Self-monitoring of blood glucose in Black Caribbean and South Asian Canadians with non-insulin treated Type 2 diabetes mellitus: a qualitative study of patients’ perspectives

BMC Endocrine Disorders

Elizabeth E Peel³  Elizabeth McCay¹  Heather Beanlands¹  Andrea Senchuk²  Mariella Fortugno²  Enza Gucciardi² 

[1] Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada;School of Nutrition, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada;School of Life & Health Sciences, Aston University, Birmingham, UK

关键词: South Asian;    Caribbean;    Diabetes mellitus;    Self-monitoring of blood glucose;   

Others  :  1085570
DOI  :  10.1186/1472-6823-13-46

 received in 2013-05-31, accepted in 2013-09-18,  发布年份 2013

【 摘 要 】

Background

To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus.

Methods

Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis.

Results

The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficial to their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients.

Conclusion

While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others.

【 授权许可】

   
2013 Gucciardi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Miller D, Berard L, Cheng A, Hanna A, Hagerty D, Knip A, et al.: Self-monitoring of blood glucose in people with type 2 diabetes: Canadian diabetes association briefing document for healthcare providers. Can J Diabetes 2011, 35:317-319.
• [2]Barnett AH, Krentz AJ, Strojek K, Sieradzki J, Azizi F, Embong M: The efficacy of self-monitoring of blood glucose in the management of patients with type 2 diabetes treated with a gliclazide modified release-based regimen. A multicentre, randomized, parallel-group, 6-month evaluation (DINAMIC 1 study). Can J Diabetes 2008, 10:1239-1247.
• [3]O’Kane MJ, Bunting B, Copeland M, Coates VE: Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ 2008, 336:1174-1177.
• [4]McAndrew L, Schneider SH, Burns E, Leventhal H: Does patient blood glucose monitoring improve diabetes control? A systematic review of the literature. Diabetes Educ 2007, 33:991-1011.
• [5]Poolsup N, Suksomboon N, Jiamsathit W: Systematic review of the benefits of self-monitoring of blood glucose on glycemic control in type 2 diabetes patients. Diabetes Technol Ther 2008, 10:S51-S66.
• [6]McGeoch G, Derry S, Moore RA: Self-monitoring of blood glucose in type-2 diabetes: what is the evidence? Diabetes Metab Res Rev 2007, 23:423-440.
• [7]Canadian Optimal Medication Prescribing and Use Service: Systematic review of use of blood glucose test strips for the management of diabetes mellitus. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2008. http://www.cadth.ca /media/pdf/BGTS_SR Report of_Clinical Outcomes.pdf webcite
• [8]Towfigh A, Romanova M, Weinreb JE, Munjas B, Suttorp MJ, Zhou A, et al.: Self-monitoring of blood glucose levels in patients with type 2 diabetes mellitus not taking insulin: a meta-analysis. Am J Manag Care 2008, 14:468-475.
• [9]St JA, Davis WA, Price CP, Davis TM: The value of self-monitoring of blood glucose: a review of recent evidence. J Diabetes Complications 2010, 24:129-141.
• [10]Allemann S, Houriet C, Diem P, Stettler C: Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis. Curr Med Res Opin 2009, 25:2903-2913.
• [11]Malanda U, Welschen LMC, Riphagen II, M Dekker J, Nijpels G, Bot SDM: Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. The Cochrane Collaboration 2012, 1:1-88.
• [12]Cameron C, Coyle D, Ur E, Klarenback S: Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin. CMAJ 2010, 182:28-34.
• [13]Canadian Agency for Drugs and Technologies in Health: Gap Analysis and Key Messages for the Prescribing and Use of Blood Glucose Test Strips for the Self-Monitoring of Blood Glucose - Optimal Therapy Report Canadian Optimal Medication Prescribing and Utilization Service. Ottawa, ON: The Agency; 2009. Ref Type: Report
• [14]Funnell MM: Self-monitoring of blood glucose: a commentary. Diabetes Educ 2007, 33:1012-1015.
• [15]Woo V, Cheng AYY, Hanna A, Berard L: Self-monitoring of blood glucose in individuals with type 2 diabetes not using insulin: commentary. Can J Diabetes 2010, 34:19-24.
• [16]Cameron C, Virani A, Dean H, Evans M, Dolovich L, Dahl M: Utilization and expenditure in blood glucose strips in Canada. Can J Diabetes 2010, 34:34-40.
