Prevalence, predictors, barriers and facilitators of self-monitoring of blood glucose in patients with type 2 diabetes: A multicentre cross-sectional study

ABSTRACT

Introduction: Self-monitoring of blood glucose (SMBG) is vital for diabetes self-care, but its uptake in Malaysia remains low. This study aimed to determine the prevalence, predictors, barriers and facilitators of SMBG among patients with type 2 diabetes in Malaysian primary care settings.
Methods: A cross-sectional study was conducted from May to September 2024 across five urban, suburban and rural primary care clinics. Participants completed a validated questionnaire on sociodemographic characteristics, clinical characteristics and SMBG practices. Multivariable logistic regression was conducted to identify the predictors of SMBG.
Results: Among the 396 participants (mean age=53.6±10.9 years), the prevalence of SMBG was 59.3%. The participants aged 50–59 years (adjusted odds ratio [AOR]=2.80, 95% confidence interval [CI]=1.03–7.62, P=0.045) and 60–69 years (AOR=3.43, 95% CI=1.25–9.38, P=0.017) were more likely to perform SMBG than those aged ≥70 years. Insulin use was strongly associated with SMBG (AOR=7.02, 95% CI=2.44–20.19, P<0.001), whereas the presence of diabetes complications was negatively associated with SMBG (AOR=0.57, 95% CI=0.33–0.98, P=0.043). The major barriers were the cost of test strips and lancets (59.6%) and frustration with high glucose readings (82.8%), while the facilitators included personal motivation (68.9%), family support (79.1%) and belief in the importance of SMBG (86.9%).
Conclusion: The prevalence of SMBG is moderate but suboptimal. Enhancing structured diabetes education and addressing financial barriers are essential to improve SMBG practice and glycaemic control.