Recently, state insurance companies have questioned whether or not sufficient evidence is available to justify SMBG coverage for children with T1D. The purpose of this study is to examine the relationship between the number of times SMBG is performed per day and HbA1c among participants < 18 years of age enrolled through December 31, 2010 in the T1D Exchange clinic registry. The registry, which will include over 60 centers in the U.S., commenced enrollment of up to 45,000 adults and children with T1D in September 2010, with longitudinal participant data collected through medical records and participant questionnaires.

The analysis included 556 participants with T1D; (mean age 11.9 years, 50% female, 83% non-Hispanic white, mean diabetes duration 4.9 years, and mean HbA1c 8.3%). SMBG was collected from home glucose meter (HGM) downloads and self-report. The mean+/- standard deviation (SD) number of SMBG per day from the 303 participants with an available download and the 550 participants with a self-reported number was 5+/-3 and 6+/-3 respectively. A strong association (P<0.001) was present between SMBG and HbA1c, with increasing daily SMBG being associated with lower HbA1c for both the HGM downloads and self-reported number [Figure 1]. This study provides strong evidence of a linear trend between number of SMBG measurements per day and HbA1c levels.

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