Home Blood Glucose Monitoring Research Articles

The effect of home visits on the quality of life of children and adolescents with type 1 diabetes mellitus

The aim of the study was to analyze the impact of home and school visits and to strengthen the knowledge on diabetes education on the quality of care and life of children and adolescents with diabetes. This was a descriptive cross-sectional study of all children and adolescents (n = 16, seven males and nine females), attending a pediatric diabetes center (mean age: 11.25 yr ± 4.82, range: 5-17 yr), mean duration of diabetes being 4.6 ± 3.9 yr, range 0.5-8.4 yr. Ten patients were visited by the medical social worker at home and school, their knowledge ondiabetes education was strengthened, and intervention effect was evaluated 4 months later. Positive effects observed were that clinic visits became regular, there was notification by school of clinical status, a reduction in number of hypoglycemic episodes at school, increased acquisition of glucometers, and daily and regular (100%) self home blood glucose (BG) monitoring. The mean center HbA1c was reduced from 12.86 ± 2.5% to 9.41 ± 1.56%, the change from previsit was 3.45%. The mean center morning BG dropped from 181.60 ± 71.96 to 127.54 ± 27.54 mg/dL reflecting change from previsit BG of 54.19 mg/dL. However, these visitations had little effect on checking of BG at school. This study stressed the importance of home and school visits and diabetes education on the quality of care and life of the children and adolescents with diabetes in our region.

Audit of outcomes of pregnancies with an abnormal 1 h glucose tolerance test value between December 2004 and December 2009

The recent NICE Diabetes in Pregnancy guideline suggest the fasting and 2 h values of the 75 g oral glucose tolerance test (GTT) should be used to diagnose gestational diabetes...

Frequency of biochemical hypoglycaemia in adults with Type 1 diabetes with and without impaired awareness of hypoglycaemia: no identifiable differences using continuous glucose monitoring

Impaired awareness of hypoglycaemia (IAH) is a major risk factor for severe hypoglycaemia in Type 1 diabetes. Although biochemical hypoglycaemia is asserted to be more frequent in IAH, this has not been estimated accurately. The aim of this study was to use Continuous Glucose Monitoring (CGM) to quantify hypoglycaemia in IAH and evaluate its use in identifying impaired awareness of hypoglycaemia. Ninety-five patients with Type 1 diabetes were classified as having normal (n = 74) or impaired awareness (n = 21) using an established method of assessing hypoglycaemia awareness. Hypoglycaemia exposure was assessed prospectively over 9-12 months using weekly 4-point capillary home blood glucose monitoring (HBGM), 5 days of CGM and prospective reporting of severe hypoglycaemia. The frequencies of biochemical and severe hypoglycaemia were compared in patients with normal and impaired awareness of hypoglycaemia. Patients with impaired awareness had a 3-fold higher incidence of severe hypoglycaemia than those with normal awareness [incidence rate ratio (IRR) 3.37 (95% CI 1.30-8.7); P = 0.01] and 1.6-fold higher incidence of hypoglycaemia on weekly HBGM [IRR 1.63 (95% CI 1.09-2.44); P = 0.02]. No significant differences were observed with CGM [IRR for sensor glucose < or = 3.0 mmol/l 1.47 (95% CI 0.91-2.39); P = 0.12; IRR for sensor glucose < or = 2.2 mmol/l 1.23 (95% CI 0.76-1.98); P = 0.40]. Patients with Type 1 diabetes with impaired awareness had a 3-fold higher risk of severe hypoglycaemia and 1.6-fold higher incidence of biochemical hypoglycaemia measured with weekly glucose monitoring compared with normal awareness, but 5 days of CGM did not differentiate those with impaired from those with normal awareness.

