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., Stedman, M., Young, R., & 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
• Start Date: Mar 14, 2018
• End Date: Mar 16, 2018
• Deposit Date: Jun 27, 2023
• Public URL: https://keele-repository.worktribe.com/output/508193
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/dme.45_13571