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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 28 - 42 (15page)
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Background: In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy. Methods: Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%. Results: HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022). Conclusion: The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.
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참고문헌 (25)
참고문헌 신청
Polonsky WH / 2011 / Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study / Diabetes Care 34:262~267
Franciosi M / 2001 / The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients: an urgent need for better educational strategies / Diabetes Care 24:1870~1877
Miller KM / 2013 / Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants / Diabetes Care 36:2009~2014
Diabetes Control / 1993 / The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus / N Engl J Med 329:977~986
Goldstein DE / 2004 / Tests of glycemia in diabetes / Diabetes Care 27(Suppl 1):S91~S93
Franciosi M / 2001 / The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients: an urgent need for better educational strategies / Diabetes Care 24:1870~1877
Miller KM / 2013 / Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants / Diabetes Care 36:2009~2014
Diabetes Control / 1993 / The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus / N Engl J Med 329:977~986
Goldstein DE / 2004 / Tests of glycemia in diabetes / Diabetes Care 27(Suppl 1):S91~S93
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