Clinical and Laboratory Observations
Predictors of control of diabetes: monitoring may be the key☆

https://doi.org/10.1016/j.jpeds.2003.12.042Get rights and content

Abstract

The factors affecting glycated hemoglobin concentration were examined in a cohort of children attending diabetes camp. Multivariate regression analysis revealed that frequency of self-monitoring of blood glucose correlated with lower glycated hemoglobin, whereas the number of insulin types used correlated with increased glycated hemoglobin. Frequent self-monitoring of blood glucose promotes long-term metabolic control.

Section snippets

Methods

All participants in FCCYD sessions during the summer of 2000 were enrolled in the study. Each camper had a HbA1c measurement performed within 3 months of camp. Ninety percent of the referring pediatric endocrinologists used a DCA 2000 (Bayer Corp, Elkhart, Ind) to measure HbA1c (95% confidence interval normal range, 4.3%-5.7%).2 The other 10% sent specimens to Quest (Orlando, Fla) or Lab Corps (Gainesville, Fla), which use affinity column chromatography by high-performance liquid chromatography

Results

One camper checked blood glucose zero times per day, one checked one time per day, 25 checked two times per day, 60 checked three times per day, 128 checked four times per day, three checked five times per day, six checked six times per day, and one checked eight times per day. Three patients received one insulin injection per day, 129 patients received two injections per day, 60 received three injections per day, and 14 received four injections per day. Seventy-two patients were on multiple

Discussion

Several studies have demonstrated that lower HbA1c correlates with frequency of SMBG.1., 5., 6., 7. Our study confirms this correlation and suggests that a simple regimen using fewer types of insulin and prescribing frequent blood glucose monitoring is the best approach for treating children with diabetes. Frequent blood glucose monitoring provides families, patients, and clinicians with information critical to the adjustment of daily insulin regimens and reflects commitment to diabetes control.

Acknowledgements

We thank Dr Arlan Rosenbloom for his help in preparing this article.

References (8)

There are more references available in the full text version of this article.

Cited by (0)

☆

Supported in part by the University of Florida General Clinical Research Center, Grant #MO1-RR00082.

View full text
Copyright © 2004 Elsevier Inc. All rights reserved.