Self-monitoring of blood glucose: psychological barriers and benefits

Snoek, Frank J.; Malanda, U.L.

doi:10.1002/edn.122

Cited by 17 publications

(22 citation statements)

References 14 publications

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“…Of those reporting a reduced frequency of testing, a considerable proportion reported pain as the reason and this is consistent with previous research with avoidance of insulin injections. 11 A USA based study found that 6% (of 1895 participants), reported fear of needles as a reason for reduced testing, and of the participants not monitoring their blood glucose, 14% reported a fear of needles. 12 In the present study (Table 3), 32% of the total group avoided glucose testing due to either dislike (with no reason stated) or injection pain, while 26% forgot or cited 'laziness'.…”

Section: Discussionmentioning

confidence: 99%

Anxiety associated with self monitoring of capillary blood glucose

Shlomowitz

Feher

2014

Br J Diabetes

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Aims: The aims were to evaluate (1) prevalence and contributing factors of anxiety to the finger prick method used to self monitor glucose: (2) whether individuals report avoidance of self monitoring due to fear of the finger prick method; and (3) levels of general anxiety. Methods: Individuals attending a specialist diabetes outpatient centre, and who self monitored their capillary blood glucose concentrations, were invited to complete a standardised questionnaire to assess anxiety associated with the finger prick method blood glucose measurement, and general day-to-day anxiety. Results: From 315 (58% male) individuals with diabetes, finger prick anxiety was observed in 30% and general anxiety in 33%. Positive correlations were found for finger prick anxiety with avoidance of testing and with general anxiety. Older individuals had less general anxiety and females reported greater anxiety to the finger prick method and general anxiety. There were ethnic differences in anxiety to the finger prick method and avoidance of testing, but not to general anxiety. Conclusions: One third of a general diabetes outpatient cohort have general anxiety and anxiety to the finger prick method for glucose testing. There are important implications for both patients and health care professionals in identifying barriers to achieving improved diabetes control.

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Section: Discussionmentioning

confidence: 99%

Anxiety associated with self monitoring of capillary blood glucose

Shlomowitz

Feher

2014

Br J Diabetes

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“…These insights can help professionals support the patients in their self-management regarding SMBG [16,20,21]. …”

Section: Introductionmentioning

confidence: 99%

Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study

et al. 2012

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BackgroundSelf-monitoring of blood glucose (SMBG), including self-regulation, is an important tool to achieve good glycemic control. However, many patients measure their glucose concentrations less often than is recommended. This study investigates patients' perspectives of SMBG and all relevant aspects influencing SMBG in patients with type 1 and insulin-treated type 2 diabetes.MethodsIn depth interviews were conducted with 13 patients with type 1 diabetes from an outpatient clinic and 15 patients with type 2 diabetes from general practices. All interviews were transcribed verbatim and analyzed using the Grounded Theory approach.ResultsA wide variety of SMBG was encountered. Perceptions, goals of SMBG and personal and contextual factors were identified, influencing the respondents' perspective of SMBG, and leading to this variety. Respondents experienced a discrepancy between their own and the professionals' perceptions and goals. Respondents' perception of SMBG ranged along a continuum from 'friend' to 'foe'. With respect to the goals, the respondents experienced tension between achieving good glycemic control and quality of life, and deliberately made their own choices. The performance of SMBG was tailored to their perceptions and personal goals. Personal and contextual factors such as hypo- or hyper (un)awareness, knowledge, and contact with professionals acted as either facilitating factors or as barriers to SMBG, depending on the respondents' perspective. A SMBG model was developed providing a representation of the factors and their interrelations.Respondents with type 1 diabetes seemed more resigned to their situation and SMBG was more integrated into their lives.ConclusionsFrom the patients' perspective, professionals positively present SMBG as a 'friend' in order to achieve strict glycemic control. Whereas patients can also perceive SMBG as a 'foe'. They primarily seek a personal balance between achieving glycemic control and quality of life, leading them to deliberately make other choices regarding SMBG performance than was recommended. Gaining insight and discussing all factors affecting SMBG will help professionals and patients come to mutually agreed goals and to tailor the performance of SMBG to the individual patient. This should result in a more optimal use of SMBG, an improved quality of life, and improved clinical parameters.

