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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Diabetes Testing'

Why Your Blood Glucose Meter Isn’t Accurate

November 30th, 2015 · 10 Comments

The most important tool for most of us who have diabetes is our blood glucose meter. But usually we have no idea how inaccurate they are.

In the United States the organization responsible for setting the standards for meter accuracy is the Food and Drug Administration. This is one of the FDA’s most important roles for people with diabetes because if our blood glucose gets too low we can fall into a coma, and if it goes to high we are more likely to get one or more of the awful complications of uncontrolled diabetes.

But few of us know what the standards are, judging from the messages that people with diabetes send me and what I read on the Internet. For years I have been writing about the need for our meters to be more accurate, but as I explored this key topic in depth I got more and more confused and told my friend Bennet Dunlap that.

see saw

Used with permission of DiabetesMine.com

“The more confused you are the more you understand status quo,” he replied. Bennet is perhaps our leading diabetes advocate and has addressed the FDA directly on this issue. Bennet created Strip Safely and together with another diabetes patient advocate, Christel Marchand Aprigliano, co-founded the Diabetes Patient Advocacy Coalition.

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Should You Use the Control Solution to Check Your Meter?

November 27th, 2015 · 7 Comments

You probably never use the control solution for your blood glucose meter. You can blame your doctor or yourself for this oversight, but the chances are that you never have heard this term before.

sugar solution

Our doctors and other medical professionals rarely discuss using a control solution. It usually doesn’t come with our blood glucose meters. And your local drug store probably doesn’t carry the one that your meter uses.

But the U.S. Food and Drug Administration, the International Organization for Standardization (ISO),  and the American Diabetes Association all recommend that we often check our meter with its control solution.  Probably every owner’s manual for all of the blood glucose meters on the market has the same message. Something is seriously out of whack here.

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The Three Ways to Diagnose Diabetes

November 25th, 2015 · 12 Comments

For years the usual way that we got diagnosed with diabetes was a fasting plasma glucose test. But there are two other ways that we get the news now.

The newest way is when a doctor told us the results of a glycosylated hemoglobin test, which we usually call simply an A1C test. While a few of us learned that we have diabetes after we had an oral glucose tolerance test, that has always been the least common diagnostic tool for diabetes.

diabetes

The blue circle is the universal symbol for diabetes

The quickest and easiest is clearly the A1C test. But it has several limitations on its accuracy. In fact, none of these three ways that our doctors diagnose diabetes is perfect.

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Blood Glucose Meters from Roche Rank Highest in Survey

November 14th, 2015 · 14 Comments

Of the four companies that dominate the blood glucose meter business in the United States, we are happiest with Roche Diagnostics, according to a new scientific survey. Number two was Abbott Laboratories, third was Bayer, and pulling up last was LifeScan.

meter study

But two of the particular meters that LifeScan makes rank among the three favorite meters. Those few people in the survey who use the OneTouch UltraLink or the OneTouch Vario liked it a lot as did the small sample size of people who rated Bayer’s Contour Next Link.

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Is a Lower A1C Level Better or Worse?

November 13th, 2015 · 14 Comments

It seems logical that the lower our blood glucose levels are the better we will be. Most of us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In fact, during the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health.

glucose meter

But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped.

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Use this Device if Needles Frighten You

October 18th, 2015 · 8 Comments

Does your fear of needles makes it difficult or impossible for you to manage your diabetes? Do you have a child who is afraid of them? Many of us have this fear, but we now have a way to cope with it.

All of us who have diabetes need to draw blood regularly with lancets for our blood glucose meters and for A1C testing. Everyone who has type 1 diabetes and about one-fourth of people with type 2 need to inject insulin at least once a day. A growing proportion of us are injecting GLP-1 analogues like Bydureon and Victoza to help keep blood glucose levels in check.

But many adults and even more children don’t do this often enough because of pain. As a result, they needlessly suffer.

insulin

Now, an inexpensive device called the Buzzy can block that pain. Some hospitals are already using it, and you can buy one without a prescription to use anywhere.

