CLINICAL TIP: Make blood sugar monitoring a family affair

April 1, 2005

A major difficulty we all face in diabetes management is gettingadolescents to keep records of their blood sugar level. Mostteenagers with type 1 diabetes check their blood sugars but do notkeep a log, so they are not able to make the best use of the data tomonitor and adjust insulin doses. I use an approach I call “patternidentification family time” to address this problem.

I ask my adolescent patients with diabetes to check blood sugarsregularly but record the level only once a week-either download itfrom the monitor or write it down. The teenager then spends fiveminutes discussing the blood sugar level with both parents, or atleast the primary care provider. They talk about any patterns, goodor bad, that they notice in current and recent readings and try tounderstand trends. I encourage the family to focus criticism on thenumbers, not the teenager. This approach promotes activediscussion of blood sugar patterns without putting the adolescenton the spot.

Most teenagers in my practice have responded positively to thisapproach. I have seen a striking change in their views of diabetescare and marked improvement in their hemoglobin A1c levels. Thesame approach can be used for any chronic illness in whichmanagement requires some task on a routine basis that the childtends to forget to do.

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