Improved Glycemic Control in Intensively Treated Type 1 Diabetic Patients Using Blood Glucose Meters With Storage Capability and Computer-Assisted Analyses

OBJECTIVE To determine the effect on glycemic control in intensively treated type 1 diabetic patients using a blood glucose meter with storage capability and computer-assisted analyses. RESEARCH DESIGN AND METHODS Glycemic control was assessed in 22 intensively treated adults with type 1 diabetes for 12 months while using a meter without memory, followed by 12 months while using a meter with memory. Log books were used to assist patients in managing aspects of the diabetes treatment plan during the first 12-month period, and computer-assisted analyses were used when the meter with memory was used. GHb levels were measured monthly throughout the 24 months of observation. RESULTS The mean GHb level averaged across all patients during the period of memory meter use (6.4%) was significantly lower than that during the period of meter use without memory (6.9%) (P = 0.0004). The change in GHb levels from each period-specific baseline level occurred at significantly different slopes (P = 0.046) when adjusted for baseline GHb level. In addition, the downward trend in GHb level was greater in those patients who increased the frequency of testing the most (r = −0.54, P = 0.01). CONCLUSIONS Use of a meter with memory in conjunction with computer-generated analyses of stored blood glucose test results can lead to improved glycemic control when used by a group of intensively treated adult diabetic patients. Improvement in glycemic control was related to frequency of blood glucose testing.

[1]  A. Schiffrin,et al.  Multiple daily self-glucose monitoring: its essential role in long-term glucose control in insulin-dependent diabetic patients treated with pump and multiple subcutaneous injections. , 1982, Diabetes care.

[2]  K. Alberti,et al.  Intensive attention improves glycaemic control in insulin-dependent diabetes without further advantage from home blood glucose monitoring: results of a controlled trial. , 1982 .

[3]  S. Colagiuri,et al.  The Diabetes Control and Complications Trial , 1983, Henry Ford Hospital medical journal.

[4]  N. Mann,et al.  A Prospective Study to Evaluate the Benefits of Long-Term Self-Monitoring of Blood Glucose in Diabetic Children , 1984, Diabetes Care.

[5]  A randomized comparative crossover evaluation of glucose monitoring technologies. , 1984, Diabetes research.

[6]  A randomized comparative crossover evaluation of glucose monitoring technologies. , 1984 .

[7]  D. Lucido,et al.  Reliability of blood glucose monitoring by patients with diabetes mellitus. , 1984, The American journal of medicine.

[8]  P. Zimmet,et al.  Computerized assessment of self-monitored blood glucose results using a Glucometer reflectance photometer with memory and microcomputer. , 1985, Diabetes research and clinical practice.

[9]  H. Shamoon,et al.  Self-Monitoring of Capillary Blood Glucose: Changing the Performance of Individuals with Diabetes , 1985, Diabetes Care.

[10]  D. Becker,et al.  The Role of Self-Monitoring of Blood Glucose in the Routine Management of Children with Insulin-dependent Diabetes Mellitus , 1985, Diabetes Care.

[11]  R. Wing,et al.  Frequency and Accuracy of Self-Monitoring of Blood Glucose in Children: Relationship to Glycemic Control , 1985, Diabetes Care.

[12]  Leonard H Epstein,et al.  Compliance to Self-Monitoring of Blood Glucose: A Marked-Item Technique Compared with Self-Report , 1985, Diabetes Care.

[13]  D. Goldstein,et al.  Glycated hemoglobin: methodologies and clinical applications. , 1986, Clinical chemistry.

[14]  O. Langer,et al.  Diabetes in pregnancy: evaluating self-monitoring performance and glycemic control with memory-based reflectance meters. , 1986, American journal of obstetrics and gynecology.

[15]  A. Schiffrin,et al.  Impact of SMBG on Control of Diabetes as Measured by HbA1: 3-yr Survey of a Juvenile IDDM Clinic , 1988, Diabetes Care.

[16]  Computer-Generated Formats for SMBG Data , 1988, Diabetes Care.

[17]  R. Pollard,et al.  A Proficiency Score for Assessing the Reliability of Self Blood Glucose Monitoring , 1988, Diabetic medicine : a journal of the British Diabetic Association.

[18]  H. Keen,et al.  A Controlled Study of the Effect of Computer‐aided Analysis of Home Blood Glucose Monitoring on Blood Glucose Control , 1989, Diabetic medicine : a journal of the British Diabetic Association.

[19]  P. Genton,et al.  Reliability of Self-Monitoring of Blood Glucose by CSII Treated Patients With Type I Diabetes , 1989, Diabetes Care.

[20]  C. Saudek Data Source Automation: New Technology for the Management of Patient‐generated Test Results , 1989, Diabetic medicine : a journal of the British Diabetic Association.

[21]  N. Fineberg,et al.  Clinical Evaluation of Computer-Assisted Self-Monitoring of Blood Glucose System , 1989, Diabetes Care.

[22]  D. Chisholm,et al.  hyperglycaemia: disparity between diabetes clinic and home blood glucose concentrations , 2007 .

[23]  The Relationship of Glycemic Exposure (HbA1c) to the Risk of Development and Progression of Retinopathy in the Diabetes Control and Complications Trial , 1995, Diabetes.

[24]  J. Wylie-Rosett,et al.  Implementation of Treatment Protocols in the Diabetes Control and Complications Trial , 1995, Diabetes Care.

[25]  P. Diggle Analysis of Longitudinal Data , 1995 .