Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes
| Autor: | Doerte Hilgard, Sabine E. Hofer, Reinhard W. Holl, Ralph Ziegler, Bettina Heidtmann, DPV-Wiss-Initiative, Joachim Rosenbauer |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Blood Glucose
Male Pediatrics medicine.medical_specialty Adolescent endocrine system diseases Endocrinology Diabetes and Metabolism Hypoglycemia Insulin dose Diabetic Ketoacidosis Germany Diabetes mellitus Internal Medicine medicine Humans Insulin Child Blood Glucose Measurement Glycated Hemoglobin Type 1 diabetes Treatment regimen business.industry Blood Glucose Self-Monitoring nutritional and metabolic diseases medicine.disease Ketoacidosis Diabetes Mellitus Type 1 Treatment Outcome Austria Child Preschool Metabolic control analysis Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Pediatric Diabetes. 12:11-17 |
| ISSN: | 1399-543X |
| DOI: | 10.1111/j.1399-5448.2010.00650.x |
| Popis: | The aim of this study was to correlate the frequency of self-monitoring of blood glucose (SMBG) to the quality of metabolic control as measured by hemoglobin A1c (HbA1c), the frequency of hypoglycemia and ketoacidosis, and to see whether the associations between SMBG and these outcomes are influenced by the patient's age or treatment regime. We analyzed data from the DPV-Wiss-database of 26 723 children and adolescents aged 0-18 yr with type 1 diabetes recorded during 1995-2006. Variables evaluated were gender, age at visit, diabetes duration, therapy regime, insulin dose, body mass index-standard deviation scores (BMI-SDS), HbA1c, rate of hypoglycemia, and ketoacidosis. In the youngest age group of children under the age of 6 yr, the frequency of SMBG was the highest compared with that in children aged 6-12 yr or children aged12 yr: 6.0/d vs. 5.3/d vs. 4.4/d (p0.001). Frequency of SMBG differed significantly also in the different groups of treatment (p0.001), but only for the continuous subcutaneous insulin infusion (CSII) group the frequency was considerably higher: 5.3/d (CSII) vs. 4.7/d (multiple daily injections) vs. 4.6/d (conventional therapy). Adjusted for age, gender, diabetes duration, year of treatment, insulin regimen, insulin dose, BMI-SDS, and center difference, SMBG frequency was significantly associated with better metabolic control with a drop of HbA1c of 0.20% for one additional SMBG per day (p0.001). Increasing the SMBG frequency above 5/d did not result in further improvement of metabolic control. A higher frequency of SMBG measurements was related to better metabolic control. But only among adolescents aged12 yr, metabolic control (HbA1c) improved distinctively with two or more blood glucose measurements. |
| Databáze: | OpenAIRE |
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