Self-Monitoring of Blood Glucose in Patients with Type 2 Diabetes Before and After Initiating Basal Insulin Treatment in China

Abstract

Objective: To investigate the situation of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes before and after initiating basal insulin treatment in China. Materials and Methods: This was a prospective analysis of data from the ORBIT study. Type 2 diabetes patients with HbA1c ≥ 7%, receiving oral antidiabetic agents, and initiated on basal insulin were recruited and followed up for 6 months. Patients were divided into three groups (low, middle, and high SMBG frequency) according to their SMBG frequency at the end of the study. Differences in glucose outcomes were compared among groups to evaluate the association between final SMBG frequency and the glucose control. Factors related to SMBG frequency were also analyzed using multivariate logistic regression. Results: Overall, 18,995 patients were enrolled. The mean self-reported frequency of SMBG at baseline, month 3, and month 6 was 5.2 ± 10.2, 7.1 ± 9.9, and 6.3 ± 7.9 times per month, respectively. Multivariate analysis showed that before initiating insulin treatment, SMBG frequency was related to hospital level, age, gender, body–mass index, education degree, current residence, diabetes duration, types of oral antidiabetic agents, and mild hypoglycemia in the previous 1 month. After initiation of insulin treatment, SMBG frequency was related to hospital level, gender, education degree, current residence, HbA1c level at baseline, current number of insulin injections, and mild hypoglycemia in the previous 1 month. Conclusion: In Chinese type 2 diabetic patients, the frequencies of SMBG before and after insulin treatment are both very low. Hospital level, gender, education degree, current residence, and mild hypoglycemia in the previous 1 month are factors related to the SMBG frequency of both before and after initiation of insulin treatment.