Feelings About Blood Glucose Monitoring Affects HbA1c in Kids
If you feel scared or frustrated when your blood sugar is high, your A1c is likely to be higher than if you don't feel scared or frustrated. That's the basic conclusion of a study published in the November 2004 Diabetes Care.
A team from the Joslin Diabetes Center in Boston and Texas Children's Hospital in Houston created a questionnaire designed to measure the feelings associated with blood glucose monitoring of kids with type 1 diabetes and their parents. Both were asked to report how often (never, sometimes, always) they felt upset, scared, guilt, or frustrated when their blood sugar is high. "Always" and "sometimes" answers scored higher than "never" answers. After analyzing the results, the researchers found that kids who had the highest scores -- indicating the most anxiety surrounding blood glucose monitoring -- also had the highest A1c values.This chart illustrates the results, showing that kids with the lowest score (i.e., lowest anxiety) had the lowest A1c, and the kids with the highest score (i.e., highest anxiety) had the highest A1c.
The researchers are not sure if the anxiety is the cause of the elevated A1c, but the association is clear. The researchers theorize that part of the issue is that "Youth and families are 'set up' to fail because it is unrealistic to expect youths to meet these goals [optimal blood glucose control] consistently or perfectly."
So what can families learn from this? As parents, we need to realize that a glucose value is just a number. We should help our kids understand that, and thank them for checking their blood sugar, regardless of the results.
For more information, see The Blood Glucose Monitoring Communication Questionnaire: An instrument to measure affect specific to blood glucose monitoring [Diabetes Care 27:2610-2615, 2004].
October 31, 2004
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