Using error grid analysis to assess blood glucose estimation accuracy in adolescents with type 1 diabetes

ABSTRACT

Despite an increase in adolescents’ use of type 1 diabetes (T1D)-related technology to aid in blood glucose (BG) management and insulin administration, adolescents with T1D often estimate their current BG levels to inform management decisions. The present study used error grid analysis to explore adolescents’ BG estimation accuracy and examined the relationship between estimation accuracy and diabetes technology use. Fifty-five adolescents diagnosed with T1D completed the study. Participants estimated their BG level before checking it with a meter, and described their use of diabetes technology. Error grid analyses indicated that most estimates did not have “clinically serious” implications; however, raw estimations differed from actual BG values by an average of 33%. Participants who reported checking their BG more frequently per day with a meter made more accurate BG estimations as measured by both error grid analysis and percentage deviations. Findings underscore the importance of encouraging adolescents with T1D to engage in BG monitoring often. Increased BG monitoring with a meter may increase adolescents’ ability to accurately estimate their BG values. Thus, advanced BG monitoring technology should be used in conjunction with meter checking. Examining BG estimation accuracy with error grid analysis holds promise for better understanding self-management practices.

Acknowledgments

Both authors developed the study concept and study design. Testing, data collection, and data analyses were performed by N. B. The manuscript was written and revised by N. B., with critical revisions and contributions from A. K. Both authors approved the final version of the manuscript for submission.

The authors would like to thank Linda W. Chang for her technical and statistical consultation on this project, and Sara Pardej for help with data collection.

The authors have no relevant conflicts of interest to disclose. Natalie E. Benjamin is the guarantor of this work, and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.