Research: Care Delivery
What is so tough about self-monitoring of blood glucose? Perceived obstacles among patients with Type 2 diabetes
Version of Record online: 19 JUL 2013
© 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK
Volume 31, Issue 1, pages 40–46, January 2014
How to Cite
Diabet. Med. 31, 40–46 (2014)
- Issue online: 12 DEC 2013
- Version of Record online: 19 JUL 2013
- Accepted manuscript online: 2 JUL 2013 11:01AM EST
- Manuscript Accepted: 27 JUN 2013
- Roche Diabetes Care
To identify patient-reported obstacles to self-monitoring of blood glucose among those with Type 2, both insulin users and non-insulin users, and to investigate how obstacles are associated with frequency of self-monitoring and use of self-monitoring data.
Patients with Type 2 diabetes (n = 886, 65% insulin users) who attended a 1-day diabetes education conference in cities across the USA completed a survey on current and recommended self-monitoring of blood glucose frequency, how they used self-monitoring results and perceived obstacles to self-monitoring use. Exploratory factor analysis examined 12 obstacle items to identify underlying factors. Regression analyses examined associations between self-monitoring of blood glucose use and the key obstacle factors identified in the exploratory factor analysis.
Three obstacle factors emerged: Avoidance, Pointlessness and Burden. Avoidance was the only significant independent predictor of self-monitoring frequency (β = −0.23, P < 0.001). Avoidance (β = −0.12, P < 0.01) and Pointlessness (β = −0.15, P < 0.001) independently predicted how often self-monitoring data were shared with healthcare professionals and whether or not data were used to make management adjustments (Avoidance: odds ratio = 0.74, P < 0.001; Pointlessness: odds ratio = 0.75, P < 0.01). Burden was not associated with any of the self-monitoring behavioural measures. Few differences between insulin users and non-insulin users were noted.
Obstacles to self-monitoring of blood glucose use, both practical and emotional, were common. Higher levels of Avoidance and Pointlessness, but not Burden, were associated with less frequent self-monitoring use. Addressing patients' self-monitoring-related emotional concerns (Avoidance and Pointlessness) may be more beneficial in enhancing interest and engagement with self-monitoring of blood glucose than focusing on day-to-day, behavioural issues (Burden).