Monetary rewards may increase SMBG testing frequency
Monetary rewards for self-monitoring blood glucose testing may increase testing and improve HbA1c in adolescents, according to recent study findings published in Diabetes Care.
Nancy M. Petry, PhD, of the University of Connecticut School of Medicine, and colleagues at Yale University School of Medicine Pediatric Endocrinology, evaluated 10 adolescents aged 12 to 19 years with a duration of diabetes of 8.2 ± 4.5 years to determine the effect of a 12-week program that rewarded money based on SMBG testing frequency. Participants received 10 cents for each test, bonuses for testing at least four times throughout a day and a maximum of $251.40. Seven participants used insulin pumps and three used injections.
Nancy M. Petry
There was an increase in SMBG from 1.8 tests per day before the intervention to 4.9 tests per day during the intervention (P < .001). The recommended threshold of four or more tests per day was reached by nine participants and for an average of 66 of the 84 days. Participants received an average total earning of $122.
Three participants reached HbA1c levels of less than 7.5%, and mean overall HbA1c levels decreased from 9.3 ± 0.9% to 8.4 ± 1.5%.
Most participants (87.5%) and 100% of parents reported they were moderately to highly satisfied with the study.
“While HbA1c levels remained reduced in many subjects a year after study completion, a criticism of reinforcement interventions is that they are costly,” the researchers wrote. “In the case of [type 1 diabetes], savings in preventing acute and long-term vascular complications might recoup the relatively low $10 per week costs of the intervention, even if provided long term. These results show the effectiveness of monetary rewards to sharply increase SMBG and lower HbA1c and provide a compelling rationale for randomized studies in much larger samples over longer periods to evaluate the efficacy and cost-effectiveness of this intervention.” – by Amber Cox
Disclosure: Petry reports no relevant financial disclosures. One of the other researchers reports consulting for Medtronic, Novo Nordisk and Sanofi.