Impact of Self-Monitoring Blood Glucose on Glycaemic Control Among Insulin-Treated Patients With Diabetes Mellitus in Northeastern Tanzania: A Randomised Controlled Trial.

Autor: Muhali SS; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania., Muhali FS; Department of Endocrinology Muhimbili National Hospital, Dar es Salaam, Tanzania., Mfinanga SG; National Institute for Medical Research Muhimbili Research Centre, Dar es Salaam, Tanzania., Sadiq AM; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Marandu AA; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania., Kyala NJ; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania., Said FH; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania., Nziku EB; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mirai TE; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Ngocho JS; Institute of Public Health Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mlay HL; Institute of Public Health Kilimanjaro Christian Medical University College, Moshi, Tanzania., Waria GG; Institute of Public Health Kilimanjaro Christian Medical University College, Moshi, Tanzania., Chambega A; Nutrition Unit Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Kessy SN; Nutrition Unit Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Kilonzo KG; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Lyamuya FS; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Mkwizu EW; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Shao ER; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Chamba NG; Faculty of Medicine Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Internal Medicine Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Jazyk: angličtina
Zdroj: Journal of diabetes research [J Diabetes Res] 2024 Jun 10; Vol. 2024, pp. 6789672. Date of Electronic Publication: 2024 Jun 10 (Print Publication: 2024).
DOI: 10.1155/2024/6789672
Abstrakt: Introduction: Tracking of blood glucose levels by patients and care providers remains an integral component in the management of diabetes mellitus (DM). Evidence, primarily from high-income countries, has illustrated the effectiveness of self-monitoring of blood glucose (SMBG) in controlling DM. However, there is limited data on the feasibility and impact of SMBG among patients in the rural regions of sub-Saharan Africa. This study is aimed at assessing SMBG, its adherence, and associated factors on the effect of glycaemic control among insulin-treated patients with DM in northeastern Tanzania. Materials and Methods: This was a single-blinded, randomised clinical trial conducted from December 2022 to May 2023. The study included patients with DM who had already been on insulin treatment for at least 3 months. A total of 85 participants were recruited into the study and categorised into the intervention and control groups by a simple randomization method using numbered envelopes. The intervention group received glucose metres, test strips, logbooks, and extensive SMBG training. The control group received the usual care at the outpatient clinic. Each participant was followed for a period of 12 weeks, with glycated haemoglobin (HbA 1c ) and fasting blood glucose (FBG) being checked both at the beginning and at the end of the study follow-up. The primary and secondary outcomes were adherence to the SMBG schedule, barriers associated with the use of SMBG, and the ability to self-manage DM, logbook data recording, and change in HbA 1c . The analysis included descriptive statistics, paired t -tests, and logistic regression. Results: Eighty participants were analysed: 39 in the intervention group and 41 in the control group. In the intervention group, 24 (61.5%) of patients displayed favourable adherence to SMBG, as evidenced by tests documented in the logbooks and glucometer readings. Education on SMBG was significantly associated with adherence. Structured SMBG improved glycaemic control with a HbA 1c reduction of -1.01 (95% confidence interval (CI) -1.39, -0.63) in the intervention group within 3 months from baseline compared to controls of 0.18 (95% CI -0.07, 0.44) ( p < 0.001). Conclusion: Structured SMBG positively impacted glycaemic control among insulin-treated patients with DM in the outpatient clinic. The results suggest that implementing a structured testing programme can lead to significant reductions in HbA 1c and FBG levels. Trial Registration: Pan African Clinical Trials Registry identifier: PACTR202402642155729.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2024 Sophia S. Muhali et al.)
Databáze: MEDLINE
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