Effectiveness of Self-Monitoring Blood Glucose in Type 2 Diabetic Mellitus Patients with Poor Glycemic Control in Primary Care Unit, Nakhon Sawan Province
Article Sidebar
Main Article Content
Abstract
Background: Diabetes mellitus (DM) is one of the non-communicable diseases that requires continuous management. Self-monitoring of blood glucose (SMBG) is a technology that helps to monitor the treatment outcomes for maintaining the appropriate blood glucose.
Objective: To compare the changes in 3-month HbA1c levels in patients with poorly controlled type 2 DM who perform SMBG versus those who do not.
Method: This was therapeutic research, using a retrospective observational cohort design. The population includes type 2 DM patients who have an HbA1c level of more than 7.5%. The sample was divided into two groups: those who used SMBG and those who did not. Data was collected retrospectively from the HosXP, including baseline characteristics, illness data and HbA1C from January to July 2024. Statistical analysis was conducted using STATA, with a significance level of alpha <0.05. General characteristics were reported as percentages, means, and standard deviation (SD). The reduction in HbA1c between the two groups was compared using multivariate gaussian regression, reporting the relationship as Mean Difference and 95% Confidence Interval.
Results: The SMBG group included 18 patients, while the non-SMBG group included 100 patients. In the SMBG group, the baseline HbA1c was 10.0±1.8%, which decreased to 9.5±1.7% after three months, showing a reduction of 0.4±1.7%. In the Non-SMBG group, the baseline HbA1c was 8.8±1.2%, which decreased to 8.3±1.5%, showing a reduction of 0.6±1.5%. When comparing the reduction in HbA1c levels, the SMBG group showed a smaller decrease than the non-SMBG group, with a mean difference of 0.2% (0.2, 95% CI: -0.73-1.05, p=0.72).
Conclusion: Performing SMBG in poorly controlled type 2 DM patients does not significantly reduce HbA1c levels compared to those who do not. However, SMBG still provides other benefits in diabetes management. Healthcare professionals should encourage the use of SMBG based on patients' glycated hemoglobin levels and their readiness.
Thaiclinicaltrials.org number, TCTR20250316004
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Diabetes Association of Thailand under the Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. Clinical Practice Guidelines for Diabetes 2023. Bangkok: Sri Muang Printing Company Limited; 2023
Health Data Center. Percentage of Diabetes Patients with Well-Controlled Blood Sugar Levels [Internet]. 2023 [cited 2024 Dec 14]. Available from: https://hdc.moph.go.th/center/public/standard-report-detail/137a726340e4dfde7bbbc5d8aeee3ac3
American Diabetes Association Professional Practice Committee. 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes-2025. Diabetes Care 2025;48(Suppl. 1):S86–S127.
American Diabetes Association Professional Practice Committee. 7. Diabetes technology: standards of care in diabetes-2025. Diabetes Care 2025;48(Suppl. 1):S146–S166.
Muhali SS, Muhali FS, Mfinanga SG, Sadiq AM, Marandu AA, Kyala NJ, et al. Impact of self-monitoring blood glucose on glycaemic control among insulin-treated patients with diabetes mellitus in Northeastern Tanzania: a randomised controlled trial. J Diabetes Res [Internet]. 2024 [cited 2024 Dec 14];2024:6789672. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11186681/pdf/JDR2024-6789672.pdf
Young LA, Buse JB, Weaver MA, Vu MB, Mitchell CM, Blakeney T, et al. Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial. JAMA Intern Med 2017;177:920-9.
Ahmed B, Sultana R, Greene MW. Adipose tissue and insulin resistance in obese. Biomed Pharmacother [Internet]. 2021 [cited 2024 Dec 14];137:111315. Available from: https://www.sciencedirect.com/science/article/pii/S0753332221001001/pdfft?md5=fe86a7ad3f92ed0546dd25ff8639b59c&pid=1-s2.0-S0753332221001001-main.pdf
Zou Y, Zhao S, Li G, Zhang C. The efficacy and frequency of self-monitoring of blood glucose in non-insulin-treated T2D patients: a systematic review and meta-analysis. J Gen Intern Med 2023;38:755-64.
Kayode OO. Diet and obesity. In: Takada A, Himmerich H, editors. Psychology and pathophysiological outcomes of eating [Internet]. 2021 [cited 2024 Dec 14]. Available from: https://www.intechopen.com/chapters/77412
American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025. Diabetes Care 2025;48(Suppl. 1):S181–S206.
Iwuala SO, Olamoyegun MA, Sabir AA, Fasanmade OA. The relationship between self-monitoring of blood glucose and glycaemic control among patients attending an urban diabetes clinic in Nigeria. Ann Afr Med 2015;14:182-7.
Harashima S, Fukushima T, Sasaki M, Nishi Y, Fujimoto S, Ogura M, et al. Self-monitoring of blood glucose (SMBG) improves glycaemic control in oral hypoglycaemic agent (OHA)-treated type 2 diabetes (SMBG-OHA study). Diabetes Metab Res Rev 2013;29:77-84.
Pragosuntung N, Hongsranagon P, Khochanam S, Udomprasertkul V. Factors associated with glycemic control in type 2 diabetes patients at primary care units, Pathumrat district, Roi-Et province, Thailand. Journal of Health Research 2017;25:195-8
Badedi M, Solan Y, Darraj H, Sabai A, Mahfouz M, Alamodi S, et al. Factors associated with long-term control of type 2 diabetes mellitus. J Diabetes Res [Internet]. 2016 [cited 2024 Dec 14];2016:2109542. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5206435/pdf/JDR2016-2109542.pdf
Klonoff DC. Benefits and limitations of self-monitoring of blood glucose. J Diabetes Sci Technol 2007;1:130-2.