Practices of Arab American Patients With Type 2 Diabetes Mellitus During Ramadan

Aims: To examine practices and complications among Arab Americans observing fasting during Ramadan. Methods: Adults with type 2 diabetes mellitus, of native Arab ancestry, and observing fasting were invited to complete an interview. Changes made to behavioral characteristics or diabetes management during Ramadan and consequences of fasting were assessed. Results: Twenty-seven patients (60.1 ± 9.8 years, 51.9% male) participated. Majority reported exercising less frequently during Ramadan. Modifications in home blood glucose monitoring (HBGM) were observed in 48% of patients, of these 25% and 17% decreased frequency or had not tested at all, respectively. Consultation with providers prior to Ramadan was reported by 67%. Education regarding medications, risks of fasting, indications to break fasting, meal plans, and exercise were not provided in the majority. Therapeutic changes were made in 50% and 46% of insulin and oral medication users, respectively. Excessive thirst was the most commonly reported symptom. The overall frequency of hypoglycemia and hyperglycemia was low. One patient stopped fasting during Ramadan due to uncontrolled hyperglycemia. Hospitalization or emergency room visits were not reported. Conclusions: Lack of patient education prior to Ramadan may contribute to the suboptimal practices reported. Pharmacists may be able to ensure safe fasting practices among Arab Americans by providing patient-specific education.

Views and practices of community pharmacists regarding services for people with type 2 diabetes

Abstract Objective To describe the views and practices of community pharmacists regarding services for people with type 2 diabetes. Method A cross-sectional questionnaire survey of a convenience sample of 317 community pharmacists in the North East of England. The 26-item questionnaire covered the setting of the pharmacy, dispensing medication, and the pharmacist's role in the primary prevention of diabetes, detecting undiagnosed diabetes and prevention of complications. Key findings There was a 51% response rate. More than 80% of respondents reported that they saw patients with diabetes “very often” or “often” when they collected their prescriptions, but three-quarters reported that they “never/rarely” or only “sometimes” advised patients what to expect from their medication and gave information to help them have a better understanding of their disease. More than 90% of the pharmacists believed that a healthy lifestyle is important, but the majority were “never/rarely” or only “sometimes” involved in its promotion. Around 10 per cent of the respondents reported that they “often” or “very often” promoted regular eye examinations. Home blood glucose monitoring was promoted by 50% of the respondents. The majority reported that they checked prescriptions for drug interactions. Conclusion This study found that community pharmacists' advice and services to people with type 2 diabetes fell short of the standards and objectives set out in the National Service Framework for Diabetes. Our findings can be used to promote discussion in the profession and with stakeholders about the future role of the community pharmacist in diabetes care.

Facial and finger erysipelas: an unusual complication of home blood glucose monitoring

Facial and finger erysipelas: an unusual complication of home blood glucose monitoring

Do current standards of primary care of diabetes meet with guideline recommendations in Trinidad, West Indies?

Aims Primary care management of diabetes was examined using the Caribbean Health Research Council (CHRC) guidelines. Methods We retrospectively examined a cross-section of 646 type 2 people with diabetics over 12 months with 1st visit between 1997 and 2005. Results There were more women (65.8%) than men (34.2%) with age range between 29 and 89 years. Blood pressure and weight were evaluated in >95% of patients at each centre. Waist circumference and BMI were not measured at any time and HbA 1c was infrequently measured (1.6–7%) over the 12 months. Information on family history (87.5%), smoking and alcohol (78.1%), exercise (21.4%), socioeconomic status (19.4%) and education (0.3%), and fasting blood sugar (97.2%), lipid profile (51.8%) and serum creatinine (37.9%) were assessed at the 1st visit. At follow-up patients were advised on treatment compliance (47.2%), diet (34.2%), exercise (18.5%) and rarely on home monitoring of blood glucose (0.3%). Peripheral sensations, pedal pulses (6%), visual acuity (3.3%), fundoscopy (12.1%) and ECG (3.9%) were scarcely examined at the annual visit. Conclusions Current management of diabetes in primary care in Trinidad falls short of Caribbean guideline recommendations. The CHRC and Ministry of Health should jointly educate caregivers of diabetes to implement the guidelines, with annual audits to identify shortfalls in management.

Realistic Expectations and Practical Use of Continuous Glucose Monitoring for the Endocrinologist

Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology. The two major sources of data acquisition included PubMed search strategies and personal experience of the author from clinical experience. Data assessing CGM accuracy, short-term outcomes (12 wk), and longer term outcomes (6 months) are reported. Potential strategies for successful and efficient use in an office or clinic setting are also discussed. Practical aspects of CGM use (alarm settings, using glycemic trending information) are also reviewed. Accuracy of this technology has improved in the short amount of time it has been available. Six-month data suggest that patient selection is a key for success. Patients who do not understand or practice the basics of intensive insulin therapy have the greatest challenges. Those who do best watch the receiver frequently, continue with frequent home blood glucose monitoring, use the trending information to make insulin adjustments, and understand the limitations of the technology. With insurance reimbursement improving, CGM is gaining acceptance as an important tool for the management of type 1 diabetes. Like home blood glucose monitoring and insulin pump therapy, this technology by itself is not a panacea for diabetes control. However, it further adds to our ability to improve the lives of people with diabetes. Long-term, the hope is that this technology will pave the way for a "closed-loop" device.

