Self-Monitoring of Blood Glucose for Patients With Type 2 Diabetes in Primary Care: A Single-Centre, 10-Year Retrospective Analysis

Justina Cheh Juan Tai; Liang Zhi Wong; Adrian Richardson

doi:10.7759/cureus.15597

Self-Monitoring of Blood Glucose for Patients With Type 2 Diabetes in Primary Care: A Single-Centre, 10-Year Retrospective Analysis

Cureus. 2021 Jun 11;13(6):e15597. doi: 10.7759/cureus.15597. eCollection 2021 Jun.

Authors

Justina Cheh Juan Tai¹, Liang Zhi Wong¹, Adrian Richardson²

Affiliations

¹ General Practice and Primary Care, University College London Medical School, London, GBR.
² General Practice and Primary Care, NHS Haringey North Central London Clinical Commissioning Group (CCG), London, GBR.

Abstract

Background While type 1 diabetics often require self-monitoring of blood glucose (SMBG), the evidence for tight blood glucose monitoring in non-insulin treated type 2 diabetes mellitus (T2DM) patients is limited. In addition to its lack of cost-effectiveness, unnecessary blood glucose monitoring may also result in anxiety and decreased quality of life. In this retrospective audit, we assessed SMBG prescribing practice at one general practice against guidelines from the National Institute for Health and Care Excellence (NICE). Methods A systematic search of T2DM patients diagnosed at a general practice in London, United Kingdom, in the last 10 years was undertaken. A total of 146 patients fulfilled these criteria, of which 100 patients were randomly selected for inclusion in this audit. Medical notes were reviewed and collated for analysis. Results Only 85% of patients with T2DM were being managed in accordance with the NICE guidelines on SMBG, while 15% were not. It was more common for patients who did not need monitoring to be inappropriately prescribed SMBG (10%) than it was for patients who needed monitoring to be under-prescribed SMBG (5%). The reasons for prescribing SMBG were often left undocumented. Conclusion Adherence to the NICE guidelines is subpar. Recommended solutions include educating healthcare professionals involved in the prescribing of SMBGs, regular reviews of the continued necessity of SMBG, and digital alerts on e-prescribing systems.

Keywords: blood glucose; blood glucose strips; diabetes; general practice; lancets; monitoring kits; primary care; self-monitoring; type 2 diabetes mellitus.