Acknowledgments Lifescan Inverness Introduction  Diabetes Mellitus is the 5 th most common cause of death in the world  Life expectancy reduced on average.

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Presentation transcript:

Acknowledgments Lifescan Inverness Introduction  Diabetes Mellitus is the 5 th most common cause of death in the world  Life expectancy reduced on average by > 20yrs for Type 1 diabetes and up to 10yrs for Type 2 diabetes  Numbers of patients diagnosed with diabetes in the UK has increased to more than 3.2 million, 6% of the population.  Just over 237,000 of the Scottish population have diabetes (4%-5.2% prevalence between health boards)  Tayside has a population representative of the rest of Scotland.  This research seeks to obtain a picture of the frequency of SMBG in insulin-treated patients with type 1 or type 2 diabetes in Tayside, as well as differences between population groups. Diabetes UK 2012; Diabetes UK 2014; Dunstan, Zimmet, Welbourne 2002 Methods The analysis of routinely collected data was undertaken using SCI-DC data, a Tayside validated population-based Diabetes Clinical Information System, held at the Health Information Centre (HIC), University of Dundee. An additional database, MEMO, records all prescriptions dispensed in Tayside; allowing the additional calculation of the number of testing strips dispensed to every patient Data Collection – Variables included  Demographic characteristics: sex, date of birth, date in and out of health region, deprivation index: (1 = most deprived, 5 = least deprived), diabetes type, date of diagnosis  Prescribing information (BNF, chapter 6) and prescriptions for strips dispensed  Death certification data Analysis was undertaken to investigate relationships between variables using a one-way analysis T-test and multiple variable ANOVA analysis. Results Conclusions Despite a growing body of evidence identifying the importance of SMBG in maintaining glycaemic control and in turn decreasing the risk of diabetic related complications, many insulin-treated patients with type 1 and type 2 diabetes are not testing at all. This level of non-testing has increased significantly over the last decade. Furthermore, testing is not carried out as frequently as recommended within both patient groups. The effect of deprivation on levels of testing among patients with type 2 diabetes is a particular concern as this has the potential to widen inequalities in diabetes outcomes. It is important that all patients who are treated with insulin and for whom SMBG may be beneficial have appropriate knowledge surrounding testing recommendations and the practice of self-monitoring. The strengths of this study are: Population approach Use of validated diabetes clinical information system Use of records of dispensed prescriptions for reagent strips However, we cannot be sure that patients necessarily used the reagent strips that were dispensed to them; neither can we be sure that patients did not receive strips from other sources. Conclusions Despite a growing body of evidence identifying the importance of SMBG in maintaining glycaemic control and in turn decreasing the risk of diabetic related complications, many insulin-treated patients with type 1 and type 2 diabetes are not testing at all. This level of non-testing has increased significantly over the last decade. Furthermore, testing is not carried out as frequently as recommended within both patient groups. The effect of deprivation on levels of testing among patients with type 2 diabetes is a particular concern as this has the potential to widen inequalities in diabetes outcomes. It is important that all patients who are treated with insulin and for whom SMBG may be beneficial have appropriate knowledge surrounding testing recommendations and the practice of self-monitoring. The strengths of this study are: Population approach Use of validated diabetes clinical information system Use of records of dispensed prescriptions for reagent strips However, we cannot be sure that patients necessarily used the reagent strips that were dispensed to them; neither can we be sure that patients did not receive strips from other sources. Patterns of self-monitoring of blood glucose (SMBG) in Tayside, Scotland, among people with Type 1 and Type 2 diabetes treated with insulin Dawn Cameron, Dr Josie Evans, Dr Leah Macaden — School of Nursing, Midwifery and Health, University of Stirling Literature cited 332,861 – 350,931 Tayside residents 13 years and over Part 1 – Year by year analysis: Part 2 – Cross-sectional analysis: 3 year period 1/1/ /12/20011 For further information Please contact  The overall number of strips dispensed to both patient groups has increased over time  The mean number of strips dispensed to those who are testing demonstrates that patients are not testing as frequently as current guidance recommends  Significant numbers of patients did not receive any strips, suggesting that they are not testing at all  This has increased significantly from previous analysis: 30-42% in type 1 diabetes and 47-57% in type 2 diabetes compared to 16% and 21% respectively in a study  In type 1 diabetes, more women than men tested, and younger patients were more likely to test  These differences were less evident in type 2 diabetes, but there was a stronger effect of deprivation with patients living in less deprived areas more likely to test Fig. 1. Tayside region of Scotland Table 1. Patients with type 1 diabetes Number of strips dispensed by year and the number of patients with any strips dispensed Table 2. Insulin-treated patients with type 2 diabetes Number of strips dispensed by year and the number of patients with any strips dispensed Table 3. Patients with type 1 diabetes Number of patients with strips dispensed: % testing Table 4. Insulin-treated patients with type 2 diabetes Numbers of patients with strips dispensed: % testing Diabetes UK. (2012). Diabetes in the Uk 2012, Key Statistics on Diabetes. Retrieved from /Diabetes-in-the-UK-2012.pdf Diabetes UK. (2014). Retrieved from s-increases-to-32-million/ Evans, J., Newton, R. W., Ruta, D. A., MacDonald, T. M., Stevenson, R. J., & Morris, A. D. (1999). Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database. BMJ (Clinical research ed.), 319(7202), 83–86. Retrieved from Dunstan, D., Zimmet, P., Welbourne, T., & al, et. (2002). The rising prevalence of diabetes and impaired glucose tolerance. Diabetes care, 25(5), 829–834