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. Issue 3 (3rd October 2017)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Journal of diabetes investigation. Volume 9:Issue 3(2018)
• Page Start: 549
• Page End: 557
• Publication Date: 2017-10-03
• Subjects: Blood glucose self‐monitoring -- Reimbursement -- Type 1 diabetes mellitus; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.12728
• Languages: English
• ISSNs: 2040-1116

Abstract

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. Abstract : Several factors, including higher SMBG frequency at baseline, were independently associated with greater benefit of the KNHIS reimbursement program such as an increase in self‐monitoring of blood glucose (SMBG) frequency and a decreased rate of severe hypoglycaemia. The results of this study newly characterize the Asian patient group of type 1 diabetes who would most benefit from reimbursement for SMBG in order to enable prioritization of limited resources.