Frequency and Accuracy of Self-Monitoring of Blood Glucose in Children: Relationship to Glycemic Control

We evaluated the long-term effects of self-monitoring of blood glucose (SMBG) on glycemic control in a large unselected group of insulin-dependent diabetic (IDD) children and adolescents (N = 282) treated at a diabetes clinic. Among those who had been taught SMBG techniques (N = 229) and reported frequency of use (N = 209), only 26% reported monitoring three or more times per day. HbA₁ levels of patients who monitored their blood most frequently did not differ from those who monitored blood less frequently or those who monitored only urine. Likewise, HbA₁ levels of patients who monitored with machines did not differ from Chemstrip bG users. Accuracy was assessed in a subsample of 100 randomly selected Chemstrip bG users by comparing their Chemstrip reading with a laboratory value. Fifty-eight percent of the readings were within 20% of the laboratory value. Accuracy did not relate to frequency of monitoring or to HbA₁ levels. These data suggest that frequency and accuracy of SMBG are independent and that neither ensures good glycemic control.