The ideal computer program for diabetes management would let you easily import your blood glucose readings from your meter and provide clear graphs showing how you are doing. It would let you enter how much insulin and oral medications you take. It would contain a database of all foods from which you could enter what you actually ate.

The ideal program doesn't exist.

The program would relate all of these factors so you could see at a glance what causes your blood glucose to go high or stay in the normal range. Even better, it would also include exercise, stress, illness, and weight—the other factors that affect blood glucose levels.

The ideal diabetes management program doesn't exist. While one program or another has some of these features, none have them all.

All programs will log your data on a sort of spreadsheet. But it's easier to do that with a word processing program. The key to usefulness is graphing, because a graph shows trends more clearly than a table.

Strangely, we haven't found any program that a survey of a diabetes mailing list members ranked as the most desired software feature, although one program to be reviewed next month comes close. The number one request from the members of the mailing list was for a program that would let you graph blood glucose levels segregated by events like fasting, after breakfast, or after exercise. The fact that you can't is especially strange, because the best selling meters let you to enter these event codes and some programs show them in the log.

Many Programs
To identify the programs to review we screened all the programs for diabetes management. From the 66 programs we found (see the Web page "On-line Diabetes Resources, Part 13: Software" at www.mendosa.com/software.htm ), we selected the commercial programs for Windows, the operating system used today by more than 90 percent of computer systems.

We tested all programs on Windows 98 running on a 400 MHz Pentium II processor with

128 Megs of RAM. We also tested most programs on Windows 95 running on a 100 MHz Pentium with 48 Megs of RAM.

The most ambitious programs are those that support input from more than one brand of meter. Only five commercial Windows programs do that.

All of the programs reviewed here support at least one LifeScan meter. There are good reasons why this brand gets more support than any other – market share and cabling.

LifeScan meters dominate the market, according to data from the Frost & Sullivan market research firm in Mountain View, California. Research Analyst Joon Kim says that LifeScan has 40 to 45 percent of the meter market, followed by Boehringer Mannheim (Roche) with 20 to 25 percent, Bayer with 10 to 15 percent, and MediSense with 10 to 15 percent. All the others together have no more than 20 percent.

The cable for the two LifeScan meters that will let you download your results to a computer is a simple one that LifeScan sells for $5 for shipping. The new Bayer cable is also a simple one, but no price has been set for it yet.

By comparison, MediSense's Precision and Boehringer Mannheim's (Roche's) Accu-Chek cable connections seem unnecessarily complicated. The Precision connection consists of an AC power adapter, a communications box, two communications cables, and an optional 9/25 pin adapter. It is also expensive. You cannot buy it separately from MediSense's Precision Link software, which sells for $139. The Accu-Chek connection has a battery operated interface cable box, a computer connector cable, and a choice of two meter interface cables. Boehringer Mannheim sells this cable kit for all five of its downloading meters for $39.95.

Meters
Eleven companies currently market a total of 30 blood glucose meters in the United States (see the Web page "On-line Diabetes Resources, Part 14: Blood Glucose Meters" at www.mendosa.com/meters.htm ). But only 12 of these have a data port:

• Bayer's Glucometer Dex and Glucometer Elite XL
• Boehringer Mannheim's Accu-Chek Complete, Accu-Chek Advantage, Accu-Chek Instant DM, and Accu-Chek Easy
• Cascade Medical's Checkmate Plus
• Chronimed's Assure
• LifeScan's One Touch Profile and One Touch II
• MediSense's Precision Q.I.D. and Precision Q.I.D. Pen Sensor

Diab-Trends Monitor
Perhaps the best of the programs that support multiple meter brands is Diab-Trends Monitor (Diabass). This program, developed in Germany and marketed by a foundation in Switzerland, has the basics and they work satisfactorily. The screens are clean and uncluttered, and the program works intuitively. It has the best graphing capability of any of these five programs.

Generally, the major problem was that some of its European features have not been properly converted. The English can be colorful and German remains in many places.

Diabetes Partner PC
Diabetes Partner PC was a frustrating program to test. It successfully imported records from a One Touch Profile and One Touch II meter. But to do so required two reinstallations of the program, which nevertheless caused repeated general protection faults and reports that different Diabetes Partner PC files had been corrupted. The method of importing data was unintuitive and nowhere documented, requiring clicking on unlabeled parts of the screen. The program failed to import records from a Precision Q.I.D. meter, causing a general protection fault instead.

Diabetes Tracker
Diabetes Tracker crashed repeatedly. It is not a finished program.

Its documentation says it will import data from Bayer's Elite, Boehringer Mannheim's Accu-Check [sic] (type not specified), LifeScan's One Touch Profile and One Touch II, and Medisense's Precision Q.I.D. meters. This statement would be laughable in a freeware program, but is unforgivable for commercial software.

The Elite meter does not have a data port and therefore cannot export data to any program. All attempts to import data from an Accu-Chek Advantage meter and a Precision Q.I.D. meter that worked with other programs failed with Diabetes Tracker, which reported that it was an "unsupported meter type." It did import readings from a One Touch Profile, but many of them were missing from the charts. It reported that it imported data from a One Touch II, but none of the readings were ever available.

HealthDesk Online For Diabetes
HealthDesk Corporation has big plans for HealthDesk Online for Diabetes, but the current version of the program is definitely not ready for prime time. It has major deficiencies that rule it out as a serious contender. It crashed repeatedly and had to be reinstalled once.

It lacks any graphing capability. While it imports data from a variety of meters, data entered into the meter before the program was set up is not available for analysis. The company says that a future version of the program will have graphing capability, a food database expanded from 14,000 to 18,000 items, and will be totally Web based.

Mellitus Manager
Mellitus Manager crashed several times during testing. It is complicated and not intuitive. It successfully imported data from the Precision Q.I.D., One Touch Profile, and Accu-Chek Advantage. It failed to import data from the Accu-Chek Complete, even though the same cabling imported successfully into Accu-Chek's proprietary program, Accutility (to be reviewed next month). This is the first software program to download data from a MiniMed pump (not tested).

The program will accept only one entry per time period, e.g. before breakfast, even if you code all of them with your One Touch Profile as fasting readings. The second reading will be bumped to a later time period.

Summary

COMMERCIAL WINDOWS PROGRAMS SUPPORTING MULTIPLE METERS

This article originally appeared in Diabetes Wellness Letter, March 1999, pages 4-6.

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