Early adolescence is ideal time to check adherence to blood glucose monitoring

Early adolescence appears to be an important time to review the importance of frequent blood glucose monitoring in children with type 1 diabetes.

It is during this time that adherence to frequent blood glucose monitoring declines, as well as control of hemoglobin (Hb)A_1c levels, report researchers in a study of the changes that occur in treatment adherence and glycemic control that occur as children approach adolescence.

The study involved 239 children with type 1 diabetes who were recruited when aged 9 to 11 years; at the 2-year follow-up, there were data from 225 children aged 11 to 14 years. The children received care at 1 of 3 sites.

An increase in HbA_1c was associated with a decrease in blood glucose monitoring frequency, after controlling for covariates. The average trajectory of the HbA_1c was 8.2% at baseline, which increased by 0.4% over the 2 years to 8.6%. The average trajectory for frequency of blood glucose monitoring was 4.9 checks per day at baseline, which fell by 0.4 checks per day, yielding a final value of 4.5 checks per day. The standard of care for blood glucose monitoring is 4 to 6 checks per day across the 3 sites participating in the study.

One less check in blood glucose per day over the 2-year period predicted a 1.26% increase in HbA_1c.

Based on these results, preventive intervention targeted toward preserving blood glucose monitoring frequency should begin in early adolescence, the researchers believe. Those youths who demonstrate reduced frequency of monitoring are the ones who can be targeted for intensive intervention.

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