）的患者达到 SMBG 标准，表明 SMBG 依从性较低。鉴于 SMBG 是糖尿病前期患者 2 型风险的个体预测因素之一，这一结果表明 SMBG 依从率有待提高。固定职业（OR=1.989，=0.035）、BMI 处于正常范围（OR=1.336，=0.049）、有吸烟习惯（OR=1.492，=0.019）、了解 SMBG 频率（OR=1.825，<0.001）、了解血糖控制目标（OR=1.414，<0.001）、了解血糖仪所有功能（OR=1.923，<0.001）、方便购买血糖仪/试纸（OR=2.329，=0.047）、忘记测血糖时进行补充测量（OR=2.044，=0.005）、测量血糖时旋转所有手指（OR=1.616，<0.001）、减少针刺部位疼痛（OR=2.114，<0.001）是 SMBG 依从性的独立促进因素。然而，血糖仪的可及性和便利性不足以及经济负担过重是 SMBG 依从性的障碍因素。此外，在糖尿病自我管理的常规长期实践中，仍然存在缺乏保健知识和针刺疼痛等瓶颈问题。
本研究验证了将 IMB 模型应用于 T2DM 和糖尿病前期患者 SMBG 的实用性。SMBG 的依从性仍有待提高，更加注重患者个体信息、动机和行为技能的改善，可能有助于长期维持更好的 SMBG 依从性。
