Association between Self-Monitoring of Blood Glucose and Glycemic Control in Patients with type 2 Diabetes Mellitus

Abstract

The relationship between the self-monitoring of blood glucose (SMBG) and glycemic control in patients with type 2 diabetes mellitus in a Veterans Affairs (VA) medical center was studied. Laboratory, inpatient, outpatient, and demographic data for patients with type 2 diabetes mellitus who were seen for three years continuously or receiving their care regularly from a single Texas VA facility between October 1, 1999, and September 30, 2002, were obtained. Local pharmacy data were used to identify patients who received blood-glucosemonitoring strips. Patients were assigned to one of four mutually exclusive groups: those who did not receive monitoring strips at all, those who received strips in fiscal year (FY) 2002 only, those who received strips in FYs 2001 and 2002, and those who received strips during all three years (FYs 2000, 2001, and 2002). Frequency of monitoring and case-mix scores were measured. Nonparametric statistics were used to compare the demographic and clinical characteristics of the four groups. Robust regression was used to analyze the relationships between SMBG and glycemic control in FY 2002. Of the 1185 patients who received oral hypoglycemic medications during all three fiscal years, 976 patients met the criteria for inclusion in one of the four groups. There were no significant differences among the four groups in baseline hemoglobin A1c (HbA1c) values, body mass index, or case-mix scores. The Kruskal-Wallis test found no significant difference among the four groups in the number of laboratory blood glucose tests conducted, but there were significant differences in the number of HbA1c tests conducted among the groups. SMBG was not associated with glycemic control in VA patients with type 2 diabetes mellitus managed on oral hypoglycemic medications.