Acta Diabetologica

, Volume 53, Issue 4, pp 637–642 | Cite as

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

  • Annika Sjoeholm
  • Andrew Gray
  • Jenny Rayns
  • Paul A. Tomlinson
  • Benjamin J. WheelerEmail author
Original Article



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.


Type 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

Informed consent was obtained from all patients for being included in the study.


  1. 1.
    The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329(14):977–986. doi: 10.1056/nejm199309303291401 CrossRefGoogle Scholar
  2. 2.
    Nathan DM, Cleary PA, Backlund JY et al (2005) Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 353(25):2643–2653CrossRefPubMedGoogle Scholar
  3. 3.
    Clarke SF, Foster JR (2012) A history of blood glucose meters and their role in self-monitoring of diabetes mellitus. Br J Biomed Sci 69(2):83–93PubMedGoogle Scholar
  4. 4.
    Mazze RS, Shamoon H, Pasmantier R et al (1984) Reliability of blood glucose monitoring by patients with diabetes mellitus. Am J Med 77(2):211–217. doi: 10.1016/0002-9343(84)90693-4 CrossRefPubMedGoogle Scholar
  5. 5.
    Gonder-Frederick LA, Julian DM, Cox DJ, Clarke WL, Carter WR (1988) Self-measurement of blood glucose: accuracy of self-reported data and adherence to recommended regimen. Diabetes Care 11(7):579–5856CrossRefPubMedGoogle Scholar
  6. 6.
    Kalergis M, Nadeau J, Pacaud D, Yared Z, Yale JF (2006) Accuracy and reliability of reporting self-monitoring of blood glucose results in adults with type 1 and type 2 diabetes. Can J Diabetes 30(3):241–247CrossRefGoogle Scholar
  7. 7.
    Wilson DP, Endres RK (1986) Compliance with blood glucose monitoring in children with type 1 diabetes mellitus. J Pediatr 108(6):1022–1024. doi: 10.1016/s0022-3476(86)80955-6 CrossRefPubMedGoogle Scholar
  8. 8.
    Chae M, Reith DM, Tomlinson PA, Rayns J, Wheeler BJ (2014) Accuracy of verbal self-reported blood glucose in teenagers with type I diabetes at diabetes ski camp. J Diabetes Metab Dis 13(1):14. doi: 10.1186/2251-6581-13-14 CrossRefGoogle Scholar
  9. 9.
    Mazze RS, Pasmantier R, Ann Murphy J, Shamoon H (1985) Self-monitoring of capillary blood glucose: changing the performance of individuals with diabetes. Diabetes Care 8(3):207–213CrossRefPubMedGoogle Scholar
  10. 10.
    McCambridge J, Witton J, Elbourne DR (2014) Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol 67(3):267–277. doi: 10.1016/j.jclinepi.2013.08.015 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Salmond C, Crampton P, Atkinson J (2007) NZDep2006 index of deprivation. University of Otago, WellingtonGoogle Scholar
  12. 12.
    Miller AR, Nebesio TD, DiMeglio LA (2011) Insulin dose changes in children attending a residential diabetes camp. Diabet Med 28(4):480–486CrossRefPubMedGoogle Scholar
  13. 13.
    Schütt M, Kern W, Krause U et al (2006) Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria. Exp Clin Endocrinol Diabetes 114(7):384–388CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Annika Sjoeholm
    • 1
  • Andrew Gray
    • 2
  • Jenny Rayns
    • 3
  • Paul A. Tomlinson
    • 1
    • 4
  • Benjamin J. Wheeler
    • 1
    • 3
    Email author
  1. 1.Department of Women’s and Children’s HealthUniversity of OtagoDunedinNew Zealand
  2. 2.Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
  3. 3.Paediatric EndocrinologySouthern District Health BoardDunedinNew Zealand
  4. 4.Department of PaediatricsSouthern District Health BoardInvercargillNew Zealand

Personalised recommendations