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The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes.
Diabetes Res Clin Pract. 2012 May; 96(2):149-55.DR

Abstract

INTRODUCTION

Patients with T2DM often view self-monitoring of blood glucose (SMBG) as burdensome and pointless, which may affect their broader attitudes toward diabetes management. We examined how a structured SMBG protocol influenced diabetes self-efficacy and autonomous motivation over time, and linked these to changes in glycemic control.

MATERIALS AND METHODS

The Structured Testing Program (STeP) is a 12-month, two-arm, cluster-randomized trial that assessed the efficacy of structured SMBG in 483 insulin-naïve T2DM patients. Measures included: Confidence in Diabetes Self-Care for Type 2 patients (CIDS-T2), Diabetes-related Autonomous Motivation (DRAM), self-management behaviors and HbA1c.

RESULTS

Intent-to-treat (ITT) and per-protocol (PP) analyses showed significant increases in CIDS-T2 scores over time (main effects p<0.0001). PP analysis showed significant between-group differences (p<0.05), with adherent STG patients displaying greater CIDS-T2 improvement than ACG patients. PP analyses showed main and between-group effects in DRAM with similar findings. Changes in CIDS-T2 were related to HbA1c changes over time; no self-management variable mediated this relationship. CIDS-T2 and HbA1c displayed a significant time-concordant relationship.

DISCUSSION

Structured SMBG leads to significant increases in self-confidence and autonomous motivation associated with diabetes self-management. Changes in self-confidence are linked to changes in glycemic control and share a time-concordant relationship.

Authors+Show Affiliations

University of California San Francisco, San Francisco, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22265215

Citation

Fisher, Lawrence, et al. "The Impact of Structured Blood Glucose Testing On Attitudes Toward Self-management Among Poorly Controlled, Insulin-naïve Patients With Type 2 Diabetes." Diabetes Research and Clinical Practice, vol. 96, no. 2, 2012, pp. 149-55.
Fisher L, Polonsky WH, Parkin CG, et al. The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes. Diabetes Res Clin Pract. 2012;96(2):149-55.
Fisher, L., Polonsky, W. H., Parkin, C. G., Jelsovsky, Z., Petersen, B., & Wagner, R. S. (2012). The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes. Diabetes Research and Clinical Practice, 96(2), 149-55. https://doi.org/10.1016/j.diabres.2011.12.016
Fisher L, et al. The Impact of Structured Blood Glucose Testing On Attitudes Toward Self-management Among Poorly Controlled, Insulin-naïve Patients With Type 2 Diabetes. Diabetes Res Clin Pract. 2012;96(2):149-55. PubMed PMID: 22265215.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of structured blood glucose testing on attitudes toward self-management among poorly controlled, insulin-naïve patients with type 2 diabetes. AU - Fisher,Lawrence, AU - Polonsky,William H, AU - Parkin,Christopher G, AU - Jelsovsky,Zhihong, AU - Petersen,Bettina, AU - Wagner,Robin S, Y1 - 2012/01/20/ PY - 2011/06/29/received PY - 2011/11/01/revised PY - 2011/12/12/accepted PY - 2012/1/24/entrez PY - 2012/1/24/pubmed PY - 2012/9/8/medline SP - 149 EP - 55 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 96 IS - 2 N2 - INTRODUCTION: Patients with T2DM often view self-monitoring of blood glucose (SMBG) as burdensome and pointless, which may affect their broader attitudes toward diabetes management. We examined how a structured SMBG protocol influenced diabetes self-efficacy and autonomous motivation over time, and linked these to changes in glycemic control. MATERIALS AND METHODS: The Structured Testing Program (STeP) is a 12-month, two-arm, cluster-randomized trial that assessed the efficacy of structured SMBG in 483 insulin-naïve T2DM patients. Measures included: Confidence in Diabetes Self-Care for Type 2 patients (CIDS-T2), Diabetes-related Autonomous Motivation (DRAM), self-management behaviors and HbA1c. RESULTS: Intent-to-treat (ITT) and per-protocol (PP) analyses showed significant increases in CIDS-T2 scores over time (main effects p<0.0001). PP analysis showed significant between-group differences (p<0.05), with adherent STG patients displaying greater CIDS-T2 improvement than ACG patients. PP analyses showed main and between-group effects in DRAM with similar findings. Changes in CIDS-T2 were related to HbA1c changes over time; no self-management variable mediated this relationship. CIDS-T2 and HbA1c displayed a significant time-concordant relationship. DISCUSSION: Structured SMBG leads to significant increases in self-confidence and autonomous motivation associated with diabetes self-management. Changes in self-confidence are linked to changes in glycemic control and share a time-concordant relationship. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/22265215/The_impact_of_structured_blood_glucose_testing_on_attitudes_toward_self_management_among_poorly_controlled_insulin_naïve_patients_with_type_2_diabetes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(11)00698-X DB - PRIME DP - Unbound Medicine ER -