K Wambui Charity1, Ajay M V Kumar2, Sven Gudmund Hinderaker3, Palanivel Chinnakali4, Sonak D Pastakia5, Jemimah Kamano6. 1. Academic Model Providing Access to Healthcare, P. O. Box 4606, Eldoret, 30100, Kenya. Electronic address: ckwambui@gmail.com. 2. International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, C6, Qutub Institutional Area, New Delhi 110016, India. Electronic address: AKumar@theunion.org. 3. The Centre for International Health, University of Bergen Overlege Danielsens Hus, Årstadveien 21, Bergen, 5020, Norway. Electronic address: Sven.Hinderaker@uib.no. 4. Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry 605006, India. Electronic address: palaniccm@gmail.com. 5. Purdue University College of Pharmacy, W7555 Myers Building, 1001W. 10th Street, Indianapolis, IN, USA. Electronic address: spastaki@gmail.com. 6. Department of Internal Medicine, College of Health Sciences, School of Medicine, Moi University, P.O. Box 4606, Eldoret, 30100, Kenya. Electronic address: shoine.hoine@gmail.com.
Abstract
AIMS: Among diabetes mellitus (DM) patients with poor glycemic control enrolled into a self-monitoring of blood glucose (SMBG) program in Kenya, to assess the level of SMBG adherence, its associated factors and its relation to glycemic control (defined as HbA1c <7% and/or 2% absolute reduction relative to baseline). METHODS: In this retrospective cohort study, we used routinely collected data of patients enrolled during 2012-2013. We assessed adherence to SMBG by dividing the number of glucose tests performed by the number recommended. A level of ≥ 80% was considered 'good adherence'. Glycemic control was considered as absolute change from baseline of 2%. RESULTS: Of 164 patients (59% female; 76% rural), the proportions with good SMBG adherence were 34%, 17%, 15% and 10% during 0-6, 7-12, 13-18 and 19-24 months into the HGM program respectively. In multivariate analysis, male gender, urban place of residence and payment for glucostrips were associated with poor adherence during 0-12 months. The mean reduction in HbA1c compared to baseline was 1.2%, 1.1%, 0.8% and 0.7% at 6, 12, 18 and 24 months, respectively. We did not find any association between SMBG adherence and glycemic control. CONCLUSIONS: Adherence to SMBG was sub-optimal, especially among those who had to pay for glucostrips. Patient education and provision of free glucostrips are recommended to improve adherence and glycemic control.
AIMS: Among diabetes mellitus (DM) patients with poor glycemic control enrolled into a self-monitoring of blood glucose (SMBG) program in Kenya, to assess the level of SMBG adherence, its associated factors and its relation to glycemic control (defined as HbA1c <7% and/or 2% absolute reduction relative to baseline). METHODS: In this retrospective cohort study, we used routinely collected data of patients enrolled during 2012-2013. We assessed adherence to SMBG by dividing the number of glucose tests performed by the number recommended. A level of ≥ 80% was considered 'good adherence'. Glycemic control was considered as absolute change from baseline of 2%. RESULTS: Of 164 patients (59% female; 76% rural), the proportions with good SMBG adherence were 34%, 17%, 15% and 10% during 0-6, 7-12, 13-18 and 19-24 months into the HGM program respectively. In multivariate analysis, male gender, urban place of residence and payment for glucostrips were associated with poor adherence during 0-12 months. The mean reduction in HbA1c compared to baseline was 1.2%, 1.1%, 0.8% and 0.7% at 6, 12, 18 and 24 months, respectively. We did not find any association between SMBG adherence and glycemic control. CONCLUSIONS: Adherence to SMBG was sub-optimal, especially among those who had to pay for glucostrips. Patient education and provision of free glucostrips are recommended to improve adherence and glycemic control.
Authors: Michael D Glidden; Yanwu Yang; Nicholas A Smith; Nelson B Phillips; Kelley Carr; Nalinda P Wickramasinghe; Faramarz Ismail-Beigi; Michael C Lawrence; Brian J Smith; Michael A Weiss Journal: J Biol Chem Date: 2017-11-07 Impact factor: 5.157
Authors: Loise Ng'ang'a; Gedeon Ngoga; Symaque Dusabeyezu; Bethany L Hedt-Gauthier; Patient Ngamije; Michel Habiyaremye; Emmanuel Harerimana; Gilles Ndayisaba; Christian Rusangwa; Simon Pierre Niyonsenga; Charlotte M Bavuma; Gene Bukhman; Alma J Adler; Fredrick Kateera; Paul H Park Journal: BMJ Open Date: 2020-07-27 Impact factor: 2.692
Authors: Viswanathan Mohan; Jayashree A Mapari; Pratibha D Karnad; Jasdeep S Mann; Vikalp K Maheshwari Journal: Indian J Endocrinol Metab Date: 2018 Jul-Aug