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Title: | Do diabetes mellitus patients adhere to self-monitoring of blood glucose (SMBG) and is this associated with glycemic control? Experiences from a SMBG program in western Kenya |
Authors: | K. Wambui, Charity Kumar Sven, Ajay M.V. Hinderaker, Gudmund Chinnakali, Palanivel Pastakia, Sonak D Kamano, Jemimah |
Keywords: | Self-monitoring of blood glucose Adherence Glycemic control |
Issue Date: | 18-Nov-2015 |
Publisher: | Elsevier |
Abstract: | Aims: Among Diabetes Mellitus (DM) patients with poor glycemic control enrolled into a self- monitoring of blood glucose(SMBG) program in Kenya, to assess the level of SMBG adherence, its associated factors and its relation to glycemic control(defined as HbA1c<7% and/or 2% absolute reduction relative to baseline). Methods: In this retrospective cohort study, we used routinely collected data of patients enrolled during 2012-2013. We assessed adherence to SMBG by dividing the number of glucose tests performed by the number recommended. A level of >80% was considered ‘good adherence’. Glycemic control was considered as absolute change from baseline of 2%. Results: Of 164 patients (59% female; 76% rural), the proportions with good SMBG adherence were 34%, 17%, 15% and 10% during 0-6, 7-12, 13-18 and 19-24 months into the HGM program respectively. In multivariate analysis, male gender, urban place of residence and payment for glucostrips were associated with poor adherence during 0-12 months. The mean reduction in HbA1c compared to baseline was 1.2%, 1.1%, 0.8% and 0.7% at 6, 12, 18 and 24 months, respectively. We did not find any association between SMBG adherence and glycemic control. Conclusions: Adherence to SMBG was sub-optimal, especially among those who had to pay for glucostrips. Patient education and provision of free glucostrips are recommended to improve adherence and glycemic control. |
URI: | http://dx.doi.org/doi:10.1016/j.diabres.2015.11.006 http://ir.mu.ac.ke:8080/jspui/handle/123456789/7108 |
Appears in Collections: | School of Medicine |
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