Blood glucose self-monitoring among patients with diabetes mellitus type 2 in family medicine practice

Abstract

Introduction. Good knowledge of diabetic patients about their disease is often not related with good glycemic control. The aim of this study was to determine the level of application of acquired knowledge about diabetes in recognizing and resolving hypoglycemic and hyperglycemic conditions in patients who did or did not do blood glucose self-monitoring as well as the impact of self-monitoring on HbA1c during education of patients with diabetes type 2. Material and methods. There were 91 patients with the type 2 diabetes who completed six months education about their disease in four family medicine practices in Tuzla Canton during the period from March to September 2005. The patients who did or did not do self-monitoring with glucometer were interviewed on knowledge about recognizing and resolving hypoglycemia and hyperglycemia by family physician and HbA1c was assessed at the beginning of the education, 3 months after reading the brochure (passive education) and additional 3 months of group (intensive) education. Results. Out of 91 interviewed patients, there were 29 who did self-monitoring by glucometer at the beginning of the education, 30 patients during the passive education and 34 after the intensive education. At the beginning of education, regardless of doing self-monitoring, the patients were less able to recognize and resolve hypoglycemia and even less hyperglycemia. At the end of education, their knowledge was better at both recognizing and resolving hypoglycemia (P=0.01) as well as at recognizing (P=0.01) and resolving hyperglycemia (P=0.001). In the patients who did self-monitoring the average value of the HbA1c did not improve significantly (P=0.44) compared to those who did not practice self-monitoring (P=0.10) during education. Conclusion. Only one third of patients with type 2 diabetes had done self-monitoring with glucometer and although their knowledge about hypoglycemia and hyperglycemia was improved during education, these patients did not have improved significant values of the HbA1c compared to patients who had not done self-monitoring.Dobro znanje pacijenata koji boluju od secerne bolesti tip 2 o ovoj hronicnoj bolesti cesto ne korelira sa dobrom kontrolom glikemije. Cilj istrazivanja je odrediti primenu znanja stecenog tokom edukacije o secernoj bolesti tip 2 u prepoznavanju i resavanju hipoglikemijskih i hiperglikemijskih stanja kod pacijenata koji sprovode ili ne sprovode samokontrolu secera u krvi kao i uticaj samokontrole na vrednosti HbA1c tokom edukacije. U istrazivanje je ukljucen 91 ispitanik sa secernom bolesti tip 2 koji se lece u porodicnoj medicini na Tuzlanskom kantonu. Ciklus od 6 meseci edukacije o secernoj bolesti sproveden je od marta do septembra 2005. godine. Pacijente koji su sprovodili ili nisu sprovodili samokontrolu secera u krvi intervjuisao je na temu znanje o prepoznavanju i resavanju hipoglikemije i hiperglikemije porodicni lekar a HbA1c je radjen na pocetku edukacije, nakon 3 meseca citanja brosure (pasivna edukacija) i dodatna 3 meseca grupne (intenzivne) edukacije. Rezultati istrazivanja su pokazali da je od 91 pacijenta samo 29 radilo samokontrolu na pocetku edukacije, 30 pacijenata tokom pasivne edukacije a 34 nakon intenzivne edukacije. Na pocetku edukacije, bez obzira na izvodjenje samokontrole, pacijenti su slabo znali da prepoznaju simptome hipoglikemije a jos slabije hiperglikemije i nisu znali adekvatnim merama da rese ova stanja. Na kraju edukacije doslo je do poboljsanja znanja i u pogledu prepoznavanja i resavanja hipoglikemije (P=0,01) kao i prepoznavanja hiperglikemije (P=0,01) kao i resavanja iste (P=0,001). Kod pacijenata koji su sprovodili samokontrolu prosecna vrednost HbA1c nije se znacajno popravila (P=0,44) u odnosu na one koji nisu sprovodili samokontrolu (P=0.10) tokom edukacije. Moze se zakljuciti da je samo jedna trecina pacijenata sa secernom bolesti tip 2 sprovodila samokontrolu i da, iako se njihovo znanje o hipoglikemiji i hiperglikemiji popravilo tokom edukacije, ovi pacijenti nisu znacajnije popravili vrednosti HbA1c u odnosu na one koji nisu sprovodili samokontrolu tokom edukacije o njihovoj bolesti.