Background: In the past years, new glucometers with integrated automated bolus calculator, are available in the market for patients whith type 1 diabetes (DM1) in multiple daily injections (MDI) therapy. The limited bibliography about the use of these meters in the pediatric population with DM1, suggests that it may have beneficial effects in terms of glycaemic control and improved quality of life.
Objective and hypotheses: The use of a glucometer with an integrated automated bolus calculator (Accu-Chek® Aviva Expert), improves glycemic control in children and adolescents with DM1.
Method: Data of children and adolescents diagnosed with DM1 followed in a tertiary hospital in were collected. Only the patients who performed at least four capilary blood glucose tests per day, and who had a knowledge on the carbohydrate counting calculation. Se collected data Hb1ACantes start using the meter, at 3 months and the last HbA1c disponible. Se sought significant differences between the three HbA1c, by Students t for paired samples.
Results: Data from 38 patients receiving treatment with MDI with insulin analogues (55% male, 45% female, age 12±4.5 years) were collected. We did not find any statistically significant difference in HbA1c values measured before they started using the glucometer, 3 months later and at the last HbA1c measurement (initial A1c: 6.9%±0.6 DE; 3 months 6.8%±0.5 (P>0.05), HbA1c 6.9±0.5% at the end of). The patients with poorest metabolic control (HbA1c >7.5%, n=7), were the ones who most improved (initial HbA1c 7.8±0. DE; 3 months 7.05% (P>0.05), HbA1c 7.2±0.5% at the end of the study±0.5 DE), but the differences founded were not statistically significant (probably due to the small sample size).
Conclusions: In our study has not been able to show improvement in HbA1c after using a glucometer with recommender bolus, although this is possibly because the population included previously showed good glycemic control. We have yet to analyze whether HbA1c beyond the use of these meters can decrease glycemic variability or hipoe hyperglycemic excursions.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology