Impact of SMBG on Control of Diabetes as Measured by HbA1: 3-yr Survey of a Juvenile IDDM Clinic

Abstract

Three hundred twelve diabetic children and adolescents were seen in our diabetic clinic and instructed to test their capillary blood glucose (CBG) twice daily and to use an algorithm to adjust their short-acting insulin. Of this group, 219 youngsters had a full 3-yr period of observation. At each clinic visit, blood was obtained for fasting blood glucose and HbA1 and, once a year, cholesterol and triglycerides were also measured. Patient and parent accuracy in measuring CBG was found to be adequate. The changes over time in HbA1 were nondifferential across age and sex, and there was no difference in the level of HbA1 between age and sex groups, the number of tests reported to have been done by the patients, the number of injections of insulin per day, or the serum cholesterol. There was a significant relationship between the HbA1 and the fasting blood glucose (P less than .001) measured by the laboratory as well as with the serum triglyceride (P less than .01). The failure to improve diabetic control, despite measures that would have been expected to do so, was believed to relate more to a lack of compliance than to a flaw in the therapeutic approach. It was interesting to note that the adolescent patients in the study were in no worse control than the younger children in the group. Although better technical skills are available today to manage diabetes, the psychosocial approach to patient motivation requires improvement.

Racial Differences in Metabolic Control of Children and Adolescents With Type I Diabetes Mellitus

“…Although girls in our study had slightly higher average HbA, values than boys, we found no evidence of statistically significant sex effects or interactive effects of race with sex and/or age. The lack of sex effects, although contrary to previous studies with smaller samples (10,16), is consistent with results from larger samples (21).…”

Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database

“…Studies carried out in selected clinic populations (children,7 young people,8 elderly people9) or under experimental trial conditions,10 – 13 or both, have shown that tests can be inaccurate and unreliable, may not be interpreted by patients correctly, and can cause psychological harm 6. We studied patterns of self monitoring and its effect on glycaemic control in an unselected population of diabetic patients who use insulin in Tayside, Scotland, using data available through the DARTS/MEMO collaboration 14 15.…”

Improved metabolic outcome in a Danish diabetic paediatric population aged 0-18 yr: results from a nationwide continuous Registration

“…Self-monitoring of blood glucose (SMBG) has been studied in numerous studies (11,12,(14)(15)(16)(17)(18), all consistently demonstrating a significant reduction in HbA1c as the number of SMBG increases. One study failed to show an association between SMBG and metabolic control (19).…”