• [17]Gomes T, Juurlink DN, Shah BR, Paterson JM, Mamdani MM: Blood glucose test strips: options to reduce usage. CMAJ 2010, 182:35-38.
• [18]The SMBG International Working Group: Self-monitoring of blood glucose in type 2 diabetes: An inter-country comparison. Diabetes Res Clin Pract 2008, 82:e15-e18.
• [19]Institute of Health Economics: Consensus statement on self-monitoring in diabetes: Institute of Health Economics, Alberta, Canada, November 14–16, 2006. Int J Technol Assess Health Care 2007, 23:146-151.
• [20]Peel E, Parry O, Douglas M, Lawton J: Blood glucose self-monitoring in non-insulin-treated type 2 diabetes: a qualitative study of patients’ perspectives. Br J Gen Pract 2004, 54:183-188.
• [21]Peel E, Douglas M, Lawton J: Self-monitoring of blood glucose in type 2 diabetes: Longitudinal qualitative study of patients’ perspectives. BMJ 2007, 335:493-498.
• [22]King H, Aubert RE, Herman WH: Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998, 21:1414-1431.
• [23]Bhopal R, Unwin N, White M, Yallop J, Walker L, Alberti KG, et al.: Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. BMJ 1999, 319:215-220.
• [24]The British Heart Foundation Statistics Website: Ethnic Differences in Prevalence of Diabetes. London, England: The British Heart Foundation; 2008.
• [25]Creatore MI, Moineddin R, Booth G, Manuel DH, DesMeules M, McDermott S, et al.: Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada. CMAJ 2010, 182:781-789.
• [26]Stretcher V, Rosenstock IM: The Health Belief Model. In Health Behavior and Health Education: Theory, Research and Practice. Edited by Glanz K, Lewis FM, Rimer BK. San Francisco: Jossey-Bass; 1997.
• [27]Harvey JN, Lawson VL: The importance of health belief models in determining self-care behaviour in diabetes. Diabet Med 2009, 26:5-13.
• [28]Tan MY: The relationship of health beliefs and complication prevention behaviors of Chinese individuals with Type 2 Diabetes Mellitus. Diabetes Res Clin Pract 2004, 66:71-77.
• [29]Hjelm KG, Bard K, Nyberg P, Apelqvist J: Beliefs about health and diabetes in men of different ethnic origin. J Adv Nurs 2005, 50:47-59.
• [30]Attride-Stirling J: Thematic networks: an analytic tool for qualitative research. Qual Res 2001, 1:385-405.
• [31]DiMatteo MR, Haskard KB, Williams SL: Health beliefs, disease severity, and patient adherence: a meta-analysis. Med Care 2007, 45:521-528.
• [32]Canadian Diabetes Association: Canadian Diabetes Association: Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2008, 32:1-251.
• [33]Lawton J, Ahmad N, Hallowell N, Hanna L, Douglas M: Perceptions and experiences of taking oral hypoglycaemic agents among people of Pakistani and Indian origin: qualitative study. BMJ 2005, 330:1247.
• [34]Ezenwaka CE, Olukoga A, Onuoha P, Worrell R, Skinner T, Mayers H, et al.: Perceptions of Caribbean type 2 diabetes patients on self-monitoring of blood glucose. Arch Physiol Biochem 2012, 118:16-21.
• [35]Karter AJ, Ferrara A, Darbinian JA, Ackerson LM, Selby JV: Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diabetes Care 2000, 23:477-483.
• [36]Nyomba BL, Berard L, Murphy LJ: The cost of self-monitoring of blood glucose is an important factor limiting glycemic control in diabetic patients. Diabetes Care 2002, 25:1244-1245.
• [37]Gerald KR, Malone RM, Bryant Shilliday B: Clinical benefit of self-monitoring of blood glucose is uncertain for non-insulin treated patients with type 2 diabetes. Clinical Diabetes 2010, 28:121-123.
• [38]Canadian Diabetes Association: Self-Monitoring of Blood Glucose (SMBG) Recommendation Tool for Healthcare Providers. Toronto, Canada: Canadian Diabetes Association; 2013.
• [39]Williams AS: Sore Fingers: How to Prevent and Treat Them. The Diabetes Action Network of the National Federation of the BlindDiabetes Support and Information 2004, 19.
• [40]Yi-Frazier JP, Smith RE, Vitaliano PP, Yi JC, Mai S, Hillman M, et al.: A person-focused analysis of resilience resources and coping in diabetes patients. Stress Health 2010, 26:51-60.
• [41]Gomersall T, Madill A, Summers LK: A metasynthesis of the self-management of type 2 diabetes. Qual Health Res 2011, 21:853-871.
• [42]Latter C, McLean-Veysey P, Dunbar P, Frail D, Sketris I, Putnam W: Self-monitoring of blood glucose: what are healthcare professionals recommending? Can J Diabetes 2011, 35:31-38.