Self-monitoring blood glucose inspires confidence, control in patients with type 2 diabetes

Issue: September 2015

NEW ORLEANS — Patients with newly diagnosed type 2 diabetes who did not require insulin found self-monitoring of blood glucose an important tool for taking control of their disease, according to research presented here.

Perspective from Mary Beth Modic, DNP, RN, CNS, CDE

“There’s quite a bit of conflict about the role of self-monitoring of blood glucose, especially in type 2 diabetes when insulin is not used,” said Dana Brackney, PhD, RN, CNS, CDE, BC-ADM, assistant professor of nursing at Appalachian State University in Boone, N.C. “I was wondering: Does testing or checking of blood sugar ... in some way add to the burden of diabetes in type 2?”

Dana Brackney

For this qualitative study, Brackney identified 11 patients, aged 47 to 73 years, BMI 22.7 to 42.2 kg/m², with type 2 diabetes for less than 2 years, and asked them to follow a personalized, structured self-monitoring blood glucose (SMBG) plan. Patients were followed from 6 months to 2.5 years.

When reviewing patients’ glucometer records, Brackney asked patients questions meant to elicit what diabetes and monitoring meant to them.

Elevations in fasting glucose caused the most concern for her patients, Brackney said.

She identified three distinct phases when patients found SMBG important: first, at initial diagnosis when patients needed to be convinced that they had a disease even though they felt healthy; next, during a phase of behavior change when patients used readings to learn how to control their glucose levels; and finally, after diabetes maintenance became routine to confirm that the disease was under control.

Brackney found that patients modified their behaviors through diet or exercise in response to SMBG readings in ways that changed their glucose levels, although the study was not designed to show improvement.

“Monitoring is not a treatment for diabetes, but it is a tool,” Brackney said. – by Jill Rollet

Reference:

Brackney D. W18B. Presented at: The American Association of Diabetes Educators Annual Meeting 2015; August 5-8, 2015; New Orleans.

Disclosure: Brackney reports no relevant financial relationships.

Perspective

Mary Beth Modic, DNP, RN, CNS, CDE

Qualitative studies should be the heart and soul of practice. Once we know what patients are feeling, thinking and desiring — as well as their families — they can give us direction to help deliver much more patient-centered care. Algorithms are important and necessary, but it’s those kind of stories that compel us to move forward. Next steps, I think, would be to look at this again with different demographics, to confirm whether those findings are replicable.

Mary Beth Modic, DNP, RN, CNS, CDE

Cleveland Clinic

Disclosures: Modic reports no relevant financial disclosures.