Diabetes Metab J.  2018 Dec;42(6):480-487. 10.4093/dmj.2018.0018.

Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes

• Joo EY
• Lee JE
• Kang HS
• Park SG
• Hong YH
• Shin YL
• Sohn M

• KMID: 2449625
• DOI: http://doi.org/10.4093/dmj.2018.0018

Abstract

BACKGROUND
This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control.
METHODS
Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires.
RESULTS
Average total daily SMBG frequency was 3.8±2.1 and frequency during the school day was 1.3±1.2. The mean HbA1c level was 8.6%±1.4%. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ≥5 significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency < 1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039).
CONCLUSION
Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

Keyword

Adolescent; Blood glucose self-monitoring; Diabetes mellitus, type 1; Schools

MeSH Terms

Adolescent*
Blood Glucose Self-Monitoring
Blood Glucose*
Diabetes Mellitus, Type 1
Friends
Hemoglobin A, Glycosylated
Humans
Odds Ratio
Blood Glucose

Figure

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  Fig. 1 Scatter plot for the relationship between the frequency of self-monitoring of blood glucose (SMBG) and the glycosylated hemoglobin (HbA1c) level. Linear regression test (β, −0.424; 95% confidence interval, −0.440 to −0.124; P=0.001).

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