This thesis has explored the validity and application of self-monitoring of blood glucose (SMBG) in diabetes mellitus from a range of perspectives, using a variety of methods. Initially, a systematic literature review was conducted to evaluate the validity of patient generated blood glucose diaries. Concern was raised over their clinical utility as, allowing for a minimal amount of 'error', just over 50% of adult diaries could be considered 'accurate/reliable'. There was also a lack of information relating to the diaries of those with type 2 diabetes and study follow-up was of short duration. As a result, a secondary data analysis was conducted to explore the validity of diaries, over a year, in a sample of patients with type 2 diabetes. Using a range of statistical techniques, and a novel approach to determining the clinical significance of recording errors, this identified an initial learning curve for 5MBG record keeping. Our understanding of the validity of 5MBG was furthered by subsequently using this database to explore the impact of measurement error on the estimation of the relationship between mean plasma glucose and glycated haemoglobin. Measurement error led to an underestimation of the relationship. When combined with biological variation this draws into question the potential for one regression equation to represent this relationship across diverse populations. The final section of this thesis concentrates on the validity and application of SMBG when telemedicine is used between antenatal women with gestational diabetes and the diabetes team. A feasibility study was conducted for a randomised controlled trial and telemedicine review was found to allow comparable management decisions to be made in less time than face-to-face review. Staff and patients found the equipment easy to use and were positive about the potential for telemedicine to be used to replace alternate outpatient diabetes review appointments.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:674727 |
| Date | January 2014 |
| Creators | Given, Joanne Emma |
| Publisher | Ulster University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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