Glycaemic risk assessment in children and young people with Type 1 diabetes mellitus.
OBJECTIVE
To ascertain if those with diabetes (and their carers) ascribe a similar level of risk to blood glucose control as healthcare professionals.


METHODS
We used a structured questionnaire to ask fifty healthcare professionals how 'dangerous' a given blood glucose value was. Their answers were modelled to produce an algorithm of assessed risk. To examine if patients (and their carers) would apportion a similar level of risk to that of healthcare professionals, the same questionnaire was issued to fifty children and adolescents with Type 1 diabetes. For patients under 8 years old the carers completed the questionnaires (n = 23). Both patient and carers together completed the questionnaire for those aged 8-11 years (n = 15) and patients over the age of 11 years completed the questionnaire themselves (n = 12). The median results and interquartile range of the assessed level of risk, as determined by the two groups, were compared using a generalized linear model.


RESULTS
A significant difference (P < 0.0001) was identified between the median risk assessments of the two groups. The zero level of assessed risk was upward shifted in the patient group by 0.8 mmol/l and indicated the patients' view of risk increased.


CONCLUSIONS
Patients with Type 1 diabetes (and their carers) evaluate the risk from blood glucose values differently from healthcare professionals. The euglycaemic state (zero ascribed risk) that patients chose was 0.8 mmol/l greater than that of healthcare professionals, indicating, perhaps, hypoglycaemia avoidance, a more pragmatic approach or less exposure to current trends in glycaemic control.
Hill
N R
NR
Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK. Nathan.Hill@ocdem.ox.ac.uk
Thompson
B
B
Bruce
J
J
Matthews
D R
DR
Hindmarsh
P
P
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D018570:Risk Assessment; D011795:Surveys and Questionnaires
D001786:Blood Glucose