title: A Minority of Patients with Type 1 Diabetes Routinely Downloads and Retrospectively Reviews Device Data.
abstract: BACKGROUND
  In type 1 diabetes (T1D), periodic review of blood glucose and insulin dosing should be performed, but it is not known how often patients review these data on their own. We describe the proportion of patients with T1D who routinely downloaded and reviewed their data at home.
  
  
  METHODS
  A cross-sectional survey of 155 adults and 185 caregivers of children with T1D at a single academic institution was performed. "Routine Downloaders" (downloaded four or more times in the past year) were also considered "Routine Reviewers" if they reviewed their data most of the time they downloaded from devices. Logistic regression was used to identify factors associated with being a Routine Reviewer.
  
  
  RESULTS
  Only 31% of adults and 56% of caregivers reported ever downloading data from one or more devices, whereas 20% and 40%, respectively, were considered Routine Downloaders. Only 12% of adults and 27% of caregivers were Routine Reviewers. Mean hemoglobin A1c was lower in Routine Reviewers compared with non-Routine Reviewers (7.2±1.0% vs. 8.1±1.6% [P=0.03] in adults and 7.8±1.4% vs. 8.6±1.7% [P=0.001] in children). In adjusted analysis of adults, the odds ratio of being a Routine Reviewer of one or more devices for every 10-year increase in age was 1.5 (95% confidence interval, 1.1, 2.1 [P=0.02]). For every 10 years since diabetes diagnosis, the odds ratio of being a Routine Reviewer was 1.7 (95% confidence interval, 1.2, 2.4 [P=0.01]). For caregivers, there were no statistically significant factors associated with being a Routine Reviewer.
  
  
  CONCLUSIONS
  A minority of T1D patients routinely downloads and reviews data from their devices on their own. Further research is needed to understand obstacles, provide better education and tools for self-review, and determine if patient self-review is associated with improved glycemic control.
authors.affiliation: 1 Division of Endocrinology, Department of Pediatrics and the Madison Clinic for Pediatric Diabetes, University of California San Francisco , San Francisco, California.
authors.forename: Jenise C
authors.initials: JC
authors.lastname: Wong
authors.affiliation: 2 Division of Endocrinology and Metabolism, Department of Medicine and Center for Digital Health Innovation, University of California San Francisco , San Francisco, California.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Neinstein
authors.affiliation: 1 Division of Endocrinology, Department of Pediatrics and the Madison Clinic for Pediatric Diabetes, University of California San Francisco , San Francisco, California.
authors.forename: Matthew
authors.initials: M
authors.lastname: Spindler
authors.affiliation: 1 Division of Endocrinology, Department of Pediatrics and the Madison Clinic for Pediatric Diabetes, University of California San Francisco , San Francisco, California.
authors.forename: Saleh
authors.initials: S
authors.lastname: Adi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000523:psychology / Q000706:statistics & numerical data*; D017028:Caregivers; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D016247:Information Storage and Retrieval / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human