A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency

Abstract

Objective: To re-examine the relation of blood glucose monitoring to glycemic control among adolescents with type 1 diabetes and to evaluate the relation of demographic, behavioral, and psychosocial characteristics of adolescents who monitor more and less frequently.

Research design and methods: Participants were 132 adolescents with type 1 diabetes (average age = 12 yr) and their parents, recruited from Children's Hospital of Pittsburgh. Adolescents were interviewed annually for five consecutive years after routine clinic appointments. At each assessment, data from blood glucose meters were downloaded and glycosylated hemoglobin A1c was recorded from medical records.

Results: More frequent blood glucose monitoring was related to better glycemic control. Adolescents who monitored more frequently were younger, from higher social status families, on insulin pumps, and had higher self-efficacy. Age-related declines in blood glucose monitoring occurred among adolescents with low self-esteem, high stressful life events, and lower parental support.

Conclusions: Given the importance of blood glucose monitoring for good glycemic control, future research should enhance adolescents' self-efficacy for monitoring and intervene with those who are at risk for age-related declines in blood glucose monitoring.

Figure 1

Relation of number of meter readings taken per day to hemoglobin A1c.

Figure 2

(a) Relation of age to number of blood glucose tests performed for patients who are low (25^th percentile; solid line) and high (75^th percentile; dashed line) in self-esteem. (b) Relation of age to number of blood glucose tests performed for patients who are low (25^th percentile; solid line) and high (75^th percentile; dashed line) in parent relationship quality.