Efectos de las intenciones de implementación en las intervenciones sobre la salud

ResumenEn la última década, las intenciones de implementación han resultado ser estrategias eficaces de autorregulación en multitud de estudios (Gollwitzer y Sheeran, 2006). En este artículo revisaremos su eficacia en el campo de la Salud. Así, las intenciones de implementación han sido útiles en la promoción de conductas saludables (por ejemplo, facilitación de pautas de dieta sana o realización de ejercicio físico), el seguimiento de metas no placenteras (auto-exploraciones o mediciones del nivel de glucosa en sangre, por ejemplo), en la facilitación del control de situaciones y circunstancias indeseadas, así como de las acciones encaminadas hacia una meta en aquellas poblaciones críticas (esquizofrénicos, niños con trastorno por déficit de atención con hiperactividad, etc.) que tienen dificultades en el control de la acción. Que la efectividad de las intenciones de implementación no está además acompañada de rigidez y no produce efectos de rebote avala la importancia de esta estrategia de autorregulación. Se discuten las limitaciones de las intenciones de implementación, así como futuras intervenciones mediante esta estrategia.

Hypoglycemia During Acute Illness in Children With Classic Congenital Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH) describes a group of genetic, autosomal recessive conditions, where there is a block in cortisol biosynthesis. Approximately 95 percent of cases are due to 21-hydroxylase deficiency, which is discussed in this article. Patients with the severe or classic form of CAH have epinephrine deficiency in addition to cortisol deficiency. Both epinephrine and cortisol are important counterregulatory hormones and help prevent hypoglycemia during physical stress. This is the first prospective study to evaluate the incidence of hypoglycemia during acute illness in children with classic CAH. Our objective was to examine blood glucose levels and symptoms of these children during the physical stressor of a typical acute illness managed at home. Twenty patients, ages 3 to 10 years with classic CAH participated. Parents were instructed regarding management of illnesses, home blood glucose monitoring and questionnaire completion. Over 29 months, 20 patients completed questionnaires and 6 patients performed home blood glucose monitoring. A blood glucose of <60 mg/dL was documented in 3 out of 8 monitored acute illness episodes, and in 2 out of 6 of monitored children. The acute illness episodes with documented blood glucose <60 mg/dL were not associated with vomiting. Our data suggest that children with classic CAH may experience lowering of blood glucose during illnesses, and patient education regarding the management of common childhood illness should include glucose supplementation.

A collaborative approach to the recruitment and retention of minority patients with diabetes in rural community health centers

ContextRecruiting and retaining minorities from rural, community health centers is a challenge. Collaboration between the researchers and health center personnel and activities to enhance trust may improve results. PurposeTo describe recruitment and retention strategies and report results of a 12-month clinical trial of a telemedicine-based diabetes self-management intervention, conducted within a rural community health center. MethodsMulti-level, multi-staged recruitment process including collaborative planning, data extraction, medical record review, telephone screen, 2 in-person enrollment visits and randomization. Target sample was adults ≥35 years of age with type 2 diabetes, glycated hemoglobin (GHb)>7% with no significant comorbidities to prevent safe participation. Follow-up visits occurred at 6 and 12 months post-randomization. FindingsOf those eligible from medical record review, 65% were African-American(AA)/other and female. Approximately 33% of those successfully contacted by telephone were randomized (n=165), yielding a predominately AA/other (73.9%) and female (74.5%) sample. Among those eligible at the Telephone Screen, a greater percentage of Non-Hispanic Whites (NHW) refused participation than AA/other (54.2% vs 45.8%), while a greater percentage of women refused compared to men (64.4% vs 35.6%). Significant baseline differences were found by ethnicity for education, insurance, transportation and diastolic blood pressure; by gender for income, transportation, weight, and home monitoring of blood glucose. Overall 6 and 12 month retention rates were 90.9% and 82.4%, respectively, with a greater percentage of AA/Other and female participants retained. ConclusionsOur collaborative approach was successful in recruiting and retaining ethnically diverse study participants who reside in a rural underserved area of South Carolina. Differences in baseline characteristics and retention by ethnicity and gender were found. Successful translational research must allow for a collaborative approach addressing factors at the level of the community health center, key personnel, and patients in an effort to build trust for the purpose of advancing the science of translating research to practice.

