# Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus

## TL;DR

Adolescents with type 1 diabetes who regularly review their glucose data tend to have better blood sugar control, and this behavior is not linked to fear of low blood sugar.

## Contribution

This study is the first to show that adolescent-initiated glucose data review improves glycemia in type 1 diabetes.

## Key findings

- 53% of surveyed adolescents with T1D reported engaging in retrospective glucose data review.
- Adolescents who reviewed glucose data had significantly better HbA1c and time in range compared to nonreviewers.
- Fear of hypoglycemia did not influence retrospective glucose data review behavior.

## Abstract

Objectives: Regular retrospective review of glucose data is an important aspect of type 1 diabetes (T1D) management. Continuous glucose monitors (CGMs) facilitate retrospective review by capturing glucose data and generating standardized reports. However, only a minority of adults with T1D retrospectively review their glucose data, and adolescents are understudied. The objectives of this study were to determine the prevalence of self-reported retrospective glucose data review by adolescents with T1D, determine factors associated with self-reported retrospective glucose data review, and assess whether self-reported retrospective glucose data review was associated with improved glycemia.

Methods: We conducted a cross-sectional survey of adolescents aged 12–18 years with T1D in conjunction with review of the associated electronic medical record, which included age, sex, date of diagnosis, clinic hemoglobin A1c (HbA1c), type of insurance, and CGM data. The survey included the Hypoglycemia Fear Survey (HFS) and questions regarding habits and attitudes associated with retrospective review.

Results: 112 out of 218 eligible individuals completed the survey (51%). Fifty-three percent of adolescents who completed the survey reported that they had engaged in retrospective glucose data review. Of these, 88% of individuals reported that they reviewed data regularly. Age, sex, race, type of insurance, and CGM use were not associated with retrospective review status. Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and time in range (TIR) compared to adolescents who indicated they do not review glucose data (p=0.006 and p=0.04, respectively). There was no difference in HFS scores between reviewers and nonreviewers including the behavioral subscale, worry subscale, and total score.

Conclusions: Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and TIR. Adolescent-initiated glucose data self-review does not appear to be driven by fear of hypoglycemia (FoH).