Aims: Correct blood pressure measurements are decisive for appropriate diabetes management. The accuracy of blood pressure (BP) readings might be negatively influenced by systematic errors such as terminal digital preference (TDP). TDP describes an observer's tendency to record the measurements using certain digits. As TDP might interfere with diabetes treatment, we used the binational Diabetes databank DPV to study the rate of and factors contributing to TDP. Methods: A total of 580578 BP

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... ngs were documented in 286 participating centers, 494301 measurements from patients with type 1 and 86277 from patients with type 2. Results: Total TDP for the digits "0" and "5" was 55 ± 50% and more frequent in smaller centers, rehabilitation centers, in non academic and in outpatient centers. A lower rate for TDP was found in Pediatric centers and centers treating patients with type 1 diabetes, in Austrian and West German centers compared to East German centers. Within the last 14 years, TDP increased with age and declined in type 1diabetes, but not in type 2 diabetes centers. Levels of systolic BP were significantly lower in centers positive for TDP. Conclusions: TDP is common among German diabetes centers. Profound differences between centers depending on the type of diabetes and the regional differences were found. Pediatric centers appear to be less susceptible for TDP. As TDP might be associated with insufficient BP management BP readings need to be improved by training academic and non-academic employees and by using automated BP devices.