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“…8,15 Questionnaires that assess fear of testing can be used to identify patients who may benefit from psychological therapy. 88 Problem solving techniques 15 and motivational interviewing are useful strategies to increase adherence with SMBG. 89 Minimizing pain with alternative lancing devices, 90 alternative site testing, 91,92 or flash glucose monitoring systems, 93 may encourage testing.…”

Section: Addressing Barriers To Technology Use and Strategies To Optimentioning

confidence: 99%

“…14 A 5-step bio-psychosocial model of SMBG facilitates understanding of testing barriers: 15 Step 1 is the decision to test: Some patients having extreme coping styles, with "blunters" who skip testing to avoid getting poor results and "monitors," who test excessively, driven by fear and anxiety.…”

mentioning

confidence: 99%

Influences on Technology Use and Efficacy in Type 1 Diabetes

Franklin

2016

J Diabetes Sci Technol

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Since 1921 technology has existed to replace insulin and treat diabetes. Although a definitive link was established between HbA1c and complication risk over 20 years ago, 1 only a minority achieve HbA1c targets despite intensified insulin regimens and new technologies. 2 This narrative review focuses on how psychosocial functioning affects uptake and use of technologies and the impact of technology on psychosocial outcomes in adults and children with type 1 diabetes and their caregivers. It examines evidence from large meta-analyses to small qualitative studies which provide detailed insight into technology use. Self Monitoring of Blood GlucoseFrequent blood glucose testing should be a routine part of diabetes self-care 3,4 as it is integral to intensive insulin therapy 1 and improves glycemic control. 5 However, studies of adult patients reveal low testing frequency, 6,7 which is influenced by psychosocial factors, with increased testing in patients of older age, female gender, longer diabetes duration, on basal bolus therapy compared with less intensive regimens, with decreased hypoglycemic awareness, higher "fear of hypoglycemia" and positive self-care personality traits 6 and less testing in ethnic minorities, smokers, those with low education, 8 low income and language barriers. 7 In adolescents, testing is more frequent in younger age groups, higher social status, and higher self-efficacy and less frequent in those with lower self-esteem, high-stress life events, lower parental support, 9,10 from single parent, lower-income, and ethnic minorities, and when given self-care autonomy before reaching cognitive and social maturity.11 In children, family functioning 12 and parental education 13 predict adherence to diabetes self-management and glycemic control.Qualitative studies in adults show that some perceive selfmonitoring of blood glucose (SMBG) as a tool to achieve good control and a normal life, but others see SMBG as a 639315D STXXX10.1177/1932296816639315Journal of Diabetes Science and TechnologyFranklin AbstractThe majority of people with type 1 diabetes have suboptimal glycemic control, increasing their complication risk. Technology to support diabetes self-care has advanced significantly and includes self-monitoring of blood glucose (SMBG), insulin pump therapy (IPT), continuous glucose monitoring (CGM), and sensor-augmented pump therapy (SAPT), which are stepping stones toward the "artificial pancreas" using closed-loop technology. Use of these technologies improves clinical outcomes for patients with the appropriate skills and motivation. This review addresses the psychosocial factors that influence both technology provision and clinical outcome and also how technology impacts on psychological outcomes. Optimal use of the various diabetes self-management technologies is influenced by previous self-care behaviors, demographic and psychological factors. Provision of IPT is also influenced by the same factors. Despite technology increasing the complexity of treatment, the lack of evidence for adverse...

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Self-monitoring of blood glucose: psychological barriers and benefits

Cited by 17 publications

References 14 publications

Anxiety associated with self monitoring of capillary blood glucose

Anxiety associated with self monitoring of capillary blood glucose

Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study

Influences on Technology Use and Efficacy in Type 1 Diabetes

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