Invasiveness as a Barrier To

Background: This study investigated the degree to which the invasive characteristic of glucose monitoring is a barrier to self-monitoring of blood glucose (SMBG). Methods: A paper-and-pencil Measure of Invasiveness as a reason for Skipping 5MBG (MISS) was created and administered to 339 people with diabetes. The correlations between MISS scores and actual 5MBG frequency, percent adherence to 5MBG recommendations, 5MBG anxiety, 5MBG burden, and knowledge of the importance of glycemic control for avoiding diabetes complications were each explored. Results: On a scale of 0-28, the average MISS score was M = 4.3 (SD = 5.4, range 0-28). Fully 63% (nearly two-thirds) of respondents reported skipping 5MBG because of the invasiveness of the procedure. MISS scores were negatively related to percent adherence to healthcare provider 5MBG recommendations as measured by memory function of automated meters (Spearman's r = -0.47, P < 0.01). MISS scores were also negatively related to absolute 5MBG Jrequency regardless of 5MBG recommendations (Spearman's r = -0.11, P < 0.05). Correlation betweentlle MISS and 5MBG anxiety was significant (Spearman's r = 0.50, P < 0.01). With highly anxious participants deleted, the magnitude of the correlation was attenuated, but persisted (Spearman's r = 0.28, P < 0.01), suggesting that invasiveness is associated with 5MBG anxiety even among patients without a blood or injection phobia. MISS scores were also correlated with the degree to which patients find routine and non-routine 5MBG checks a burden (routine r = 0.38, P < 0.01; non-routine r = 0.45, P < 0.01). Results of Mann-Whitney U tests indicated higher MISS scores among participants with less knowledge about the importance of glycemic control in the development of diabetes vascular complications. Conclusions: Invasiveness is a common and serious barrier to 5MBG. These findings suggest that people with diabetes would perform 5MBG more frequently and have improved quality of life with non-invasive 5MBG. optimal in both type 1 and type 2 diabetes} For example, in a study of 3,567 people with type 2 diabetes, 14% tested their blood glucose levels less than one time per week, and 38% stated that they never practiced 5MBG.2 There is no evidence to suggest that adherent patients mis~~~£.r~nt themselves as non-adherent, nor is INTRODUCTION S ELF-MONITORING OF BLOOD GLUCOSE (SMBG) is considered a cornerstone of diabetes care regimens. Despite differences in the operationalization of "adherence," it is well documented that rates of 5MBG adherence are subUniversity of Connecticut Health Center, Farmington, Connecticut.