Self‐monitoring of blood glucose; frequency, determinants and self‐adjustment of treatment in an adult Swedish diabetic population

Objective To analyse the utilisation of self‐monitoring of blood glucose (SMBG) among adult diabetic subjects. Methods A cross‐sectional study with a standardized interview, a physical examination, and an evaluation of medical records comprising all known diabetic subjects living in six defined primary health care districts in southern Sweden. Of 1861 identified subjects aged >25 years, 90.1% participated. Mean age was 66±0.4 yrs; 94% were diagnosed ≥30 yrs, and 70.4% were not gainfully employed. Results SMBG was used by 36.3% of all subjects (20.5% regularly, 15.8% sporadically). In 51.8% of cases regularly performing SMBG the results were used for self‐adjustment of treatment (SAT). In multiple logistic regression analysis SMBG was related to awareness of illness (OR [95% CI]; 2.64[1.59–4.40]), treatment with insulin (2.52 [1.92–3.29]), and inversely related to age (50–69 yrs; 0.70[0.50–0.99], >70 yrs; 0.40[0.28–0.59]). The strongest independent influence on SAT based on SMBG results was awareness of illness (3.42[1.74–6.74]), followed by duration >10 yrs (1.74[1.28–2.38]), and there was an inverse relation to a multiple disease pattern in terms of cardiocerebrovascular disease and age. Living conditions, social position, or treatment location were not evidently related to SMBG or SAT. Conclusions A large proportion of adult individuals does not use SMBG regularly. Regular SMBG performers do not use it for SAT, and thus the use is not optimized for achieving good glycaemic control and especially with regard to awareness of illness.