Facilitating access to glucometer reagents increases blood glucose self-monitoring frequency and improves glycaemic control: a prospective study in insulin-treated diabetic patients

Aims To investigate whether availability of glucometer reagents increases the frequency of self-blood glucose monitoring (SBGM) and improves glycaemic control in diabetic patients. Methods Sixty-two insulin-treated diabetic patients were randomized to two groups, matched for age, gender, education, income, type and duration of diabetes, years of insulin treatment, number of daily insulin injections, and haemoglobin (Hb)A(1c). All patients were given a glucometer, but one group (no cost, NQ was provided glucometer test strips free of charge. The other group (control, C) had to purchase strips as they found it necessary. Both groups of patients were followed longitudinally at 2-monthly intervals for 12 months with measurement of blood glucose and HbA(1c), and the frequency of SBGM was determined by downloading the glucometer memory. Results The SBGM frequency was significantly higher in the NC group vs. the C group during the first 4 months (2.0 +/- 0.2 tests/day vs. 1.4 +/- 0.1 tests/day, P < 0.025). Mean HbAlc remained stable over the 12 months in the NC group, whereas an increase with time was observed in the C group. The difference in HbA(1c) between the two groups was significant (P < 0.002) after 6 months. Random blood glucose measured at each visit and average glucose recorded by the glucometer were also lower in the NC group vs. the C group (P < 0.005). There was a negative correlation between HbA(1c) and SBGM frequency, and HbA(1c) in patients testing at least twice a day was lower than in those testing less than twice a day (8.8 +/- 0.2% vs. 9.6 +/- 0.2%, P < 0.001). Conclusions In this prospective study, having easy access to glucometer strips provided free of charge to patients increased SBGM frequency. The relationship between HbA(1c). and SBGM frequency supports the view that SBGM is an essential tool in diabetes management.