Continuous blood glucose monitoring: does it really affect diabetic control?

AbstractThere remains uncertainty concerning the use of continuous blood glucose monitoring (CBGM) systems in the assessment and management of diabetes control.We examined 42 consecutive patients who attended a district hospital over a two‐year period and had CBGM performed to determine if the data obtained had benefited patient care.There was an easily identifiable pattern in the 72‐hour glycaemic trend in 25 patients. Out of this number, 15 patients had nocturnal hypoglycaemia. The average follow‐up time was seven months, whilst the total daily dose of insulin administered per day fell insignificantly from 55.7 initially to 55.4 units/24hr. HbA1c improved marginally over this time in all patients, reducing from 8.88% to 8.55%.CBGM offers a marginal advantage over home blood glucose monitoring where glycaemic patterns are poorly understood. However, from our observations, the use of CBGM independently in the management of glycaemic control in diabetes is, overall, ineffective, but it may be useful in the identification of nocturnal hypoglycaemia. Copyright © 2008 John Wiley &amp; Sons.

The management of women with gestational diabetes can be stratified according to diagnostic oral glucose tolerance test results

AbstractThe ACHOIS trial (Australian Carbohydrate Intolerance Study in Pregnant Women) confirmed the benefits of treating gestational diabetes mellitus (GDM). Optimum management strategies remain uncertain. In our unit, women with GDM are allocated into two treatment groups according to their diagnostic oral glucose tolerance test (OGTT) result. Those with a fasting glucose &lt;6mmol/L and two‐hour post‐load glucose of 7.8–9mmol/L are treated conservatively: dietitian‐led, with weekly blood glucose test two hours post‐meal; while those with a fasting glucose ≥ 6mmol/L or two‐hour post‐load glucose ≥ 9mmol/L are treated intensively: regular clinic reviews, with four times daily home blood glucose monitoring (HBGM).This study aimed to investigate any difference in outcomes between the conservative group (n = 35) and the intensive group (n = 46).Eighty‐one GDM patients attending the joint obstetric clinic between May 2001 and March 2004 were identified, and pregnancy outcomes in the two groups were compared.There were no significant differences in mean birth weight (conservative group 3572±458g, intensive group 3601±666g, p = 0.597), rates of macrosomia [&gt;4kg] (conservative 20%, intensive 30%, p = 0.3) and large for gestational age [&gt;95th centile] (conservative 29%, intensive 41%, p = 0.2).It was concluded that the care of women with GDM can be stratified based on diagnostic OGTT results and managed accordingly, which may allow for a more resource‐efficient management strategy in this group. Copyright © 2008 John Wiley &amp; Sons.

Latent Autoimmune Diabetes in Adults and Pregnancy: Foretelling the Future

W.S. is a 25-year-old woman referred for newly diagnosed gestational diabetes mellitus (GDM) after having a 1-hour plasma glucose (PG) of 150 mg/dl during a 50-g glucose challenge test at 28 weeks' gestation. She denied any history of polyuria, polydipsia, polyphagia, or visual disturbances. During this pregnancy, she had gained only 5 lb by 31 weeks and denied any complications. Before the pregnancy, her baseline weight was 205 lb, and her BMI 33 kg/m2. Overall, she was feeling well and tolerating her pregnancy well. Her medical history was significant for a single pregnancy 4 years ago that was not complicated by GDM. She delivered a healthy, full-term girl weighing 7 lb, 4 oz, by an uncomplicated spontaneous vaginal delivery (SVD). She denied any subsequent history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). She denied a family history of type 2 diabetes. However, her 4-year-old daughter had been diagnosed with type 1 diabetes. She denied any tobacco or alcohol use. After being diagnosed with GDM, she received appropriate dietary counseling and was instructed in home blood glucose monitoring. Secondary to persistent fasting hyperglycemia, she was started on human insulin NPH, 5 units subcutaneously daily at bedtime. She continued to monitor fasting and 2-hour postprandial blood glucose values. Her GDM was followed closely, and her NPH insulin was titrated to 14 units at bedtime. Because of ongoing postprandial hyperglycemia, insulin lispro was added for prandial coverage, in a dose of 1 unit/20 g of carbohydrate consumed. Her blood glucose control improved on intensive insulin therapy. Her hemoglobin A1c (A1C) was excellent at 5.5%. At term, she delivered a healthy boy of 8 lb, 8 oz, by uncomplicated SVD. The patient was scheduled for a postpartum follow-up, including a 75-g oral glucose tolerance test (OGTT). She denied …

