Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
Prim Care Diabetes. 2021 Oct;15(5):832-836. doi: 10.1016/j.pcd.2021.05.006. Epub 2021 May 21.
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).
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.
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).
BGM remains a potent predictor of glycemic control, warranting continued targeting in clinical efforts to improve glycemic management in youth with T1D.
本研究旨在比较三种血糖监测（BGM）频率达标方法，并探讨它们与 1 型糖尿病（T1D）青少年血糖控制的关系。
横断面数据来自三项临床试验的基线评估。通过病历回顾获取 T1D 青少年的临床和人口统计学特征。通过家长-青少年访谈、病历回顾和血糖仪下载来评估 BGM 频率。为了检验 A1c 与 BGM 频率之间的关系，我们进行了方差分析。
在 T1D 青少年（N=385，50%为女性，年龄 13.6±2.5 岁，74%使用胰岛素泵）中，三种评估 BGM 频率的方法显著相关。自我报告的 BGM 频率（6.4±2.3 次/天）明显高于血糖仪下载（5.6±2.4 次/天，p<0.0001）和临床医生报告（5.7±2.4 次/天，p<0.0001）。对于所有方法，更频繁的 BGM 与更低的 A1c 和更低的平均血糖相关（p<0.0001）。每增加一次每日血糖检测，A1c 就会降低 0.2%（p<0.0001）。
BGM 仍然是血糖控制的有力预测指标，需要在临床努力中继续作为目标，以改善 T1D 青少年的血糖管理。
