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

Making Blood Glucose Testing Fun

June 16th, 2010 · 1 Comment

If you didn’t think that testing your blood glucose could be fun, you probably haven’t tried Bayer Diabetes Care’s new Didget blood glucose meter.

I hope that you aren’t as poor a speller as I am. If so, you might have thought that Bayer named its new meter for the word that we use to denote a finger or a number. Both meanings make sense when we use fingersticks to test the level of our blood. But most people spell that word “digit.”

The Didget is the first blood glucose meter that connects directly to the Nintendo DS and DS Lite gaming systems. Lots of American kids have an Nintendo, but unfortunately I’m not a kid, so I don’t.

Bayer just sent me at no charge their newest meter, which the U.S. Food and Drug Administration cleared for sale on March 12. Unaccountably, however, the company forgot to include an Nintendo, so I’m still not having any fun testing my blood.

Bayer’s New Didget Meter

But if you have an Nintendo in your home as well as a child with diabetes, this could be the way to go. It awards points that kids can use to unlock new game levels and customize their gaming experience.

Kids ages 4 to 14 are the target audience. The Didget comes with a full-length Nintendo adventure game, “Knock ‘Em Downs World’s Fair.” You can even use the Didget meter separately without using an Nintendo, if you don’t have one yet. My guess, however, is that this wouldn’t be as much fun. Soon it will also connect to Bayer’s Didget World, a password-protected Web community where kids can create their own page and spend points that they earn when they consistently monitor their levels.

The Didget meter uses Bayer’s Contour test strips and takes just 5-seconds and 0.6 microliters of blood. It is now available for purchase in the United States through CVS.com, Drugstore.com, and Walgreens.com. The suggested retail price is $74.99. If it gets your child to test his or her blood glucose more often, this is cheap fun.

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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Posted in: Diabetes Testing

Education Helps in A1C and Weight Control

May 28th, 2010 · No Comments

Your best help in reducing your A1C and your weight could be to work with a Certified Diabetes Educator and a nutritionist. That’s the implication of a study that Issac Sachmechi, M.D., presented at the annual meeting and clinical congress of the American Association of Clinical Endocrinologists in Boston today.

Health Central sent me to the meeting, where I interviewed Dr. Sachmechi this morning. He is clinical associate professor of medicine at Mount Sinai School of Medicine in New York City and Queens Hospital Center in Jamaica, New York.
Dr. Sachmechi presented his poster and abstract, “Impact of Diabetes Education on HbA1C and Weight Reduction at the meeting.” He told me that he designed the study and involved the chief resident and one of his colleagues. Certified Diabetes Educators and nutritionists provided the diabetes education.

Dr. Sachmechi Supports Diabetes Education

Don’t people with diabetes generally get diabetes education? “No,” Dr. Sachmechi replied. “In many areas of the country people with diabetes don’t get nutritional advice or see CDEs. The CDEs show them how to do home glucose monitoring, how to prevent hypoglycemia, the importance of exercise, and other things that are needed for the care of diabetes.”

But doesn’t it cost a lot of money? “I don’t think so,” Dr. Sachmechi replied. “Certainly, a session with a CDE costs less than a session with a physician!”

The study group of 150 people included people with type 2 diabetes who their primary care physician referred to two CDEs and a dietitian. A control group of 150 people with type 2 diabetes didn’t get to see either a CDE or a dietitian.

The researchers compared the A1C and weight of the study participants before and then six months after the study. A1c went down 1.02 percent in the study group but only 0.59 percent in the control group. The average weight went down 2 pounds in the study group but only 0.71 pounds in the control group.

“This is one of the few studies demonstrating a measurable improvement in diabetes control and weight loss solely due to diabetes education and diet counseling in a municipal hospital with limited resources,” Dr.Sachmechi concluded. Dr. Sachmechi’s study worked with people with diabetes who are largely uninsured and generally have poor health literacy. My conclusion is if diabetes education works there, it can work for you too.

Dr. Sachmechi tells me that he is now working on the impact of support groups on the impact of A1c and other measures of diabetes control. Do support groups help us? That’s what he hopes to find out, and I will let you know here the results of that study.

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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Posted in: Psychosocial

Don’t Let Hospitals Ruin Your Control

May 28th, 2010 · 4 Comments

When I had elective surgery a year and one-half ago and then when I had an emergency operation about six months ago, I told the hospital that I wanted them to provide me with a diabetes diet. Big mistake. They have no idea what a proper diabetes diet is.

