Frequency of mealtime insulin bolus predicts glycated hemoglobin in youths with type 1 diabetes.
BACKGROUND: Within pediatric diabetes management, two electronic measures of adherence exist: frequency of daily blood glucose monitoring (BGM) and the BOLUS score, a measure of frequency of mealtime insulin bolusing. Past research has demonstrated that the BOLUS score is superior to daily BGM in predicting youths' glycated hemoglobin (HbA1c) in a cross-sectional study. We present data comparing the two adherence measures in predicting HbA1c using a prospective, longitudinal design.
SUBJECTS AND METHODS: Blood glucose meter data and insulin pump records were collected from a clinical database of 175 youths with type 1 diabetes (mean age, 11.7 ± 3.6 years at baseline). Youths' HbA1c levels occurring at the download time and at 3, 6, 9, and 12 months post-downloads were also collected. We calculated youths' mean BGM and BOLUS score using a standardized protocol.
RESULTS: Intraclass correlations (ICCs) revealed significant absolute equivalence between youths' predicted HbA1c values using BOLUS and BGM scores and future actual HbA1c values up to 12 months post-download. However, the ICCs of BOLUS scores with future HbA1c values were consistently higher than those of the BGM scores. Also, the predictions of the BOLUS scores were significantly more accurate (P ≤ 0.002) than those of the BGM scores based on the root mean squared error of predictions.
CONCLUSIONS: In a prospective, longitudinal design, youths' BOLUS scores were superior to youths' daily BGM in predicting future values of HbA1c. Calculating a BOLUS score versus BGM can help researchers and clinicians achieve a better prediction of youths' HbA1c.
Diabetes technology & therapeutics
Adolescent; Adolescent Behavior; Blood Glucose; Blood Glucose Self-Monitoring; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Female; Glycated Hemoglobin A; Humans; Hypoglycemic Agents; Insulin; Longitudinal Studies; Male; Meals; Medication Adherence; Postprandial Period; Predictive Value of Tests; Prospective Studies; Reproducibility of Results
Adolescent Behavior; Blood Glucose Self-Monitoring; Diabetes Mellitus, Type 1; Glycated Hemoglobin A; Hypoglycemic Agents; Insulin; Meals; Medication Adherence; Postprandial Period; Predictive Value of Tests; Reproducibility of Results
Patton, S. R., DeLurgio, S. A., Fridlington, A., Cohoon, C., Turpin, A. L., Clements, M. A. Frequency of mealtime insulin bolus predicts glycated hemoglobin in youths with type 1 diabetes. Diabetes technology & therapeutics 16, 519-523 (2014).