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Check Your Blood Sugar Without Pain

September 16th, 2015 · 2 Comments

Unless we have a complication of uncontrolled diabetes, it’s not painful. But checking our blood sugar level sure can hurt. Some people don’t even check their blood sugar because they have needle phobia.

Injecting insulin or one of the incretin mimetics (like Byetta, Victoza, or Bydureon) rarely hurts, as I know from my own experience with Byetta. Diabetes can of course lead to painful complications, but by tightly managing our sugar control we are almost certain to avoid them.

Lancets and the lancing devices that hold lancets can cause pain. But they don’t have to.

lancet

I’m still amazed that we put so much emphasis on the meters that check our blood sugar while seldom giving a second thought to our lancets. This is where the rubber meets the road. Over the years I’ve seen lots of comparison of our meters, but not a single one comparing lancets.

Until now.

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The Myth of the Weekly Weigh In

August 9th, 2015 · 4 Comments

It’s a myth. Did you really believe that you could manage your weight better when you step on the scales just once a week instead of every morning?

It’s a sad fact that most of the so-called experts tell us that it’s a mistake to weigh daily. “In most instances, weighing yourself every day is unnecessary and unhealthy,” is supposedly one of the “10 Common Mistakes” we make about weighing ourselves. Actually, suggesting that weighing daily is a mistake is itself one of the most common mistakes you can read about and hear.

Girl with a pearl earring

When I learned I have type 2 diabetes, my doctors and nurses told me to weigh myself once a week because the inevitable daily fluctuations would discourage my weight loss efforts. They probably told you the same thing. They were ignoring two small studies “Charting of daily weight pattern” and “The efficacy of a daily self-weighing.” But they can’t ignore a large, new study that shows that daily weighing helps us take off the pounds and keep it off.

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Reducing Pain with Better Lancets

July 13th, 2015 · 9 Comments

By
Dr. Christopher Jacobs Ph.D.,
Biomedical Engineering
CEO, Genteel LLC

Transparency

Genteel LLC neither makes nor markets lancets; however, the company does manufacture and sell a vacuum-assisted lancet holder (poker), so it is in the company’s best interest for its customers to use the best possible lancet. Genteel undertook this study so its customers would have a better lancing experience; however, because Genteel uses regular square shaft lancets, it follows that what makes a lancet optimum with Genteel will, in almost every case, ensure it also works best regardless of which poker a person chooses. It is Genteel’s hope that use of a better lancet, which will lower pain and increase blood draw consistency, will encourage users to test more often, because the proper lancet will significantly decrease the discomfort and pain.

Figure 1: Genteel LLC engineer doing close-up examination of lancets to be rated

Figure 1: Genteel LLC engineer doing close-up examination of lancets to be rated

Background

At Genteel’s laboratory, we performed a “Consumer Report” type study on many brands and models of lancets, commonly referred to as “square shaft.” These are the most popular individual lancets, found worldwide(see Figure 2). If the shaft is viewed horizontally, as an arrow would fly, the base would appear to be square, with no flanges or rings. Genteel purchased and tested thousands of these, and after examination, found the need for considerably more reliable engineering and production quality control to make a really good lancet. There was sufficient difference found between brands and models such that the user could have a noticeably improved lancing experience just by changing to a better brand and model. While this study was undertaken on square shafts lancets, the knowledge gained could apply to many other types.

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Diabetes Testing Is Useless

April 17th, 2015 · 25 Comments

Unless people with diabetes are taking insulin, they waste their time and money when they test their blood sugar.

meter

I agree with the conclusions of a review from the Cochrane Collaboration, the most respected group that reviews scientific studies. The review concluded that among people who have had type 2 diabetes for more than one year and aren’t using insulin the effect of testing “is small.” And when they have diabetes longer it makes even less difference. Even worse: no evidence shows that testing “affects patient satisfaction, general well-being, or general health-related quality of life.”

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