At that time I had read the book by Richard K. Bernstein, M.D., Dr. Bernstein’s Diabetes Solution. But I hadn’t focused on his guide to hospitalization. You can be sure that if I have a chance, the next time a hospital tries to run my diabetes life, I will guide it with a letter to them like the one here.

This week he told me that I was free to reproduce that guide here. What happened was this.

One of the regular readers of my articles here sent me a copy of a letter that she had written protesting the awful treatment that she had received in a hospital in Wyoming and in another hospital in Colorado. She wanted to get the letter to Dr. Bernstein, who she and I both look to for guidance on controlling our diabetes.

When I passed on her letter to him, Dr. Bernstein was sympathetic. But he added that he gets even worse horror stories from other people who run into our American health care system.

“They all relate to the ignorance and lack of compassion of physicians and hospital personnel,” he said. “I asked my literary agent if we should transcribe them for a book. I was told that people don’t want to read depressing stories, and no publisher would be interested. If you think this kind of thing would serve a purpose on your blog, just post a request for stories about interactions with medical personnel and you’ll be overwhelmed.” [Read more →]

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Posted in: Psychosocial

The Trouble with Naps

May 28th, 2010 · No Comments

My most recent post here reviewed a new study indicating that resting after meals is hard on the pancreas, could lead to diabetes, and could make existing diabetes worse. This is an interesting hypothesis and one that you can check out yourself.

But one of my correspondents suggests that the results might be related to the fact that overweight people who overeat at a meal are more likely to lie down. “Edgy thin people probably jog instead,” she says.

That’s a good suggestion, and I’m not sure that the authors of the new study controlled for weight. But now comes a closely related study that indirectly offers support for the hypothesis that lying down after we eat isn’t a good idea.

People in China in the 50s and over who regularly take naps after a meal increase their risk of diabetes by 28 to 36 percent, according to a study just published in Sleep, the official publication of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The authors of the study are associated with universities and hospitals in China and the U.K.

Correlation, of course, doesn’t prove causality. It is suggestive and may be a good suggestion to follow, because the only downside is probably being a bit tired, which in fact could lead to a better night’s sleep. Anyway, a little jog after a meal will do a lot more to reduce blood glucose than lying down ever will.

The authors of the study that I review last week are in Kazakhstan and Ukraine, while the new study is China-based. Some of the most interesting research on diabetes now seems to be coming from countries that hadn’t been at the forefront of diabetes research. This Internet age seems to be leveling the playing field.

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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Posted in: Diabetes Diet

Testing the Tests of A1C

March 3rd, 2010 · 3 Comments

Bayer Diabetes Care’s A1CNow+ monitor for us to test our A1C level at home carries the highest certificate of accuracy. As I wrote here in June, the NGSP (formerly the National Glycohemoglobin Standardization Program) certified this device as having documented traceability to the Diabetes Control and Complications Trial reference method, which established relationships between A1C levels and risk for complications of diabetes. The DCCT method is the gold standard for reliable A1C testing.

So I was surprised to read an article in the journal Clinical Chemistry indicating that this was one of the A1C testing devices that didn’t meet “the general accepted analytical performance criteria.” Two Dutch researchers led by Erna Lenters-Westra reported that the local distributor in the Netherlands of the A1CNow+ Bayer “concluded that the EP-10 [protocol] outcome data did not warrant progression” to the two other protocols the study used.

But the key sentence — buried in the full-text of the study and missing from the online abstract — is this, “The bias found with the EP-10 protocol of the A1CNow was probably due to EDTA interference problems.”

I had to ask Bayer representatives what all this means. This is what the company told me:

“Bayer has reviewed the Lenters-Westra study published in Clinical Chemistry that used Bayer Diabetes Care’s A1CNow+® monitor as part of their evaluation,” the company wrote back. “Bayer believes that the results that the study authors obtained did not accurately capture the proven performance of the A1CNow+ device due to use outside the manufacturer’s specifications [emphasis added]. [Read more →]

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Posted in: Diabetes Testing

Glucocard Vital

March 3rd, 2010 · 5 Comments

For people with diabetes the so-called “vital signs” that health care people talk about have to include our blood glucose level. So I couldn’t think of a better name for a blood glucose meter than “Vital.”

