Related Experiment Videos
The accuracy of blood glucose testing by children
P S Strumph1, C L Odoroff, J M Amatruda
1Department of Medicine, University of Rochester School of Medicine and Dentistry, NY 14642.
Insights
Children with diabetes are less accurate reading their own blood glucose strips compared to trained staff, especially at high and low glucose levels. This impacts timely diabetes management.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Clinical Diagnostics
Background:
- Existing research assesses adult accuracy in reading blood glucose strips.
- Limited data exists on children's self-monitoring accuracy for diabetes.
- Meter-to-meter variability in strip readings is an understudied area.
Purpose of the Study:
- To evaluate the accuracy of children with diabetes reading their own glucose oxidase strips.
- To compare children's visual strip readings against trained staff readings.
- To assess meter-to-meter variability in analyzing glucose strips.
Main Methods:
- 356 Chemstrip bG strips were visually read by diabetic children and a trained staff member at a summer camp.
- Strips were subsequently analyzed using two Accu-Chek bG meters.
- Accuracy was defined as readings within +/- 15% of the meter reading.
Main Results:
- Children's visual readings were less accurate (51% misreading) than staff readings (33% misreading).
- Accuracy was lowest at low (40-79 mg/dl) and high (240-399 mg/dl) blood glucose values for both groups.
- Children significantly underestimated high blood glucose levels more than staff.
Conclusions:
- Children with diabetes exhibit lower accuracy in visually reading glucose strips compared to trained staff.
- Self-monitoring accuracy is particularly compromised at critical low and high blood glucose ranges.
- Findings highlight potential challenges in pediatric diabetes self-management and the need for accurate monitoring tools.
Abstract:
While studies have evaluated the accuracy of adult patients and health personnel in reading various glucose oxidase impregnated strips to estimate blood glucose, there are no studies exclusively evaluating the accuracy of children with diabetes reading their own strips as compared to a staff member, and meter to meter variability in reading these strips. We evaluated the accuracy of reading chemstrip bG by children at a summer camp. The children's visual readings of their own strips were compared to the visual reading of a single staff member. A total of 356 Chemstrip bG's were visually read by diabetic children and a single trained staff member at a summer camp for diabetics. The strips were then analyzed by two Accu-Chek bG meters. Intermachine variability was found to be negligible over the entire bG range. For the purposes of this study, we define accurate visual readings as those within +/- 15 percent of the meter reading of a given strip. At low bG values (40-79 mg/dl), accuracy by children and staff is low, with underestimating occurring in 39 percent of staff readings and 57 percent of children's readings. At intermediate bG values (120-239 mg/dl) readings are more accurate, especially when read by the staff, with misreadings occurring in only 16-19 percent of the strips. At high bG values (240-399 mg/dl), accuracy by children is decreased, with underestimation 500 percent more often than staff. We conclude that children are less accurate at reading Chemstrip bG than a trained staff member (51% versus 33% misreading), especially at the upper and lower ranges of bG values when visual readings are least accurate, and the need for therapeutic intervention is the greatest.