title: Prior knowledge of blood glucose meter download improves the accuracy of verbal self-reported blood glucose in teenagers with type I diabetes at ski camp.
abstract: OBJECTIVE
  Despite advances in diabetes management, self-monitoring of blood glucose (SMBG) remains fundamental. A number of studies, principally in adults, have confirmed that logbook entries and verbal SMBG reports are prone to common errors. In the context of an adolescent diabetes camp, the accuracy of verbally reported SMBG is crucial for guiding safe therapeutic management, and negating the risk of exercise-induced hypoglycemia. We aimed to assess whether awareness of a planned meter download at the completion of a diabetes camp would improve the overall accuracy of verbally reported SMBG.
  
  
  METHODS
  Adolescents with type one diabetes (n = 26) attended a 3-day ski camp in 2014. Verbally reported SMBG values were recorded by camp supervisors at multiple time points throughout the camp. The intervention involved ensuring that all participants (at camp commencement) were aware of a planned meter download and SMBG review at camp conclusion. These data were then compared with historical camp data from 2012, collected using identical methodology, in which participants (n = 20) were unaware of the planned meter download. For analysis, blood glucose (BGL) data were classified as: matching, phantom (verbal SMBG value with no corresponding meter download value), and over- or underestimate (verbally reported value >/< meter downloaded value).
  
  
  RESULTS
  Dual data regarding verbal SMBG and meter downloads were obtained on 550 instances of BGL testing during the 2014 camp (the intervention group). This was compared to dual data for 396 historical tests from the 2012 control group. For the intervention group, the overall error rate was 4.7 %, over 34 % of participants. There was a statistically significant improvement in accuracy compared to historical nonintervention data, in which there was an error rate of 14.1 % over 70 % of participants (p < 0.001). There was also a decrease in phantom readings to 2 %, from 8.6 % in 2012 (p < 0.001).
  
  
  CONCLUSIONS
  This study demonstrates an improvement in accuracy and reliability of verbally reported SMBG, following a simple intervention of ensuring participants were aware of a meter download at the completion of camp. This intervention could be easily incorporated into adolescent diabetes camp safety protocols and may provide an easy, low-cost way of improving verbally reported SMBG accuracy and therefore safety on camp.
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.
authors.forename: Annika
authors.initials: A
authors.lastname: Sjoeholm
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gray
authors.affiliation: Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand.
authors.forename: Jenny
authors.initials: J
authors.lastname: Rayns
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.|Department of Paediatrics, Southern District Health Board, Invercargill, New Zealand.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Tomlinson
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand. Ben.wheeler@otago.ac.nz.|Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand. Ben.wheeler@otago.ac.nz.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Wheeler
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D008297:Male; D010349:Patient Compliance; D015203:Reproducibility of Results; D057566:Self Report / Q000592:standards*; D012865:Skiing; D012984:Software
chemical_list: D001786:Blood Glucose
keywords: Adolescent; Camp; Self-management; Self-monitoring blood glucose; Type 1 diabetes mellitus