Analysis of Clinical Outcome and Healthcare Resource use in Insulin Treated Diabetic Patients Based on Self-Monitoring of Blood Glucose Levels

Purpose: The purpose of the study hereof is to evaluate the appropriate use of blood glucose self-monitoring devices (strips), the risks of hypoglycemia, the incidence of hospitalization or death related to diabetes, and to calculate the use of healthcare resources based on self-monitoring of blood glucose (SMBG), in insulin treated patients. Methods: A retrospective study was conducted based on current administrative flows. The study included patients having at least one insulin prescription from November 1, 2009 to April 30, 2011 (inclusion period). The index date was defined as the date within the inclusion period in which the patient presented the first insulin prescription. All patients were under observation for 18 months starting from the index date (observation period). Screening was conducted during the 12 months prior to the observation. Patients who resorted to self-monitoring of blood glucose were identified by the number of test strips prescribed by the National Health Service. Consumption data refer to the observation period of the analysis. Results: 3,890 patients were included, 26.4% of which resorted to self-monitoring less than once a day whereas 10% never did. The incidence of hypoglycemia was linked to daily use or lack of use of SMBG (27.3 vs. 10.6). Based exclusively on the cost of hospitalization, lack of use of SMBG resulted in an increased consumption of healthcare resources. Conclusions: Based on the results presented, we hope that this study will encourage development and implementation of educational and training programs on self-management of diabetes, and of models on adopting clinical decisions and on healthcare provided, based on monitored values.