Challenges for measurement science and measurement practice: the collection and interpretation of home-monitored blood glucose data

In insulin-dependent diabetes mellitus, home monitoring of blood glucose was a major breakthrough in the empowerment of patients and for the first time provided raw data of sufficient accuracy from which to infer insulin therapy adjustments. Typically recorded on paper, such data are often illegible, lack details of measurement times and insulin doses and omit contextual information on diet, behaviour and general health. Home meter technology is offering improved access to patient data and allowing a more flexible range of variables to be recorded. Psychometric questionnaires give a broader view of individual and patient group perceptions of the disease and its treatment. This paper reports on early studies of home data collection using the Accutrend DM meter and the Diabetes Quality of Life and Treatment Satisfaction Questionnaires. It also describes a prototype computer system for interpreting data collected with such meters and advising on insulin dosage adjustment, based primarily on principles of time series analysis together with mathematical models of insulin profiles and search algorithms.