Adherence of self-monitoring of blood glucose in persons with type 1 diabetes in Sweden

Journal article, 2017

Objective: The primary aim was to evaluate the extent to which persons with type 1 diabetes perform selfmonitoring of blood glucose (SMBG) according to guidelines. Secondary objectives were to investigate predictors for good SMBG adherence, reasons for non-adherence, and association between SMBG frequency and hemoglobin A1c (HbA1c). Methods: This was a survey-based cross-sectional study. Questionnaires were sent out to 600 random patients at five sites. Patients were included if they were diagnosed with type 1 diabetes and ?18 years old and excluded if they were currently using continuous glucose monitoring (CGM). Analysis of data was performed separately for the three sites where the answer frequency was ?70%. Results: In total, 138 of 314 study participants, 43.9% (95% CI 38.5% to 49.4%) performed SMBG ?4 times per day. For the three clinics where ?70% of surveyed patients were included in the analysis, results were similar, 41.3% (95% CI 34.7% to 47.8%). Top three reported reasons for not performing more frequent SMBG were lack of time, not remembering, and self-consciousness. Frequency of SMBG was associated with HbA1c levels (p<0.0001). 30% of patients believed that ?3 SMBG/day was recommended by healthcare providers. Conclusions: Less than 50% of patients in Sweden follow guidelines of SMBG ?4 times per day, despite glucose meters and strips being generally available at no cost. This indicates a need for further support in performing SMBG and increased availability of other tools for glucose monitoring.