Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes: A prospective cohort study

Sang Man Jin, Jong Ha Baek, Sunghwan Suh, Chang Hee Jung, Woo Je Lee, Cheol Young Park, Hae Kyung Yang, Jae Hyoung Cho, Byung Wan Lee, Jae Hyeon Kim

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Abstract

Aims/Introduction: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes, in terms of glycemic control and the rate of severe hypoglycemia. Materials and Methods: This was a prospective cohort study of 466 adult patients with type 1 diabetes from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months. Factors associated with a > 5% reduction in glycated hemoglobin (HbA1c) and decreased rate of severe hypoglycemia (SH) at 12 months from baseline were evaluated. Results: At the end of the 12 months of follow up, 158 of 466 patients (33.9%) achieved >5% reduction in HbA1c, and 47 of 111 patients (42.3%) had a decreased rate of SH relative to baseline. Higher HbA1c (P < 0.001), lower total daily insulin dose at baseline (P = 0.048) and an increase in self-monitoring of blood glucose (SMBG) frequency during follow up (P = 0.001) were independently associated with >5% reduction in HbA1c. A higher SMBG frequency (P < 0.001), higher rate of SH at baseline (P = 0.029) and lack of hypoglycemic unawareness (P = 0.044) were independently associated with an increase in the frequency of SMBG during follow up. Higher SMBG frequency at baseline (P < 0.001) was independently associated with a decreased rate of SH. Conclusions: Several factors, including higher SMBG frequency at baseline, were independently associated with reduced HbA1c and a decreased rate of severe hypoglycemia, showing that patients with these characteristics derive the most benefit from reimbursement of blood glucose test strips.

Original languageEnglish
Pages (from-to)549-557
Number of pages9
JournalJournal of Diabetes Investigation
Volume9
Issue number3
DOIs
Publication statusPublished - 2018 May

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Hematologic Tests
Type 1 Diabetes Mellitus
Hypoglycemia
Blood Glucose
Cohort Studies
Prospective Studies
Glycosylated Hemoglobin A
Hypoglycemic Agents
Tertiary Care Centers

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Jin, Sang Man ; Baek, Jong Ha ; Suh, Sunghwan ; Jung, Chang Hee ; Lee, Woo Je ; Park, Cheol Young ; Yang, Hae Kyung ; Cho, Jae Hyoung ; Lee, Byung Wan ; Kim, Jae Hyeon. / Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes : A prospective cohort study. In: Journal of Diabetes Investigation. 2018 ; Vol. 9, No. 3. pp. 549-557.
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abstract = "Aims/Introduction: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes, in terms of glycemic control and the rate of severe hypoglycemia. Materials and Methods: This was a prospective cohort study of 466 adult patients with type 1 diabetes from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months. Factors associated with a > 5{\%} reduction in glycated hemoglobin (HbA1c) and decreased rate of severe hypoglycemia (SH) at 12 months from baseline were evaluated. Results: At the end of the 12 months of follow up, 158 of 466 patients (33.9{\%}) achieved >5{\%} reduction in HbA1c, and 47 of 111 patients (42.3{\%}) had a decreased rate of SH relative to baseline. Higher HbA1c (P < 0.001), lower total daily insulin dose at baseline (P = 0.048) and an increase in self-monitoring of blood glucose (SMBG) frequency during follow up (P = 0.001) were independently associated with >5{\%} reduction in HbA1c. A higher SMBG frequency (P < 0.001), higher rate of SH at baseline (P = 0.029) and lack of hypoglycemic unawareness (P = 0.044) were independently associated with an increase in the frequency of SMBG during follow up. Higher SMBG frequency at baseline (P < 0.001) was independently associated with a decreased rate of SH. Conclusions: Several factors, including higher SMBG frequency at baseline, were independently associated with reduced HbA1c and a decreased rate of severe hypoglycemia, showing that patients with these characteristics derive the most benefit from reimbursement of blood glucose test strips.",
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Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes : A prospective cohort study. / Jin, Sang Man; Baek, Jong Ha; Suh, Sunghwan; Jung, Chang Hee; Lee, Woo Je; Park, Cheol Young; Yang, Hae Kyung; Cho, Jae Hyoung; Lee, Byung Wan; Kim, Jae Hyeon.

In: Journal of Diabetes Investigation, Vol. 9, No. 3, 05.2018, p. 549-557.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes

T2 - A prospective cohort study

AU - Jin, Sang Man

AU - Baek, Jong Ha

AU - Suh, Sunghwan

AU - Jung, Chang Hee

AU - Lee, Woo Je

AU - Park, Cheol Young

AU - Yang, Hae Kyung

AU - Cho, Jae Hyoung

AU - Lee, Byung Wan

AU - Kim, Jae Hyeon

PY - 2018/5

Y1 - 2018/5

N2 - Aims/Introduction: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes, in terms of glycemic control and the rate of severe hypoglycemia. Materials and Methods: This was a prospective cohort study of 466 adult patients with type 1 diabetes from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months. Factors associated with a > 5% reduction in glycated hemoglobin (HbA1c) and decreased rate of severe hypoglycemia (SH) at 12 months from baseline were evaluated. Results: At the end of the 12 months of follow up, 158 of 466 patients (33.9%) achieved >5% reduction in HbA1c, and 47 of 111 patients (42.3%) had a decreased rate of SH relative to baseline. Higher HbA1c (P < 0.001), lower total daily insulin dose at baseline (P = 0.048) and an increase in self-monitoring of blood glucose (SMBG) frequency during follow up (P = 0.001) were independently associated with >5% reduction in HbA1c. A higher SMBG frequency (P < 0.001), higher rate of SH at baseline (P = 0.029) and lack of hypoglycemic unawareness (P = 0.044) were independently associated with an increase in the frequency of SMBG during follow up. Higher SMBG frequency at baseline (P < 0.001) was independently associated with a decreased rate of SH. Conclusions: Several factors, including higher SMBG frequency at baseline, were independently associated with reduced HbA1c and a decreased rate of severe hypoglycemia, showing that patients with these characteristics derive the most benefit from reimbursement of blood glucose test strips.

AB - Aims/Introduction: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes, in terms of glycemic control and the rate of severe hypoglycemia. Materials and Methods: This was a prospective cohort study of 466 adult patients with type 1 diabetes from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months. Factors associated with a > 5% reduction in glycated hemoglobin (HbA1c) and decreased rate of severe hypoglycemia (SH) at 12 months from baseline were evaluated. Results: At the end of the 12 months of follow up, 158 of 466 patients (33.9%) achieved >5% reduction in HbA1c, and 47 of 111 patients (42.3%) had a decreased rate of SH relative to baseline. Higher HbA1c (P < 0.001), lower total daily insulin dose at baseline (P = 0.048) and an increase in self-monitoring of blood glucose (SMBG) frequency during follow up (P = 0.001) were independently associated with >5% reduction in HbA1c. A higher SMBG frequency (P < 0.001), higher rate of SH at baseline (P = 0.029) and lack of hypoglycemic unawareness (P = 0.044) were independently associated with an increase in the frequency of SMBG during follow up. Higher SMBG frequency at baseline (P < 0.001) was independently associated with a decreased rate of SH. Conclusions: Several factors, including higher SMBG frequency at baseline, were independently associated with reduced HbA1c and a decreased rate of severe hypoglycemia, showing that patients with these characteristics derive the most benefit from reimbursement of blood glucose test strips.

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