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

Entries Tagged as 'Testing'

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Automatically Upload Your Glucose Levels

December 13th, 2011 · 1 Comment

The future of blood glucose software will arrive in less than two weeks. I have seen the future and it works.

Until now, all the computer programs for logging our blood glucose numbers were incomplete. Still, for the past 15 years I have tried to include all those programs in my directory of Diabetes Management Software.

The biggest lack is their general inability to automatically upload the blood glucose readings from our meters. Except for a few proprietary and often expensive programs that work only with one meter, we have had to manually enter our numbers.

No more.

The future is Glooko, and it works with six of the leading meters from three of the four meter market leaders. It works with LifeScan’s OneTouch UltraMini, OneTouch Ultra2, and OneTouch UltraLink; with Bayer’s Contour; and with Abbott’s FreeStyle Freedom Lite and FreeStyle Lite.

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Testing Coumadin at Home

December 7th, 2011 · 3 Comments

Most people think that the big advantage of being able to test their Coumadin levels at home would be the convenience of not having to get tested at a clinic every month. But in fact the big advantage is the more information and therefore greater control you would get from weekly testing at home.

Few people are getting those levels tested at home yet. Before my wife died four and one-half years ago we tried in vain to get medical insurance coverage for that home testing. She had had to take Coumadin for atrial fibrillation, which was probably one of the complications that she had from her diabetes.

Medicare started covering home testing for people who had mechanical heart valves in 2001. But it wasn’t until 2008, a year after Catherine died, that they started covering that testing for chronic atrial fibrillation and deep vein thrombosis.

If you have Medicare the cost is minimal. Medicare covers 80 percent of the cost, and if you have a secondary supplement, it picks up the rest, $26 per month.

The cost is for renting the testing device and buying the test strips. For the weekly testing you need four test strips per month, but you get two extras to use if you have a problem with them.

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Direct Access to Lab Results

November 10th, 2011 · 2 Comments

The Medicine 2.0 conference that I attended at Stanford University for the past three days was largely about the intelligent use of technology and the future of medicine. But we also got some good news.

The U.S. Department of Health and Human Services just published a proposed rule in the Federal Register that would allow us to get our laboratory test results directly from the lab.

Alan Greene, M.D., the moderator of a panel on “The Networked Patient,” announced the news at the conference. Dr. Greene created the first physician website, Dr. Greene’s Housecalls, in 1995.

Right now very few states give us direct access to our lab results. If and when the HHS proposal goes into effect, most of us will get a new right. The proposed rule is online and is subject to a 60-day comment period.

Dr. Greene would have liked to have more, he said. If and when the rule goes into effect, we will get our lab results when we ask for them — not automatically.

But I see the proposed rule as a glass at least half full. It’s in line with the trend giving us more control over our own healthcare.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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CGMS Reduces A1C

October 31st, 2011 · No Comments

CGMS is short for continuous glucose monitoring system. If you want to know all the time what your blood glucose level is, wearing one of these devices is the only way to go.

But few people with type 2 diabetes ever use one. This might change now that a diabetologist lets all of his patients use them.

Simply wearing a CGMS improves their blood glucose level as much as taking most diabetes medications. It changes our behavior when we know what the food we eat and the exercise we get does to our level.

This is a breakthrough in diabetes control. I learned about it from the diabetologist who uses it in his practice. And I met him because of networking.

For the past three days I have been participating in Medicine 2.0, which the organizers describe as a conference on “social media in medicine and next generation medicine.”

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Why We Check Our Blood

April 18th, 2011 · 2 Comments

With all the emphasis on how we check our blood glucose levels using all the new meters that we can choose from, many of us who have type 2 diabetes forget or never learned why we check our levels. Anyone who has type 1 diabetes has to know why he or she checks as do those type 2s who uses insulin. Those of us who inject insulin check their levels so they can take more if their levels are too high or take a glucose tab or something similar if they are too low.But three-fourths of all type 2s don’t take insulin. Some of them still use the first oral medication, one of the sulfonylureas that can cause hypos, a level below about 70 mg/dl. Then they too will need to take something like a glucose tab to bring their level back to normal.

The overwhelming majority of all people who have diabetes rarely if ever get hypos. So why should they go through the trouble of checking their blood glucose? What can they do with that information?

If our doctors and nurses ever told us why, most of us have forgotten by now. As a result, a lot of people with diabetes don’t bother at all any more with blood glucose checks.

That’s a shame, because even people who don’t use insulin or one of the sulfonylureas, can benefit from checking if they do it at the right time.

The most right time is after eating a big meal, especially one that has a substantial amount of starch in it. Nothing raises our blood glucose level as much and as fast as starch — the stuff in potatoes and grains and grain products, like bread, bagels, pizza, or anything made from wheat flour.

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Which Blood for Checking Glucose

April 5th, 2011 · 2 Comments

The blood that we need to use to check our blood glucose levels may seem obvious. After all, it’s a check, not a test to pass or fail. We need to use our own blood, not blood borrowed from a friend or foe.

But until now some basic questions about blood glucose testing haven’t had a tested answer. They do now with the publication of a study in this month’s issue of Diabetes Care, a professional journal of the American Diabetes Association.

The abstract of the study, “Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood” is free online. My friend Dr. Bill Quick, who also writes about diabetes for HealthCentral, sent me the full text of the study.

