Prior knowledge of blood glucose meter download improves the accuracy of verbal self-reported blood glucose in teenagers with type I diabetes at ski camp
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Despite advances in diabetes management, self-monitoring of blood glucose (SMBG) remains fundamental. A number of studies, principally in adults, have confirmed that logbook entries and verbal SMBG reports are prone to common errors. In the context of an adolescent diabetes camp, the accuracy of verbally reported SMBG is crucial for guiding safe therapeutic management, and negating the risk of exercise-induced hypoglycemia. We aimed to assess whether awareness of a planned meter download at the completion of a diabetes camp would improve the overall accuracy of verbally reported SMBG.
Adolescents with type one diabetes (n = 26) attended a 3-day ski camp in 2014. Verbally reported SMBG values were recorded by camp supervisors at multiple time points throughout the camp. The intervention involved ensuring that all participants (at camp commencement) were aware of a planned meter download and SMBG review at camp conclusion. These data were then compared with historical camp data from 2012, collected using identical methodology, in which participants (n = 20) were unaware of the planned meter download. For analysis, blood glucose (BGL) data were classified as: matching, phantom (verbal SMBG value with no corresponding meter download value), and over- or underestimate (verbally reported value >/< meter downloaded value).
Dual data regarding verbal SMBG and meter downloads were obtained on 550 instances of BGL testing during the 2014 camp (the intervention group). This was compared to dual data for 396 historical tests from the 2012 control group. For the intervention group, the overall error rate was 4.7 %, over 34 % of participants. There was a statistically significant improvement in accuracy compared to historical nonintervention data, in which there was an error rate of 14.1 % over 70 % of participants (p < 0.001). There was also a decrease in phantom readings to 2 %, from 8.6 % in 2012 (p < 0.001).
This study demonstrates an improvement in accuracy and reliability of verbally reported SMBG, following a simple intervention of ensuring participants were aware of a meter download at the completion of camp. This intervention could be easily incorporated into adolescent diabetes camp safety protocols and may provide an easy, low-cost way of improving verbally reported SMBG accuracy and therefore safety on camp.
KeywordsType 1 diabetes mellitus Adolescent Self-monitoring blood glucose Self-management Camp
The authors wish to thank the staff of the pediatric diabetes team, and all the participants and their families for their forbearance and generous participation in this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all patients for being included in the study.
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