Mealtime Insulin BOLUS Score More Strongly Predicts HbA1c Than the Self-Care Inventory in Youth With Type 1 Diabetes.
Document Type
Article
Publication Date
3-2025
Identifier
DOI: 10.1177/19322968231192979; PMCID: PMC11873986
Abstract
BACKGROUND: To meet their glycated hemoglobin (HbA1c) goals, youth with type 1 diabetes (T1D) need to engage with their daily T1D treatment. The mealtime insulin Bolus score (BOLUS) is an objective measure of youth's T1D engagement which we have previously shown to be superior to other objective engagement measures in predicting youth's HbA1c. Here, to further assess the BOLUS score's validity, we compared the strengths of the associations between youth's HbA1c with their mean insulin BOLUS score and a valid, self-report measure of T1D engagement, the Self-Care Inventory (SCI).
METHODS: One-hundred and five youth with T1D self-reported their T1D engagement using the SCI. We also collected two weeks of insulin pump data and a concurrent HbA1c level. We scored youth's SCI and calculated their mean insulin BOLUS score using standardized methods. For the analyses, we performed simple correlations, partial correlations, and multiple regression models.
RESULTS: Youth had a mean age of 15.03 ± 1.97 years, mean time since diagnosis of 8.11 ± 3.26 years, and a mean HbA1c of 8.78 ± 1.49%. The sample included n = 58 boys (55%) and n = 96 families (91%) self-identified as white. Simple correlations between youth's age, HbA1c, SCI total score, and BOLUS score were all significant. Partial correlation and regression models revealed that youth's insulin BOLUS score was more strongly associated with HbA1c than the SCI.
CONCLUSIONS: Youths' BOLUS score has better concurrent validity with HbA1c than the SCI. We should consider reporting the BOLUS score as an outcome metric in insulin pump data reports.
Journal Title
J Diabetes Sci Technol
Volume
19
Issue
2
First Page
340
Last Page
344
MeSH Keywords
Humans; Diabetes Mellitus, Type 1; Male; Adolescent; Glycated Hemoglobin; Female; Insulin; Self Care; Hypoglycemic Agents; Meals; Child; Self Report; Insulin Infusion Systems; Blood Glucose
PubMed ID
37568277
Keywords
insulin pump; pediatrics; treatment engagement; type 1 diabetes
Recommended Citation
Christie J, Clements MA, Williams DD, Cernich J, Patton SR. Mealtime Insulin BOLUS Score More Strongly Predicts HbA1c Than the Self-Care Inventory in Youth With Type 1 Diabetes. J Diabetes Sci Technol. 2025;19(2):340-344. doi:10.1177/19322968231192979
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