Endocrine Abstracts

Aims: The use of glucose meter downloads provides statistics (mean blood glucose level, S.D.) which may have a role in outpatient Diabetes monitoring. We aimed to compare these measures with the current gold standard, HbA1c.

Methods: Thirty-eight patients had blood glucose readings downloaded from their monitoring device (Accuchek) at clinic visits over 25 months. Statistical analysis from the Accuchek Software package was performed to produce a data report including the following parameters: number of glucose readings, test frequency, mean blood glucose, S.D of glucose readings. The HbA1c was also recorded for each clinic visit and used for comparison to the download parameters. Reports with a test frequency of <2/day were excluded from analysis.

Results: 115 downloads were obtained. Number of recorded glucose levels per download report had a range of 69–500 readings (frequency 2.0–6.0/day, mean 3.6). HbA1c levels had a median 9.9 (range 6.8–14). S.D of glucose readings correlated significantly with an increased HbA1c value (regression coefficient of 0.54, P<0.0001, 95% CI 0.39, 0.68). A significant positive correlation was also found between mean blood glucose and HbA1c values (regression coefficient of 0.91, P<0.0001, 95% CI 0.60, 1.22). Mean blood glucose level also correlates well with S.D of readings (regression coefficient 1.2, P<0.0001, 95% CI 0.84, 1.56). Outliers included a girl with leukaemia and two patients with extended ‘honeymoon periods’.

Conclusions: Parameters such as mean blood glucose and S.D correlate very well with HbA1c despite lack of control over frequency/timing of measurements. However, the other parameters used in this study may be useful adjuncts in recognising patients with unusual diabetes control patterns (outliers) who require closer investigation as to why this may be occurring.