Effectiveness of Home Blood Glucose Monitoring on Controlling Type II Diabetes Mellitus in Two University Hospitals, Riyadh

Effectiveness of Home Blood Glucose Monitoring on Controlling Type II Diabetes Mellitus in Two University Hospitals, Riyadh

The Rate of Improvement in Metabolic Control in Children with Diabetes Mellitus Type 1 on Insulin Glargine Depends on Age

To evaluate the changes in the glycemic profile and metabolic control after introducing glargine in children with DMT1 in a one-year follow up. 70 children (36 boys) at the average age of 12.03+/-2.50 with the mean diabetes duration of 3.35+/-2.19 years were observed. Glargine was substituted for NPH in children treated with multiple daily injections. The analysis showed the differences in the dynamics of changes in mean glycemia based on home blood glucose monitoring and HbA1c between prepubertal children (Group 1) and teenagers (Group 2). A significant reduction in mean glycemia from baseline to 12 months was observed at all chosen points in Group 2: fasting glycemia (125+/-27 mg/dl vs 117+/-17 mg/dl,p<0.05), bedtime glycemia (128+/-24 mg/dl vs. 117+/-20 mg/dl,p=0.001) and 3 a.m. glycemia (143+/-47 mg/dl vs. 90+/-25 mg/dl,p<0.001). A significant decrease in mean glycemia in Group 1 was observed from the beginning of treatment only at bedtime (0-12 months:129+/-27 mg/dl vs. 112+/-25 mg/dl,p=0.001) and at 3 am with the delay (6-12 months:122+/-36 mg/dl vs. 90+/-22 mg/dl,p<0.05). A significant improvement in HbA1c between baseline and 12 months was observed in both groups but with different dynamics of changes: 6.91+/-0.77% vs. 6.59+/-0.65% (p<0.05) and 7.44+/-1.26% vs. 7.18+/-1.58% (p=0.001) respectively in the groups. A trend towards decreasing the number of hypoglycemic episodes and no changes in BMI and insulin requirement were noted. Introduction of glargine provides diabetic children with a better stabilization of the daily glycemic profile even in the cases of baseline good metabolic control. The rate of reaching the target in a long-term observation depends on age. A slower reduction of glycemia observed in smaller subjects suggests a great individuality in the regimen of diabetic children.

Diabetes care, glycemic control, and complications in children with type 1 diabetes from Asia and the Western Pacific Region

Aims The incidence of type 1 diabetes is increasing in many parts of Asia, where resources may not enable targets for glycemic control to be achieved. The aims of this study were to describe glycemic control, diabetes care, and complications in youth with type 1 diabetes from the Western Pacific Region and to identify factors associated with glycemic control and hypoglycemia. Methods A cross-sectional clinic-based study on 2312 children and adolescents (aged <18 years; 45% males) from 96 pediatric diabetes centers in Australia, China, Hong Kong, Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, and Thailand was conducted. Clinical and management details were recorded, and finger-pricked blood samples were obtained for central glycated hemoglobin (HbA 1c). Results The median age of the patients was 12.5 years [interquartile range (IQR)=9.4–15.3 years]; diabetes duration, 4.4 years (IQR=2.5–7.2 years); and HbA 1c level, 8.3% (IQR 7.4%–9.7%). Insulin treatment consisted of one or two daily injections in 61% of the patients (range=22%–90% by country), and home blood glucose monitoring (range=67%–100%) was practiced by 96%. HbA 1c level was significantly associated with country, age, diabetes duration, sex, insulin dose per kilogram, insulin regimen, and frequency of home blood glucose measurement in multiple regression analysis. The incidence of severe hypoglycemia, defined as any episode requiring assistance in the previous 3 months, was 73 per 100 patient-years and was associated with country, male sex, higher HbA 1c level, an insulin regimen with three or more injections, and more frequent home blood glucose testing. The incidence of diabetic ketoacidosis was 10 per 100 patient-years and was associated with country, higher HbA 1c level, and higher insulin dose per kilogram. Conclusions There is marked variability in glycemic control, hypoglycemia, complication rates, and diabetes care among children from the Western Pacific Region. Most are not achieving adequate glycemic control, placing them at high risk of microvascular complications.

