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A retrospective analysis of prospectively collected database of blood sugar downloads from SMART metres and near patient A1C tests. Strategy for change Change was implemented through education with MDT approach. Families were supported through the process of changing metres and offered open access to MDT. Measurement of improvement The effect of the planned changes were measured by patient confidence in self-management, glycaemic control, Variability of blood sugars versus A1C levels and need for hospital admissions.Better understanding amongst the patients of their own control led to the patient empowerment in a friendlier home environment.Mean A1C for 100 downloads was 61.67 mmol/mol (9.8 mmol/L) that was comparable to a mean blood sugar of 9.6 mmol/L with a mean standard deviation of 4.7. However this correlation changed when the data was stratified based on Standard deviation (SD).1. SD <2: mean A1C was 45.7 mmol/mol (7.6 mmol/L) compared to average mean blood sugar 5.53 mmol/L. 2. SD 2-4: co-related to mean A1C 53.9 mmol/mol (8.7 mmol/ L) to average mean blood sugar 7.9 mmol/L. 3. SD >4: mean A1C 63.4 mmol/mol (10 mmol/L) and average mean blood sugars-9.97 mmol/L were exactly same. 4. SD >6: mean A1C of 73.89 mmol/mol (11.6 mmol/L) compared to average mean blood sugar of 12.4 mmol/L.Admissions due to DKA and hypoglycaemia decreased by half. Effects of changes Better control closer to home improving patient experience and quality of life at reduced heath care cost. There was initial hesitation around new metre and tight targets which was overcome by education, close supervision and reflection. Lessons learnt SMART metre download review is a good way of analysing blood sugars targets, variability and control over a period of time.They are better predictors of glycaemic control It has its advantages in empowering patients at the comfort of their own homes. Message for others SMART metres have taken paediatric diabetes management closer to home.Mean blood sugars are a better indicator of glycaemic control and variability when the standard deviation is between 0-4. G557(P) ABSTRACT WITHDRAWN

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