Outcomes of Increasing Diabetes Self-Monitoring in an HMO;Final rept

摘要

The authors evaluated whether a policy change to cover the cost of blood glucose monitors increased self-monitoring of blood glucose (SMBG) among diabetic patients in a managed care setting. A secondary aim was to determine if initiating SMBG was associated with increased regularity of medication use and improved glucose control (HbA(sub 1c)) as compared with non-initiators of SMBG. The authors collected 48 months of data from a computerized medical record system for 3,219 contiguously enrolled adult diabetes patients on drug therapy. There was marked rise in trials of SMBG after coverage among oral sulfonylurea-managed patients. The monthly initiation rate of SMBG increased by 99% (relative change) and the number of test strips consumed per patient increased by 75% (relative change) during the first six months after the coverage. Among patients who initiated SMBG, there were sudden improvements 37% (relative change) in regularity of diabetes medication use by six months after initiation and glucose control (0.63% increase). Coverage of the cost of blood glucose monitors significantly increased SMBG in a managed care organization. Initiating SMBG was associated with increased regularity of use of medications and a reduction in high blood glucose levels that are associated with diabetes complication.