The seven Dutch diabetes professionals who researched basic questions about blood glucose testing recruited 123 people with diabetes. They checked the variability of their blood glucose testing results in four different situations:

1. When they did or did not wash their hands

2. After they handled fruit (specifically apples or bananas)

3. After washing their fingers that had touched the fruit

4. And two different amounts of pressure applied to their fingers — squeezing

Their conclusions were simple and straightforward. But now for the first time we have them based on the actual experience of real people who have diabetes:

1. We don’t have to waste a drop of blood to use a second drop — but only if we wash our hands first.

2. But when we aren’t in a position to wash our hands and they aren’t particularly dirty or exposed to something that has sugar in it, testing with a second drop of blood will work.

3. Which finger we use doesn’t matter.

4. When we apply heavy pressure — meaning squeezing a lot — we can get unreliable results.

“The first choice is to wash the hands with soap and water, dry them, and use the first drop of blood,” the authors wrote. “Firm squeezing of the finger should be avoided.” The authors admitted that they had a hard time defining the difference between firm and light squeezing.

Strangely, the study did not look at the old recommendation that we should use alcohol to clean our fingers. Maybe they read my review of the Clever Chek meter, which I wrote here in November 2007. I hope that I disposed of the myth that it’s better not to use alcohol.

“The [Clever Chek] packaging includes a box of ‘Alcohol Prep Pads,’” I wrote then. But, “Any alcohol on the skin may interfere with your test result, so the experts don’t recommend that you use alcohol prep pads routinely. Only where you don’t have warm water is it a good idea to use alcohol to clean the test area. And be sure to air dry it well before testing.”

Now, let’s all go and test our blood glucose with confidence that we know what we are doing.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Testing Both Blood Glucose and Blood Pressure at Home

March 20th, 2011 · 10 Comments

Since three-fourths of those of us who have diabetes also have high blood pressure, a combined blood glucose and blood pressure monitoring device makes a lot of sense. Years ago I reviewed basic devices here, but now we have the
chance to use something that seems to approach the sophistication of the devices that nurses regularly use in doctors’ offices. And is probably even better.

The Fora D20 has a regular arm cuff attached to the device that measures either our BG or our BP. This gives me more confidence than the basic devices that previously were all that we had for monitoring our blood pressure at home.

I don’t automatically assume that doctors and their nurses can take better care of our medical needs than we can ourselves. Clearly, we have a greater interest in our own health.

But with blood pressure testing even more considerations come into play. We can do it better at home.

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Integrated Testing

February 12th, 2011 · 2 Comments

The experts on the blood glucose meters that we rely on tell me not to hold my breath while waiting for painless, or non-invasive, devices. The GlucoWatch, sold as the first and only non-invasive meter, came and went several years ago. Nothing similar is coming in the foreseeable future.But new and better meters appear all the time. And a whole new concept is on the immediate horizon.

This concept is a completely integrated testing device. That means the device contains not only the blood glucose meter but also test strips and a lancet.

I think that this big step forward to easier and more discreet testing is right around the corner. In fact, if you live in Europe, you can get it right now.

Mendor is a small Finnish company headquartered in Helsinki. It calls its integrated system the Mendor Discreet. It has CE status for sale in the EU, but U.S. approval is awaiting FDA action on the company’s 501(k) clearance request.

Meanwhile, Mendor CEO and co-founder Kristian Ranta was kind enough to send me a Mendor Discreet in advance of its release here. I have one in my hands as I write — which isn’t easy since I generally type with all 10 of my fingers.

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Meters for Christmas

January 26th, 2011 · No Comments

If Santa gave you a new blood glucose meter for Christmas, my guess is that you didn’t get what you wanted. But I’m sure that you got what you needed.

In all the history of diabetes only two developments stand out for giving us control. The first was the discovery of insulin in the early 1920s, and the second was the invention of the blood glucose meter in the late 1960s.

An endocrinologist once told me that we need to get a new blood glucose meter every year. His thinking was that they can wear out or get damaged out of alignment when they fall on the floor. Perhaps an even better argument is that every year new and better meters come our way.

A case is point is the Fora V12 blood glucose monitoring system. Made by Fora Care Inc. of Newbury Park, California, and sold by MedPoint Advantage in Birmingham, Alabama, this reasonably priced little meter has the latest bells and whistles.

Requiring no coding — not having to match a number on a vial of test strips to a number on the meter — the Fora V12 makes testing easy. And easier yet is that you don’t even have to look at the meter because it will talk to you in either English or Spanish, at your choice. It also gives you a quick result in seven seconds and takes a tiny blood sample of only 0.7 microliters.

One thoughtful little touch that I appreciate is that the Fora V12 takes two AAA batteries rather than the usual lithium ones. While bigger, AAA batteries are easier to find in our stores when you need replacements.

MedPoint Advantage is the exclusive national distributor for the Fora V12, says Chief Operating Officer Lee Stallings. Their phone number in Birmingham is (866) 563-3764.

The Fora V12 sells for $29.99. A box of 50 blood glucose test strips sells for $28.99. Or you can save by getting a box of 100 for $53.98, a box of 150 for $80.97, or a box of 200 for $107.96.

We all need to think about getting a new meter each year. Christmas is a good time for such presents. Now, tell me please, did you get a new blood glucose meter from a loved one? I hope that you had such good luck.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Comparing Meter Accuracy

January 14th, 2011 · 24 Comments

Anyone who has been trying to control his or her diabetes for more than a few days often gets disappointed with checking blood glucose levels. Our disappointment is sometimes not how high those levels go but how erratic our meters and test strips seem to be behaving.

Meter accuracy is a pain — an emotional pain that can be more than the physical pain of lancing. Just which meter systems are accuracy?

That’s probably the question that people newly diagnosed with diabetes ask me the most. And now for the first time we have the beginning of an answer.

In my 15 years of following diabetes developments I haven’t seen a single scientific comparison of the blood glucose meters that we have to work with. Until now.
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