A method for assessing quality of control from glucose profiles

As the practice of multiple assessments of glucose concentration throughout the day increases for people with diabetes, there is a need for an assessment of glycaemic control weighted for the clinical risks of both hypoglycaemia and hyperglycaemia. We have developed a methodology to report the degree of risk which a glycaemic profile represents. Fifty diabetes professionals assigned risk values to a range of 40 blood glucose concentrations. Their responses were summarised and a generic function of glycaemic risk was derived. This function was applied to patient glucose profiles to generate an integrated risk score termed the Glycaemic Risk Assessment Diabetes Equation (GRADE). The GRADE score was then reported by use of the mean value and the relative percent contribution to the weighted risk score from the hypoglycaemic, euglycaemic, hyperglycaemic range, respectively, e.g. GRADE (hypoglycaemia%, euglycaemia%, hyperglycaemia%). The GRADE scores of indicative glucose profiles were as follows: continuous glucose monitoring profile non-diabetic subjects GRADE = 1.1, Type 1 diabetes continuous glucose monitoring GRADE = 8.09 (20%, 8%, 72%), Type 2 diabetes home blood glucose monitoring GRADE = 9.97 (2%, 7%, 91%). The GRADE score of a glucose profile summarises the degree of risk associated with a glucose profile. Values < 5 correspond to euglycaemia. The GRADE score is simple to generate from any blood glucose profile and can be used as an adjunct to HbA1c to report the degree of risk associated with glycaemic variability.

Preconception care of women attending adult general diabetes clinics—Are we doing enough?

Background The presence of diabetes in pregnancy can result in substantial morbidity to both mother and baby if management is sub-optimal. Aims To assess the process of standards of preconception care (against the National Service Framework standards) of women attending the adult general diabetes clinics in a district general hospital. Methods Retrospective review of case notes of women aged 18–40 years attending the general diabetes clinics for annual review, over a period of 6 months. Results Seventy sets of notes were reviewed. The mean age of the patients was 32 years. Fifty-six patients had type-1 diabetes and 14 patients had type-2 diabetes. Mean duration of diabetes was 13 years. Eighty-six percent of the patients had blood pressure recordings documented. Mean blood pressure was 124/74 mmHg. Mean HbA1c was 9.1%. Documented evidence of home blood glucose monitoring was seen in 66% of the patients. Preconception counselling/contraception were discussed in 17 patients (25%). Twenty-nine patients (41%) were on potentially teratogenic medications. Alcohol and smoking history was not documented in 91% and 61% of the patients, respectively. Conclusions This retrospective assessment highlights that reproductive issues in an at risk population of women with diabetes are not included in routine management of diabetes care in outpatient clinics.

Young adults with Type 1 diabetes in tertiary education: do students receive adequate specialist care?

To examine the clinical characteristics of, and diabetes management provided for, young people with Type 1 diabetes in tertiary education. The medical case records of a group of 55 students aged 18-24 years, all of whom had Type 1 diabetes and had been referred to a hospital diabetes clinic, were examined. A mean (SD) attendance of 80% (28%) was observed for all clinic appointments. Despite greater use of intensified insulin therapy (increasing from 37% to 83%) of students neither mean HbA1c nor mean body mass index changed significantly. Microvascular complications were infrequent. Documentation in the case notes of the frequency of home blood glucose monitoring was inadequate in 25% of patients as was the recorded frequency of mild (self-treated) hypoglycaemia in (20%) of patients. Despite a satisfactory frequency of clinic attendance and organisation of insulin regimens by medical staff, glycaemic control remained unchanged throughout University attendance. The inadequate documentation of dietary habits, frequency of home blood glucose monitoring, hypoglycaemia, social habits and activities in both groups may provide a partial explanation, as other variables were not addressed. Young adults with Type 1 diabetes may benefit from receiving specialist care in a clinic dedicated to their particular needs.