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

Entries Tagged as 'Diabetes Testing'

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 was originally published on Health Central.

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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 was originally published on Health Central.

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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 was originally published on Health Central.

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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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Tiny tiniBoy Lancets

September 14th, 2010 · 2 Comments

Even though Dr. Stanley Kim isn’t a diabetes specialist, he had plenty of motivation to invent the thinnest and shortest lancets ever. Dr. Kim is a hematologist and oncologist who is a member of the board of trustees of San Antonio Community Hospital in Upland, California, and president-elect of the hospital’s medical staff.


Stanley Kim, M.D.

The story started, he told me, about three years ago when he learned that he had type 2 diabetes. “The lancets that I used hurt too much for me,” he said. “I resisted whenever I had to check my blood glucose and knew that something wasn’t right.”

The story continued when he went to the hospital’s pediatrics and neonatal departments. “The lancets that they used were pretty thick, and the babies would cry. You could tell that the babies were suffering. So I thought that I could make a very thin and short lancet that wouldn’t hurt as much.”

Like firefighters who rescue people out of burning houses, this was something that he had to do. “This was my  motivation.”

Like most people, I learned about Dr. Kim’s lancets by word of mouth. A correspondent named Ashique Iqbal recently brought them to my attention. Dr. Kim has actually been marketing them since late October of last year, he told me.

“I never advertised them,” he continued. He did go to the Children with Diabetes Friends for Lifeconvention in late  June and early July 2010 at Disney World. “We tested 200 to 300 children, and they all said it was wonderful. It is now being sold mostly for children.

Dr. Kim calls his tiny lancets “tiniBoy” and says that although the tiniBoy lancet is very beneficial for diabetic kids and  babies, it still works well for adults like me, as I also do not like pain.

He currently markets then through the tiniboy.comwebsite and Amazon. A box of 100 lancets goes for $9.95, and Dr. Kim tells me that he is working to broaden his outreach through Medicare and private insurance. “We would like to be able to provide tiniBoy lancets for whatever the insurance would pay.”


Comparative Lancet Sizes

The tiniBoy lancets are compatible with most of the current lancing devices. The exceptions, Dr. Kim tells me, are the Accu-Chek Multiclix and Softclix devices.

Dr. Kim’s technical review of the tiniBoy lancets appears in the January  28, 2010, issue of Clinical Medicine Insights: Endocrinology  and Diabetes. You can read the abstract online at “A Pain-free Lancet  with a Small Needle for Glucose Measurement.”

But perhaps even more persuasive are the positive comments by people with diabetes who have purchased tiniBoy lancets from Amazon. My guess is that you have as much motivation to switch to these tiny lancets as the Amazon reviewers and Dr. Kim had.

This is a mirror of one of my articles that was originally published on Health Central.

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A New Talking Meter

September 14th, 2010 · 6 Comments

At least 38 companies now offer us meters that we can use to test our blood. I list and link them in my web page “Blood Glucose Meters,” Part 14 of the On-line Diabetes Resources.

Almost all of those 38 companies sell their meters in the U.S., and most of them have several different meters for sale here. So why would we ever need a new one?

For one thing, meters are getting better. While they still aren’t good enough, higher standards of accuracy and precision may be coming soon, as I wrote here a year ago.

Instead, meter manufacturers focus on adding features. Many of these features are just nice bells and whistles. But one feature is essential for some of us.

Since loss of vision is all too common a complication of diabetes, many of us need a blood glucose meter that will talk to us. Not only people who are totally blind but the much larger number of us who have limited vision need a meter that they can listen to rather than look at.

Actually, we have had talking meters for many years. Diagnostic Devices in Charlotte, North Carolina, has offered two different Prodigy meters for at least five years, as I indicate on my “Blood Glucose Meters” web page. Diabetic Supply of Suncoast in Vega Baja, Puerto Rico, offers two different versions of the Advocate blood glucose meters that talk. Last year Omnis Health in Natick, Massachusetts, became the third company to currently offer a talking meter, the Embrace Blood Glucose Monitoring System.

And now here is BioSense Medical Devices in Duluth, Georgia, with another talking meter, the Solo V2. We all the choices already available, does anyone need the new meter?


The Solo V2 Talking Meter [Read more →]
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