Arkray in Edina, Minnesota, seems to agree. At least that’s what the call their new meter. You may not be familiar with Arkray, but it is the world’s fifth largest manufacturer of diabetes self-monitoring systems. This company calls their new meter the “Glucocard Vital.”

The U.S. Food and Drug Administration approved the Glucocard Vital in November. Arkray just ramped up production and sent me one of the first of these meters, the newest meter on the market.

Yesterday I put my Glucocard Vital through its paces. It performed perfectly for me. Since I test so many blood glucose meters, I like to use them before ever looking at the user instruction manual.

I just pulled out one of the test strips, inserted it in the meter, which then turned out automatically with the battery already in place. Even the date was already correctly set. Later, of course, I did read the manual to see if it contains anything of importance that I need to tell you about.


The Newest Blood Glucose Meter

[Read more →]

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Prescription Discount Card

March 3rd, 2010 · 6 Comments

A few days ago an Accu-Chek Aviva blood glucose meter arrived in my mail. The meter itself was nothing new. Three years ago when Roche Diabetes Care introduced the Aviva I wrote a glowing review of it, appropriately titled “Viva Aviva!

What is new is the smallest item in all those papers that accompany a new meter nowadays. It’s a wallet-sized card that Roche calls the Accu-Chek Connect.

This is one powerful little card! For some people it means that we don’t have to pay more than $15 for each prescription we get for Accu-Chek Aviva test strips.

The Front of the Discount Card

The Back of that Card

[Read more →]

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Posted in: Diabetes Testing

Limiting Test Strips

January 21st, 2010 · 4 Comments

Today people who have diabetes can be thankful that the United States doesn’t have a single-payer health care system. Based on two Canadian studies released today, most of us could face the prospect that our health insurance would soon cease to cover the cost of testing with blood glucose strips.

The studies both proposed that Canada could save money by cutting benefits to people with type 2 diabetes who are using drugs other than insulin. Last year 63 percent of people with diabetes in the province of Ontario who weren’t using insulin used on average 1.29 test strips per day. Although many of us would say that’s too little, one of the studies concluded that it’s too much.

The Canadian Medical Association Journal CMAJ on December 21 released these studies subject to revision. You can read the full-text of one study at “Blood glucose test strips: options to reduce usage.” The full-text of the other new study is at “Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin.”

Each article recognizes that those of us who inject insulin have to test regularly to avoid hypos, if for no other reason. All type 1s and about one-fourth of type 2s inject insulin. [Read more →]

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Good Drugs, Bad Drugs

January 21st, 2010 · 3 Comments

We know that the only person who can tell us what to eat and exercise is ourself. But most of us need a third leg of diabetes control — one or more of the prescription drugs — and we usually leave that decision up to our doctor.

Often this is a big mistake. Many of our doctors are too set in their ways. The problem is simply that doctors too are human.

Older doctors have practiced most of their lives with a Hobson’s choice of one oral diabetes drug. In 1957 the first sulfonylureas became available by prescription in the United States. Not until about 40 years later did the Food and Drug Administration approve a second diabetes drug, metformin.

Until we could get metformin, we did have the opportunity to take insulin instead of a sulfonylurea. And we had a lot of different sulfonylureas to choose from, making it appear that our choice was greater that it really was. Brand names include Amaryl, Glucotrol XL, Diaßeta, Glynase, Micronase, as well as Dymelor, Diabinese, Orinase, and Tolinase. Combination drugs like Metaglip, Glucovance, Avandaryl, and Duetact also are part sulfonylurea. [Read more →]

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Posted in: Diabetes Medication

“Food, Inc.”

December 22nd, 2009 · No Comments

American agriculture changed more in the past 50 years than it did in the previous 10,000 years since humans started cultivating grains and domesticating cattle, pigs, and poultry. This affects all Americans, but none more than those of us who have diabetes, which started its steep rise at about the same time that our farms became so much more efficient under the management of just a few huge multinational corporations.

This correlation certainly isn’t proof that modern agriculture caused the rise of diabetes. It remains, however, a likely suspect.

Neither can we fairly claim that the giant corporations that control most of American agriculture are the cause of anything more than being efficient. These companies are doing what companies are supposed to do — making a lot of money by doing what all companies try to do.


The root of the problem is our government. The federal government of the United States of America set the conditions under which the great consolidation of American agriculture took place. This is our “farm policy.”
[Read more →]

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Posted in: Diabetes Diet

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