Abstract
BackgroundWhile type 1 diabetics often require self-monitoring of blood glucose (SMBG), the evidence for tight blood glucose monitoring in non-insulin treated type 2 diabetes mellitus (T2DM) patients is limited. In addition to its lack of cost-effectiveness, unnecessary blood glucose monitoring may also result in anxiety and decreased quality of life. In this retrospective audit, we assessed SMBG prescribing practice at one general practice against guidelines from the National Institute for Health and Care Excellence (NICE).MethodsA systematic search of T2DM patients diagnosed at a general practice in London, United Kingdom, in the last 10 years was undertaken. A total of 146 patients fulfilled these criteria, of which 100 patients were randomly selected for inclusion in this audit. Medical notes were reviewed and collated for analysis.ResultsOnly 85% of patients with T2DM were being managed in accordance with the NICE guidelines on SMBG, while 15% were not. It was more common for patients who did not need monitoring to be inappropriately prescribed SMBG (10%) than it was for patients who needed monitoring to be under-prescribed SMBG (5%). The reasons for prescribing SMBG were often left undocumented.ConclusionAdherence to the NICE guidelines is subpar. Recommended solutions include educating healthcare professionals involved in the prescribing of SMBGs, regular reviews of the continued necessity of SMBG, and digital alerts on e-prescribing systems.
Highlights
Diabetes is recognized by the World Health Organization (WHO) and International Diabetes Federation (IDF) as a major health problem, with about 463 million adults living with diabetes and 4.2 million deaths caused by diabetes in 2019 alone [1]
85% of patients with type 2 diabetes mellitus (T2DM) were being managed in accordance with the National Institute for Health and Care Excellence (NICE) guidelines on self-monitoring of blood glucose (SMBG), while 15% were not
This retrospective audit found that only 85% of patients with T2DM were being managed in accordance with the NICE guidelines on SMBG while 15% were not
Summary
Diabetes is recognized by the World Health Organization (WHO) and International Diabetes Federation (IDF) as a major health problem, with about 463 million adults living with diabetes and 4.2 million deaths caused by diabetes in 2019 alone [1]. Self-monitoring of blood glucose (SMBG) was first introduced in the 1960s and has developed significantly since due to accumulating evidence that regular monitoring of blood glucose is an important part of diabetes management [3]. While type 1 diabetics often require self-monitoring of blood glucose (SMBG), the evidence for tight blood glucose monitoring in non-insulin treated type 2 diabetes mellitus (T2DM) patients is limited. In addition to its lack of cost-effectiveness, unnecessary blood glucose monitoring may result in anxiety and decreased quality of life. In this retrospective audit, we assessed SMBG prescribing practice at one general practice against guidelines from the National Institute for Health and Care Excellence (NICE)
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