Relationship Between HbA1c And Capillary Blood Glucose Self-Monitoring In Type 2 Diabetics

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Introduction: Diabetes Control and Complications Trial has established the importance of glycemic control in reducing the progression of retinopathy, nephropathy, and neuropathy in type 1 diabetics. There is little literature linking the frequency of glycemic monitoring with glycated hemoglobin A (HbA1c) in type 2 diabetics. The objectives were to assess the influence of glycemic self-monitoring on HbA1c in three groups of patients with type 2 diabetes (with insulin, with oral antidiabetics and with combination therapy). Methods: The glucometer capillary surveys of 117 patients were counted in the 30 days prior to the visit to the Integrated Diabetes Unit at Centro Hospitalar Tondela-Viseu. In the three groups considered, sociodemographic characteristics (age, gender, area of residence, household and schooling) were evaluated and compared. Results: There was no statistically significant association between HbA1c and the frequency of capillary glucose in any of the groups. In the evaluation of sociodemographic data, contrary to what was expected, the area of residence and schooling did not influence the value of HbA1c. Conclusion: These results question the role of glycemic monitoring in the metabolic control of type 2 diabetics, highlighting the need to implement therapeutic education programs so that these patients can adequately intervene in the therapeutic adjustment as a function of the information obtained by capillary glycemia.

1. Nathan Dm. The Diabetes Control And Complications Trial/Epidemiology Of Diabetes Interventions And Complications Study At 30 Years: Overview. Diabetes Care. 2014;37(1):9-16.

2. Miller Km, Beck Rw, Bergenstal Rm, Goland Rs, Haller Mj, Mcgill Jb, Et Al. Evidence Of A Strong Association Between Frequency Of Self- Monitoringof Blood Glucose And Hemoglobin A1c Levels In T1d Exchange Clinic Registry Participants. Diabetes Care. 2013;36(7):2009-14.

3. Strain Wd, Cos X, Hirst M, Vencio S, Mohan V, Vokó Z, Et Al. Time To Do More: Addressing Clinical Inertia In The Management Of Type 2 Diabetes Mellitus. Diabetes Res Clin Pract. 2014;105(3):302-12.

4. Snoek F. Barriers To Good Glycaemic Control: The Patient’s Perspective. Int J Obes [Internet]. 2000;24:S12-20.

5. Gonder-Frederick La, Cox Dj, Ritterband Lm. Diabetes And Behavioral Medicine: The Second Decade. J Consult Clin Psychol. 2002;70(3):611-25.

6. Rushforth B, Mccrorie C, Glidewell L, Midgley E, Foy R. Barriers To Effective Management Of Type 2 Diabetes In Primary Care: Qualitative Systematic Review. Br J Gen Pract. 2016;66(643):E114-27.

7. Dorsey Jl, Becker Mh, Al. E. Glycemic Targets: Standards Of Medical Care In Diabetes-2018. Diabetes Care. 2018;41(Supplement 1):S55-64.

8. Bridges Jf, Brignac D, Thomas S, Kent C, Ogbuli M, Draper J, Et Al. Optimizing Hga1c And Glucose Monitoring Frequency In Patients With Type 2 Diabetes. Med Sci Monit [Internet]. 2012;18(12):Cr693-7.

9. Shichiri M, Kishikawa H, Ohkubo Y Wn. Long-Term Results Of The Kumamoto Study On Optimal Diabetes Control In Type 2 Diabetic Patients. Diabetes Care. 2000;23.

10. Khowaja K, Waheed H. Original Article Self-Glucose Monitoring And Glycaemic Control At A Tertiary Care University Hospital, Karachi , Pakistan. J Pak Med Assoc. 2010 Dec;60(12):1035-8.

11. Fisher L, Polonsky W, Parkin Cg, Jelsovsky Z, Amstutz L, Wagner Rs. The Impact Of Blood Glucose Monitoring On Depression And Distress In Insulin-Naïve Patients With Type 2 Diabetes. Curr Med Res Opin [Internet]. 2011;27(Sup3):39-46.

12. Wang Js, Lee I Te, Lee Wj, Lin Sd, Su Sl, Tu S Te, Et Al. Glycemic Excursions Are Positively Associated With Changes In Duration Of Asymptomatic Hypoglycemia After Treatment Intensification In Patients With Type 2 Diabetes. Diabetes Res Clin Pract [Internet]. 2016;113:108-15.

13. Osman O, Sherifali D, Stolee P, Heckman G. Diabetes Management In Long-Term Care: An Exploratory Study Of The Current Practices And Processes To Managing Frail Elderly Persons With Type 2 Diabetes. Can J Diabetes [Internet]. 2016;40(1):17-30.

14. Rossi Mc, Lucisano G, Ceriello A, Mazzucchelli C, Musacchio N, Ozzello A, Et Al. Real-World Use Of Self-Monitoring Of Blood Glucose In People With Type 2 Diabetes: An Urgent Need For Improvement. Acta Diabetol [Internet]. 2018;0(0):0.

15. Farmer A. Meta-Analysis: Self-Monitoring In Non-Insulin-Treated Type 2 Diabetes Improved Hba1c By 0.25%. Ann Intern Med. 2012;156(12):24199.

16. Malanda Ul, Bot Sd, Nijpels G. Self-Monitoring Of Blood Glucose In Noninsulin-Using Type 2 Diabetic Patients: It Is Time To Face The Evidence. Diabetes Care. 2013;36(1):176-8.

17. Schnell O, Alawi H, Battelino T, Ceriello A, Diem P, Felton Am, Et Al. Self-Monitoring Of Blood Glucose In Type 2 Diabetes: Recent Studies. J Diabetes Sci Technol. 2013;7(2):478-88.

18. Clar C, Barnard K, Cummins E, Royle P, Waugh N. Self-Monitoring Of Blood Glucose In Type 2 Diabetes: Systematic Review. Health Technol Assess (Rockv). 2010;14(12):1-140.

19. Robson J, Smithers H, Chowdhury T, Bennett-Richards P, Keene D, Dostal I, Et Al. Reduction In Self-Monitoring Of Blood Glucose In Type 2 Diabetes: An Observational Controlled Study In East London. Br J Gen Pract. 2015;65(633):E256-63.

20. Sociedade Portuguesa De Diabetologia. Diabetes: Factos E Números. Vol. 11, Relatório Anual Do Observatório Nacional Da Diabetes 11/2014. 2014. 0-64 P.

21. Huang Ym, Shiyanbola Oo, Chan Hy. A Path Model Linking Health Literacy, Medication Self-Efficacy, Medication Adherence, And Glycemic Control. Patient Educ Couns [Internet]. 2018;

22. Olesen K, F Reynheim Al, Joensen L, Ridderstråle M, Kayser L, Maindal Ht, Et Al. Higher Health Literacy Is Associated With Better Glycemic Control In Adults With Type 1 Diabetes: A Cohort Study Among 1399 Danes. Bmj Open Diabetes Res Care [Internet]. 2017;5(1):E000437.

23. Billings Lk, Parkin Cg, Price D. Baseline Glycated Hemoglobin Values Predict The Magnitude Of Glycemic Improvement In Patients With Type 1 And Type 2 Diabetes: Subgroup Analyses From The Diamond Study Program. Diabetes Technol Ther [Internet]. 2018;20(8):561-5.

24. Olry De Labry Lima A, Moya Garrido Mn, Espín Balbino J. Systematic Review Of Economic Evaluation Studies And Budget Impact On Ambulatory Monitoring Of Capillary Glucose In Type 2 Diabetics. Prim Care Diabetes [Internet]. 2014;8(1):13-21.

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