The relationship between the frequency of self-monitoring of blood glucose and glycemic control in patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion or on multiple daily injections

J Diabetes Investig. 2015 Nov;6(6):687-91. doi: 10.1111/jdi.12362. Epub 2015 May 25.

Abstract

Aims/introduction: We investigated the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycemic control in type 1 diabetes mellitus patients on continuous subcutaneous insulin infusion (CSII) or on multiple daily injections (MDI) using data management software.

Materials and methods: We recruited 148 adult type 1 diabetes mellitus patients (CSII n = 42, MDI n = 106) and downloaded their SMBG records to the MEQNET™ SMBG Viewer software (Arkray Inc., Kyoto, Japan). The association between the SMBG frequency and the patients' hemoglobin A1c (HbA1c) levels was analyzed using the χ(2)-test and linear regression analysis was carried out to clarify their relationship.

Results: The odds ratio of achieving a target HbA1c level of <8% (63.9 mmol/mol) was significantly higher in subjects with SMBG frequencies of ≥3.5 times/day compared with those with SMBG frequencies of <3.5 times/day in the CSII group (odds ratio 7.00, 95% confidence interval 1.72-28.54), but not in the MDI group (odds ratio 1.35, 95% CI 0.62-2.93). A significant correlation between SMBG frequency and the HbA1c level was detected in the CSII group (HbA1c [%] = -0.24 × SMBG frequency [times/day] + 8.60 [HbA1c {mmol/L} = -2.61 × SMBG frequency {times/day} + 70.5], [r = -0.384, P = 0.012]), but not in the MDI group.

Conclusions: A SMBG frequency of <3.5 times per day appeared to be a risk factor for poor glycemic control (HbA1c ≥8%) in type 1 diabetes mellitus patients on CSII.

Keywords: Continuous subcutaneous insulin infusion; Self-monitoring of blood glucose; Type 1 diabetes mellitus.