Associations among Self-Monitoring of Blood Glucose, Other Self-Care Behaviors, Health Care Utilization, and Mortality in Diabetes

Background: Most previous studies of predictors of health care utilization and mortality in people with diabetes have focused on metabolic profiles and diabetes complications. Few studies have examined the impact of diabetes self-care behaviors on health care utilization and mortality. From the health promotion perspective, for people with diabetes it remains unclear whether diabetes self-care behaviors, such as self-monitoring of blood glucose, adhering to a medication schedule, foot care, having a healthy diet, and controlling weight, reduce their health care utilization and mortality. Objective: The objectives of this study are shown as followed. First year: To investigate self-monitoring of blood glucose and its associated factors among diabetes. Moreover, we like to explore the association between self-monitoring of blood glucose and other diabetes self-care behaviors. Second year: To examine the association between self-monitoring of blood glucose and other self-care behaviors and health care utilization among diabetes. Third year: To examine the association between self-monitoring of blood glucose and other self-care behaviors and mortality among diabetes. Method: This is a prospective study. The study population included participants in the National Health Interview Survey (NHIS) in Taiwan in 2005. Those individuals aged 18 and above with diabetes confirmed by physicians will be included in this study. Of the potential participants, those who provided consent for data linkage to 2005-2006 claims data from the Bureau of National Health Insurance could be obtained, will be eligible for analysis to explore the association between diabetes self-care behaviors and health care utilization in the present study. Deaths will be verified by indexing to the National Register of Deaths with a personal identification number. Statistical analysis: Logistic regression analysis will be performed to assess the association between self-monitoring of blood glucose and its associated factors in diabetes. Negative binomial regression and Generalized linear models will be used to estimate the parameters specified in the health care utilization model. Multivariate Cox’s proportional hazards models will be used to examine the association between diabetes self-care behaviors and mortality. We used the SAS (SAS Institute, Cary, NC)-callable SUDAAN (RTI Inc., Research Triangle Park, NC) for all analyses.

Project ID:PF9907-7028
External Project ID:NSC99-2410-H182-007