Cultural diversity as a factor in self-monitoring blood glucose in gestational diabetes.

O Langer, N Langer, J M Piper, B Elliott, A Anyaegbunam
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Abstract

The routine use of self-monitoring of capillary blood glucose by pregnant diabetic patients currently provides the basis for both clinical management and ongoing investigation. Strategies must therefore be developed to ensure that these data are reliable and accurately reported by patients and are not influenced by diverse socioeconomic levels or varied geographic locations. To explore this issue, we used glucose reflectance meters with a memory microchip capable of storing up to 440 consecutive blood glucose determinations. Two diverse groups of women from Texas and New York who had gestational diabetes performed self-monitoring of blood glucose from diagnosis until delivery. Both groups recorded their blood glucose results daily in a logbook. The reporting performance of all the participating subjects resulted in an actual compliance rate of 60% to 70% of testings required of the patients. Comparison of African-American, Mexican-American, and white populations revealed no significant differences in patient performance or compliance. Moreover, no differences were found between the groups at different geographic locations (New York, Texas) in patients' willingness and ability to comply with the regimen of self-monitoring blood glucose. These findings suggest that the use of memory reflectance meters, in conjunction with patient education and positive interaction between patient and care provider, will result in high patient compliance regardless of socioeconomic level or ethnic diversity.

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文化多样性是妊娠糖尿病患者自我监测血糖的一个因素。
目前妊娠糖尿病患者常规使用自我监测毛细血管血糖为临床管理和正在进行的研究提供了依据。因此,必须制定战略,以确保这些数据是可靠的,由患者准确报告,并且不受不同社会经济水平或不同地理位置的影响。为了探讨这一问题,我们使用了葡萄糖反射仪,其内存微芯片能够存储多达440个连续的血糖测定。来自德克萨斯州和纽约的两组不同的患有妊娠糖尿病的妇女从诊断到分娩都进行了自我血糖监测。两组人每天都在日志上记录他们的血糖结果。所有参与受试者的报告表现导致患者所需测试的实际依从率为60%至70%。非裔美国人、墨西哥裔美国人和白人的比较显示,患者的表现或依从性没有显著差异。此外,在不同地理位置(纽约、德克萨斯州)的组之间,患者遵守自我监测血糖方案的意愿和能力没有差异。这些发现表明,无论社会经济水平或种族差异如何,使用记忆反射仪,结合患者教育和患者与护理提供者之间的积极互动,都将导致患者的高依从性。
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