Use of Memory Meters to Measure Reliability of Self Blood Glucose Monitoring

Abstract

Glucose reflectance meters equipped with memories were used in 21 insulin-dependent diabetic patients to assess reliability of self blood glucose monitoring records. Results reported in logbooks showed widespread discrepancies when compared with corresponding meter-held records. Discrepancy rates of at least one in five were observed in 11 patients. Unreliable reporting was usually recognized by clinical staff, and associated with high glycosylated haemoglobin levels and poor technique in measuring blood glucose at home.

Comparing patient‐generated blood glucose diary records with meter memory in diabetes: a systematic review

“…When combining the three types of ‘error’, approximately one quarter of diaries in those with Type 1 diabetes agreed completely with meter memory records; i.e. 100% concordance and 0% under‐ and over‐reporting . More than a third of diaries in teenagers and young adults agreed completely with meter memory records.…”

“…When the individual agreement measures were combined, Williams et al . found a weak correlation between overall reliability and HbA 1c , where HbA 1c increases as reliability decreases. During the initial period of their study, Kalergis et al .…”

“…The range of over‐reporting was much greater than under‐reporting, with some diaries containing almost completely fabricated results . Teenagers who maintained their own diaries had the greatest average over‐reporting; with four in every 10 diary values not actually measured using the meter .…”

“…Under-reporting, when values are not recorded in the diary, is calculated by determining the percentage of meter values that are missing from the diary. These two measures are simple to define and have been used in the majority of the literature comparing diary and meter values [20][21][22]29,[32][33][34][35][36].…”

Intensive insulin therapy in clinical practice

“…Unfortunately the optimum interval for obtaining professional advice remains untested. Self-monitored results and targets need to be audited against glycated haemoglobin levels, given the problems of accuracy and selection that the former can suffer [35,36].…”