Blood glucose monitoring (BGM) still matters for many: Associations of BGM frequency and glycemic control in youth with type 1 diabetes

      Highlights

      • Our findings support the need for more meter download use in clinical practice.
      • Frequent BGM was associated with lower A1c and lower mean glucose.
      • Acknowledging BGM importance among low-adherent youth justify the use of technologies.

      Abstract

      Aims

      This study aimed to compare three approaches of blood glucose monitoring (BGM) frequency attainment and to examine their associations with glycemic control in youth with type 1 diabetes (T1D).

      Methods

      Cross-sectional data was derived from the baseline assessment in three clinical trials. Clinical and demographic characteristics of youth with T1D was obtained by chart review. BGM frequency was assessed by parent-youth interview, chart review, and meter downloads. To examine the relationship between A1c and frequency of BGM we performed analysis of variance.

      Results

      In youth with T1D (N = 385, 50% female, age 13.6 ± 2.5 years, 74% pump users), the 3 methods of assessing BGM frequency were significantly correlated. Frequency by self-report (6.4 ± 2.3 times/day) was significantly higher than both meter download (5.6 ± 2.4 times/day, p < 0.0001) and clinician report (5.7 ± 2.4 times/day, p < 0.0001). For all methods, more frequent BGM was associated with lower A1c and lower mean glucose (p < 0.0001). For each additional daily blood glucose check, there was a 0.2% decrease in A1c (p < 0.0001).

      Conclusion

      BGM remains a potent predictor of glycemic control, warranting continued targeting in clinical efforts to improve glycemic management in youth with T1D.

      Keywords

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      References

        • Patterson C.C.
        • Karuranga S.
        • Salpea P.
        • et al.
        Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Diabetes Atlas, 9th edition.
        Diabetes Res. Clin. Pract. 2019; 157107842
        • American Diabetes Association
        Children and adolescents: standards of medical care in diabetes-2020.
        Diabetes Care. 2020; 43: S163-S182
        • Foster N.C.
        • Beck R.W.
        • Miller K.M.
        • et al.
        State of type 1 diabetes management and outcomes from the T1D exchange in 2016-2018.
        Diabetes Technol. Ther. 2019; 21: 66-72
        • Fan W.
        • Zheng H.
        • Wei N.
        • Nathan D.M.
        Estimating HbA1c from timed self-monitored blood glucose values.
        Diabetes Res. Clin. Pract. 2018; 141: 56-61
        • Gomes M.B.
        • Tannus L.R.
        • Cobas R.A.
        • et al.
        Determinants of self-monitoring of blood glucose in patients with type 1 diabetes: a multi-centre study in Brazil.
        Diabet. Med. 2013; 30: 1255-1262
        • Garg S.K.
        • Hirsch I.B.
        Self-monitoring of blood glucose.
        Diabetes Technol. Ther. 2019; 21: S4-S12
        • Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
        Hemoglobin A1c and mean glucose in patients with type 1 diabetes: analysis of data from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial.
        Diabetes Care. 2011; 34: 540-544
        • Nathan D.M.
        • Kuenen J.
        • Borg R.
        • et al.
        Translating the A1C assay into estimated average glucose values.
        Diabetes Care. 2008; 31: 1473-1478
        • Miller K.M.
        • Beck R.W.
        • Bergenstal R.M.
        • et al.
        Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants.
        Diabetes Care. 2013; 36: 2009-2014
        • Ziegler R.
        • Heidtmann B.
        • Hilgard D.
        • et al.
        Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes.
        Pediatr. Diabetes. 2011; 12: 11-17
        • Blackwell M.
        • Tomlinson P.A.
        • Rayns J.
        • Hunter J.
        • Sjoeholm A.
        • Wheeler B.J.
        Exploring the motivations behind misreporting self-measured blood glucose in adolescents with type 1 diabetes — a qualitative study.
        J. Diabetes Metab. Disord. 2015; 15: 16
        • Guilfoyle S.M.
        • Crimmins N.A.
        • Hood K.K.
        Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report.
        Pediatr. Diabetes. 2011; 12: 560-566
        • Chae M.
        • Reith D.M.
        • Tomlinson P.A.
        • Rayns J.
        • Wheeler B.J.
        Accuracy of verbal self-reported blood glucose in teenagers with type I diabetes at diabetes ski camp.
        J. Diabetes Metab. Disord. 2014; 13: 14
        • Sjoeholm A.
        • Gray A.
        • Rayns J.
        • Tomlinson P.A.
        • Wheeler B.J.
        Prior knowledge of blood glucose meter download improves the accuracy of verbal self-reported blood glucose in teenagers with type I diabetes at ski camp.
        Acta Diabetol. 2016; 53: 637-642
        • Commissariat P.V.
        • Volkening L.K.
        • Guo Z.
        • ElBach J.L.
        • Butler D.A.
        • Laffel L.M.
        Associations between major life events and adherence, glycemic control, and psychosocial characteristics in teens with type 1 diabetes.
        Pediatr. Diabetes. 2018; 19: 85-91
        • Telo G.H.
        • Volkening L.K.
        • Butler D.A.
        • Laffel L.M.
        Salient characteristics of youth with type 1 diabetes initiating continuous glucose monitoring.
        Diabetes Technol. Ther. 2015; 17: 373-378
        • Caccavale L.J.
        • Nansel T.R.
        • Quick V.
        • Lipsky L.M.
        • Laffel L.M.
        • Mehta S.N.
        Associations of disordered eating behavior with the family diabetes environment in adolescents with type 1 diabetes.
        J. Dev. Behav. Pediatr. 2015; 36: 8-13
        • Monaghan M.
        • Clary L.
        • Mehta P.
        • Stern A.
        • Sharkey C.
        • Cogen F.R.
        • Vaidyanathan P.
        • Streisand R.
        Checking in: a pilot of a physician-delivered intervention to increase parent-adolescent communication about blood glucose monitoring.
        Clin. Pediatr. (Phila). 2015; 54 (Epub 20 April 2015, PMID: 25896723, PMCID: PMC4615374): 1346-1353https://doi.org/10.1177/0009922815581833
        • Driscoll K.A.
        • Johnson S.B.
        • Tang Y.
        • Yang F.
        • Deeb L.C.
        • Silverstein J.H.
        Does blood glucose monitoring increase prior to clinic visits in children with type 1 diabetes?.
        Diabetes Care. 2011; 34: 2170-2173
        • Delamater A.M.
        • Kurtz S.M.
        • White N.H.
        • Santiago J.V.
        Effects of social demand on reports of self-monitored blood glucose in adolescents with type 1 diabetes mellitus.
        J. Appl. Soc. Psychol. 1988; 18: 491-502
        • Blumer I.
        The contemporary role of masked continuous glucose monitoring in a real-time world.
        J. Diabetes Sci. Technol. 2016; 10: 790-792