• Title/Summary/Keyword: SMBG

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Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes

  • Joo, Eun Young;Lee, Ji-Eun;Kang, Hee Sook;Park, Shin Goo;Hong, Yong Hee;Shin, Young-Lim;Sohn, Min
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.480-487
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    • 2018
  • Background: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. Methods: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. Results: Average total daily SMBG frequency was $3.8{\pm}2.1$ and frequency during the school day was $1.3{\pm}1.2$. The mean HbA1c level was $8.6%{\pm}1.4%$. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ${\geq}5$ significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). Conclusion: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

Clinical Benefits of Self-monitoring of Blood Glucose in Non-insulin Treated Patients with Type 2 Diabetes : A systematic Review and Meta-analysis (제 2형 당뇨 환자에서 자가혈당측정의 임상적 유용성 : 체계적문헌고찰 및 메타분석)

  • Choi, Yoon-Young;Sohn, Hyun-Soon;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.183-192
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    • 2010
  • While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

Effect of Self-Monitoring of Blood Glucose Based Diabetes Self-Management Education on Glycemic Control in Type 2 Diabetes (자가혈당 측정결과기반 당뇨교육프로그램이 제2형 당뇨병환자의 혈당조절에 미치는 효과)

  • Sim, Kang Hee;Hwang, Moon Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.2
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    • pp.127-136
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    • 2013
  • Purpose: The aim of the study was to evaluate the effect of self-monitoring of blood glucose (SMBG)-based Diabetes Self-Management Education (DSME) on glycemic control in type 2 diabetes. Methods: This study was designed to compare changes in glycemic control over 12months in SMBG-based DSME group (n=65) versus control group (n=65). Data were obtained from medical records type 2 diabetic patients treated with oral antidiabetic agents and above HbA1c 7.0% from June 2006 to August 2008. All participants completed DSME defined as informational intervention of lifestyle habits and reinforcement of educational Monthly News letter delivered by the diabetes nurse educator. SMBG-based DSME group requested to measure blood glucose 7 times a day for a week and to record their diary and received counseling with a focus on diet and lifestyle during the education. Assessments were conducted baseline, 3, 6 and 12 months. HbA1c was used as an index of glycemic control. Results: 12 months later, the level of HbA1c was reduced by $1.28{\pm}1.68%$ in experimental group and $0.49{\pm}1.05%$ in the control group. We found a significant effect of $Time^*$ Group interaction (p=.013). Conclusion: SMBG-based DSME for patients with type 2 diabetes with oral antidiabetic agents was effective in improving glycemic control and maintaining long-term glycemic control.

Effects on Glycemic Control by Continuous Self Monitoring of Blood Glucose in Diabetic Patients (당뇨병환자의 지속적 자가 혈당관리에 따른 혈당조절의 효과)

  • Jang, Gyeong-Wha;Kwon, Myung-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.2
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    • pp.104-111
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    • 2010
  • Purpose: To evaluate the effects of continuous self monitoring of blood glucose (SMBG) on glycemic control in diabetic patients. Methods: Among the diabetic patients who visited the department of internal medicine in H hospital from April 1 to October 27 2008, 76 patients were divided into the experimental group (n=39) and control group (n=36). The experimental group was required to measure blood glucose levels at least twice every other day using SMBG; their compliance was aided by weekly telephone reminders for 3 months after discharge. Glycated hemoglobin, fasting blood sugar and postprandial 2 hours glucose level, triglyceride and high density lipoprotein were measured before and after the study. Results: Baseline characteristics were not different between the experimental and control groups. Three months later, there was a significant difference in postprandial glucose between the two groups (t=-2.042, p=.045). Conclusion: There was significant improvement of glycemic control after the use of continuous SMBG, suggesting its value in strict glycemic control and the merit of an aggressive education program.

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Comparison of blood glucose concentrations from capillaries and veins in SMBG (자가혈당측정시 채혈방법에 따른 혈당치의 비교)

  • 김진학
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.143-147
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    • 1998
  • 당뇨병환자의 자가혈당조절에 있어서의 기준이 되는 혈당측정에 있어서 하나의 지침을 제공하기 위해 본 연구는 말초혈관과 상완정맥에서의 혈액을 채취하여 이들 검사물들의 혈당치를 직접적으로 비교했다. 30명의 건강한 한국인 성인 남자(연령 : 평균=30세)로부터, 공복시의 혈액을 세가지의 서로 다른 방법들(우선 손가락 끝에 말초혈관을 울혈이 되도록 한 뒤에, 이후 같은 편의 팔의 상완정맥에서, 마지막으로 다시 처음 검채를 시행했던 바로 그 말초의 천자부위에서 혈액을 짜내는 방법으로.)로 각각의 대상에서 검채하였다. 검사물들의 혈당치는 간편측정용 혈당측정기(Glucocard, KDK Corp., Japan. 1995)로 측정한 결과 상완정맥에서 채취한 혈액의 혈당치(107.58$\pm$21.03mg/dl)가 말초에서 채취한 혈액(울혈 후 : 100.21$\pm$24.03mg/dl, .짜낸 경우 : 97.84$\pm$22.45mg/dl)들 보다 높았다(T=2.86. p=.0081 : T=3.084. p=.0055). 그러나 이 결과는 기타의 연구들에서의 결과와는 일치하지 않았다. 이러한 불일치는 자가혈당측정기가 인슐린 의존형 당뇨환자는 물론이고 비의존성 당뇨환자들의 자가관리에 결정적인 지침이 된다는 점을 고려할 때, 좀 더 통제된 상황에서 더욱 많은 사람을 대상으로 한 임상시험을 통해 자가 혈당측정치에 있어서 기계요인에 대한분석이 이루워질 필요를 시사하고 있다. 또한 동일한 부위에서 서로 다른 방법들(혈관을 울혈을 시킨 천자하여 얻은 경우와 천자 후 그 부위를 짜서 검사물을 얻는 방법)에 의해서 얻어진 혈액의 헐당치 측정 결과 간에 차이가 없는 것으로 나타나서(t=0.72, p=.4791), 일반적으로 혈당치의 측정 시 검채한 양이 부족할 때, 새로이 천자하여 검사를 시행하는 것을 원칙으로 인식하고 있으나 본 연구결과를 볼 때, 이러한 채혈의 방식에 의한 차이는 환자의 안녕의 차원에서 고려하여 필요하다면 간과될 수도 있음을 의미하고 있다.

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Design of a Non-Invasive Blood Glucose Sensor Using a Magneto-Resonance Absorption Method (자기공명흡수법에 의한 무혈혈당측정기의 디자인)

  • Kim Dong-Kyun;Won Jong-Hwa;Potapov Sergey N.;Protasov Evgeniy A.
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.42 no.2 s.302
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    • pp.33-38
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    • 2005
  • In this paper, the sensing unit of a non-invasive blood glucose sensor for home users, using a magneto-resonance absorption method, have been designed and manufactured. The sensor is capable of non-invasively determining blood glucose levels through measuring the 1H spin-lattice relaxation time in human body, The comparison of initial models, with different dimensions and shapes, for the sensing unit has led us to select the materials of the final model, which has adequate size and weight for home use. Through the design optimization using the FEM model, the dimension of final model has been determined to satisfy the required strength and uniformity of the magnetic field in the detecting area.