Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose
Diabetes & Metabolism Journal
; : 28-42, 2018.
Article
em En
| WPRIM
| ID: wpr-739784
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.METHODS:
Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up < 7%.RESULTS:
HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P < 0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P < 0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022).CONCLUSION:
The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.Palavras-chave
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Índice:
WPRIM
Assunto principal:
Glicemia
/
Peptídeo C
/
Hemoglobinas Glicadas
/
Automonitorização da Glicemia
/
Prevalência
/
Análise Multivariada
/
Seguimentos
/
Jejum
/
Diabetes Mellitus Tipo 2
/
Glucose
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Diabetes & Metabolism Journal
Ano de publicação:
2018
Tipo de documento:
Article