Adherence to self-monitoring of blood glucose in Chinese patients with type 2 diabetes: current status and influential factors based on electronic questionnaires

Xin Wang; Jun-Fei Luo; Lin Qi; Qing Long; Jia Guo; Hong-Hong Wang

doi:10.2147/PPA.S211668

Adherence to self-monitoring of blood glucose in Chinese patients with type 2 diabetes: current status and influential factors based on electronic questionnaires

Patient Prefer Adherence. 2019 Jul 25:13:1269-1282. doi: 10.2147/PPA.S211668. eCollection 2019.

Authors

Xin Wang¹, Jun-Fei Luo², Lin Qi^{3

4}, Qing Long¹, Jia Guo¹, Hong-Hong Wang¹

Affiliations

¹ Xiangya School of Nursing, Central South University, Changsha, Hunan, People's Republic of China.
² The College of Literature and Journalism, Central South University, Changsha, Hunan, People's Republic of China.
³ Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
⁴ Hunan Key Laboratory of Tumor Models and Individualized Medicine, the Second Xiangya Hospital, Changsha, Hunan, People's Republic of China.

Abstract

Background and purpose: Self-monitoring of blood glucose (SMBG) is important to the management of diabetes mellitus, yet most patients with type 2 diabetes mellitus (T2DM) do not perform SMBG as recommended. The current status and influential factors of SMBG in China have not been well investigated. This study aimed to describe the present status of SMBG adherence in China and investigate the influential factors based on electronic questionnaires.

Patients and methods: A cross-sectional study was conducted from June to July of 2017 at hospitals in Changsha, China. Seven hundred and twenty-one patients with T2DM completed the information‑motivation‑behavioral (IMB) skills questionnaire and other electronic questionnaires composed of demographic and clinical characteristics as well as diabetes-related and psychological scales. Univariate comparisons and multivariate logistic regression were used to explore the relationships among SMBG adherence and related factors.

Results: Seven hundred and twenty-one patients with valid questionnaires were included. Only 27.5% (198/721) of the patients with T2DM were SMBG adherent based on the guideline of the Chinese Diabetes Society (CDS) in 2017. Among all groups of treatment regimens, the rate of SMBG adherence was highest at 36.6% (82/224) in patients on oral hypoglycaemic drugs (OHAs). In multivariable analysis, the treatment of OHAs (OR =3.731, CI 2.162-6.437) and diet/exercise (OR =3.534, CI 1.841-6.783), the patient having their own blood glucose meter (OR =6.916, CI 4.054-11.800) and a higher education level (OR =3.780, CI 1.688-8.466) were significantly associated with SMBG adherence.

Conclusion: Most Chinese patients with T2DM did not perform SMBG as recommended. The treatment of OHAs and diet/exercise, the patient having their own blood glucose meter, a higher education level and other factors were correlates of SMBG adherence. There is clearly a need for prospective, multicenter, large-scale studies to explore the reasons for patients' failure to practice SMBG adherence.

Keywords: China; adherence; glycemic control; self-monitoring of blood glucose; type 2 diabetes mellitus.