Yanbing Zeng1,2, Jielong Wu1,2, Yaofeng Han1,2, Fan Chen1,2, Lele Chen1,2, Shuyu Yang3, Ya Fang1,2. 1. State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China. 2. Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen, China. 3. Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Abstract
BACKGROUND: This study examined the combined effects of self-monitoring of blood glucose (SMBG) and educational attainment on glycemic control in type 2 diabetes mellitus (T2DM) patients. METHODS: A cross-sectional survey was performed among community residents with T2DM. Good glycemic control was defined as HbA1c <7% in the most recent measurement. Multivariable logistic regression was used to examine associations of glycemic control with SMBG, educational attainment, and their combined effects by controlling for certain covariates, with further stratification by sex. RESULTS: Complete data were available for 798 patients, of which 58.52% had good glycemic control. Higher education and SMBG were associated with good glycemic control (P < 0.05). In the SMBG group, tertiary-educated patients had the greatest odds of good glycemic control (odds ratios 2.56; 95% confidence interval 1.31-4.99). Among those performing SMBG, the odds of good glycemic control were higher for those with higher education levels (Ptrend = 0.003), whereas there was no clear trend for those not performing SMBG (Ptrend = 0.071). For subjects attaining secondary and tertiary education levels, the odds of good glycemic control were higher in those performing SMBG, although there was no significant difference between the two groups for those with a primary education. Glycemic control decreased slightly among males with a primary level education, but showed an increasing trend among females with a primary level education. CONCLUSIONS: Sex-specific educational disparities exist in the association between SMBG and glycemic control. More detailed guidelines for SMBG according to a subject's socioeconomic position and sex are required.
BACKGROUND: This study examined the combined effects of self-monitoring of blood glucose (SMBG) and educational attainment on glycemic control in type 2 diabetes mellitus (T2DM) patients. METHODS: A cross-sectional survey was performed among community residents with T2DM. Good glycemic control was defined as HbA1c <7% in the most recent measurement. Multivariable logistic regression was used to examine associations of glycemic control with SMBG, educational attainment, and their combined effects by controlling for certain covariates, with further stratification by sex. RESULTS: Complete data were available for 798 patients, of which 58.52% had good glycemic control. Higher education and SMBG were associated with good glycemic control (P < 0.05). In the SMBG group, tertiary-educated patients had the greatest odds of good glycemic control (odds ratios 2.56; 95% confidence interval 1.31-4.99). Among those performing SMBG, the odds of good glycemic control were higher for those with higher education levels (Ptrend = 0.003), whereas there was no clear trend for those not performing SMBG (Ptrend = 0.071). For subjects attaining secondary and tertiary education levels, the odds of good glycemic control were higher in those performing SMBG, although there was no significant difference between the two groups for those with a primary education. Glycemic control decreased slightly among males with a primary level education, but showed an increasing trend among females with a primary level education. CONCLUSIONS: Sex-specific educational disparities exist in the association between SMBG and glycemic control. More detailed guidelines for SMBG according to a subject's socioeconomic position and sex are required.
Authors: Woolton Lee; Jennifer T Lloyd; Katherine Giuriceo; Timothy Day; William Shrank; Rahul Rajkumar Journal: Health Serv Res Date: 2020-07-27 Impact factor: 3.402