Evaluación de la técnica de análisis domiciliario de glucemia capilar entre la población con diabetes de siete comunidades autónomas de España

Abstract

BackgroundThe importance and significance of the blood glucose self monitoring technique on improving the quality of life in people with diabetes is well known. ObjectivesTo determine and evaluate the correct performance of the blood glucose selfmonitoring technique among the diabetes mellitus population and to compare this technique and the blood glucose self-monitoring frequency with the degree of glycaemic control of the disease. Material and methodsIt is a multicentre, randomised and systematic study in which a population with diabetes mellitus from seven Spanish Regions who performed home blood glucose self-monitoring tests between January 1st and September 30th 2010 were included. ResultsData from 455 patients were analyzed with an equal distribution regarding geographic area and gender (53% females, 47% males). Related to the evaluation of the blood glucose self monitoring technique and the glucose meters used for this purpose, 87% re-used the lancets (40% more than 10 times). 42% did not rotate puncture areas. Only 58% mentioned a previous hand-washing and 13% used antiseptics, mainly alcohol. Some patients (20%) had no clear idea about when and for what purpose they performed the blood glucose self-monitoring test and 60% did not modify the treatment according to the results. Most of the study patients (89%) had a dirty and/or broken capillary puncture device. The majority (60%) of the glucose meters required some kind of previous coding, which was not correct in 20 of them; 26% did not have alert messages and 4% had expired test strips. Nine per cent of the sample had not recorded any HbA1C (83% were DM2 patients) and 70% of those recorded were >7%. ConclusionsAccording to the results of our study, it is shown that not teaching the correct use of the blood glucose self-monitoring technique is needed, but it must also be evaluated periodically by the professionals. Both the glucose meters and capillary puncture devices also need to be reviewed, taking into account the very high re-use rate of the lancets found. We must think carefully about the biosecurity of the patients who perform this technique. Regarding the used devices, a lack of knowledge about them is shown as regards important issues such as coding, test strips expiry date and alert messages among others. These are very important as they are able to alter the true results, and therefore the decission making process. A high number of patients had poor metabolic control, which is in agreemnt other published series and, despite the current recommendations proposed by the Scientific Societies, the modifications suggested related to the frequency of both HbA1C and blood glucose self-monitoring were not performed.