Aims: The use of glucose meter downloads in outpatients enables clinicians to monitor how frequently children with type 1 diabetes mellitus are testing their blood glucose level on a daily basis. We tested the hypothesis that increased frequency of blood glucose testing improves HbA1c value, the current gold standard in monitoring diabetic control.
Methods: Thirty-eight patients had their glucose meter (Accuchek) downloaded at outpatient clinic visits over a 25-month period. The Accuchek download package was used to give values for number of blood glucose readings and a daily frequency value (number of tests per day). HbA1c values were also measured at clinic visits and comparison made with test frequency. Sub-group analysis was performed using insulin regime as a parameter. Regimes were divided according to frequency of insulin administration (twice daily, three times daily, basal bolus or pump regimes).
Results: 115 downloads were obtained. Test frequency for the whole cohort had a range of 2.06.0/day (mean 3.6). HbA1c levels had a range of 6.814 (median 9.9). There was only very poor correlation of test frequency with HbA1c (regression coefficient 0.04) and this had low power of significance (P=0.03, 95% CI −0.02, −0.33). There was no difference in correlation found on sub-group analysis according to insulin regime (regression coefficients range −0.19 to −0.28).
Conclusions: Increasing frequency of testing blood glucose level does not correlate well with any improvement in HbA1c level. This holds true for children on any of four different groups of insulin dosing regimes. Other techniques are more likely to be effective in improving HbA1c values than solely increasing the frequency of glucose testing in children.
09 - 11 Nov 2011
British Society for Paediatric Endocrinology and Diabetes