Real-world evidence confirms that increased blood glucose monitoring strip (BGMS) accuracy reduces glycated haemoglobin (HbA1c) variance

HEALD, AH; Livingston, M; Fryer, A; Cortes, MGY; Gadsby, R; Ollier, W; Stedman, M; Young, RJ; Craig, J

Abstract

Aim: An in silico study has reported a link between less accurate BGMS and poorer glycaemic control, leading to significant differences in both hyper- and hypoglycaemic events. Our aim was to see if we could detect this effect of BGMS accuracy on glycaemic control within the NHS published real-world data.

Methods: The England National Diabetes Audit (NDA) 2013 to 2016 reports at practice levels for Type 1 diabetes % results within HbA1c bands. An HbA1c mean and standard deviation (SD) could be calculated for each practice year. Practice overall BGMS accuracy SD (BGMS-SD) can be calculated from the quantity of main types of BGMS prescribed and the reported accuracy of each as % results within ± % bands of actual value.

Results: The study included 4,560 practice years and 165,000 patients with Type 1 diabetes years with overall BGMS-SD = 6.5% and HbA1c mean = 63.7/SD = 11.2mmol/mol. Linear regression between practice year BGMS-SD and HbA1c-SD gave a correlation coefficient = 8.17, p = 0.018. Using this model, BGMS-SD was converted through HbA1c-SD to BG-SD based on aggregation of 300 results (three tests/day for three months). This showed that using BGMS at the ISO accepted standard (95% results ≤±15% reference), a patient with BG 10mmol/l could expect at least once per week the true blood glucose value to be >±1.8mmol/l from that measured vs the best-performing BGMS (95% results ≤±5%) corresponding >±0.6mmol/l.

Conclusion: This is consistent with the values reported in the in silico model. Use of less accurate BGMS are associated both theoretically and in practice with a larger SD in BG and HbA1c with consequences for patient confidence and health.

Citation

HEALD, A., Livingston, M., Fryer, A., Cortes, M., Gadsby, R., Ollier, W., …Craig, J. (2018, March). Real-world evidence confirms that increased blood glucose monitoring strip (BGMS) accuracy reduces glycated haemoglobin (HbA1c) variance. Poster presented at Diabetes UK Professional Conference 2018, London ExCeL, London, UK

• Presentation Conference Type: Poster
• Conference Name: Diabetes UK Professional Conference 2018
• Conference Location: London ExCeL, London, UK
• Start Date: Mar 14, 2018
• End Date: Mar 16, 2018
• Deposit Date: Jun 27, 2023
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/dme.45_13571