Association Between Self-Monitoring Blood Glucose Frequency and Glycemic Control in Type 1 Diabetes Patients: A Retrospective Study at Khon Kaen Hospital
DOI:
https://doi.org/10.64960/srimedj.v41i1.270058Keywords:
type 1 diabetes mellitus, SMBG, HbA1c, glycemic control, Thailand, diabetes educationAbstract
Background and Objective: Self-monitoring of blood glucose (SMBG) is an essential component of type 1 diabetes mellitus (T1DM) management, particularly in settings where continuous glucose monitoring remains inaccessible. Evidence from international cohorts suggests a strong inverse relationship between SMBG frequency and glycated hemoglobin (HbA1c), yet local data in Thailand remain limited. This study aimed to examine the association between SMBG frequency and glycemic control among adults with T1DM attending Khon Kaen Hospital.
Methods: A retrospective cohort study was conducted using electronic medical records from January 2024 to January 2025. Adults aged ≥15 years with T1DM and at least two clinic visits that documented SMBG frequency and HbA1c were included. Demographic characteristics, comorbidities, diabetes complications, and insulin regimens were recorded. SMBG frequency was categorized based on receiver operating characteristic analysis to discriminate poor glycemic control (HbA1c >9%). Statistical analyses included Wilcoxon rank sum tests, chi-square or Fisher’s exact tests, and univariate logistic regression.
Result: Fifty patients with 102 visits met eligibility criteria. The median age was 22 years, and most were female. The optimal SMBG threshold predicting poor glycemic control was 2.5 checks/day; this informed the categorization of SMBG <3 versus ≥3 times/day. Patients performing SMBG ≥3 times/day had significantly lower HbA1c values compared with those monitoring less frequently (8.4% vs. 9.5%, p=0.014). Higher education level was strongly associated with frequent SMBG (OR 9.00, 95% CI 1.46–55.48). Higher HbA1c was associated with reduced odds of frequent SMBG (OR 0.80 per 1% HbA1c increase, 95% CI 0.66–0.95). SMBG frequency also varied significantly across HbA1c categories, with patients achieving HbA1c <7% most likely to report ≥4 tests/day.
Conclusion: More frequent SMBG, especially three or more times a day, is associated with better glycemic control in Thai adults with T1DM. These findings align with global research and highlight the need for enhanced diabetes education, improved access to monitoring supplies, and targeted support for individuals with lower educational attainment to optimize glycemic outcomes.
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