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I love new toys! Having diabetes
means I have an excuse to buy some new ones that I hadn't even considered
before. This page documents the blood glucose meters and software
that I've used and my excuses for trying new stuff.
I record my blood glucose level
immediately before and 2 hours after every meal using a LifeScan
Ultra meter. For meter reviews, see http://www.mendosa.com/meters.htm,
http://www.childrenwithdiabetes.com/d_0i_000.htm,
and the October 2001 issue of Consumer
Reports. Also see the FDA site on Glucose
Meters & Diabetes Management.
Before buying a meter, check
with your insurance company to see which test strips they will pay
for; contact the meter manufacturer and ask about the possibility
of receiving a free meter from them; ask your local pharmacist if
they will provide a free meter if you buy the test strips from them;
try buying a less-expensive meter and exchange it for a more expensive
one; also check with your local diabetes association, they may have
coupons for a free meter. Manufacturers make money from test strips
not from meters! I can't help wondering if that's why noninvasive
meters aren't generally available yet! For promising steps in the
right direction, see GlucoWatch;
the SensElly
sensor being developed by SINTEF;
ear
heat emissions device; and optical
measurement of blood glucose levels.
Should lancets be reused?
No! Why? See http://www.bddiabetes.com/ca/english/managingdiabetes/dangers.asp
Index
My
first meters: Roche
AccuSoft Advantage and LifeScan FastTake
My current and preferred meter:
LifeScan Ultra
My newest meters: Accu-Chek
Compact, Precision QID, MediSense
Precision Xtra; and TheraSense FreeStyle
Diabetes tracking software: LifeScan InTouch,
Diabetes Diary, BalancePC, and Palm-based
Using your meter: to determine
when to eat
 My
first meters
Within two weeks of being diagnosed,
in November 2000, I purchased a Roche
AccuSoft
Advantage blood glucose meter and starting monitoring my blood
2 to 4 times per day during November and December 2000. Although
I liked the Advantage meter and found it very easy to use,
I subsequently changed to a LifeScan FastTake
meter in January 2001. Why? The FastTake meter needs a smaller
blood sample (equates to smaller needle holes and less pain), is
faster, and had the ability to upload data to my PC with the $20
LifeScan InTouch
software and cable kit that I purchased at a local pharmacy;
it was going to cost me about $75 to get the cable and software
for the Advantage meter. I also seriously considered the
TheraSense Freestyle meter, but I couldn't
find a Canadian supplier (the FreeStyle became available
locally in April 2002 and I exchanged my Precision
QID for a
FreeStyle in August 2002).
 LifeScan
Ultra meter
On March 9, 2001, I exchanged
my Roche Advantage meter for a new LifeScan Ultra
meter kit, at no cost, and started using it on March 26. The Ultra
kit includes: meter, UltraSoft lancet device (same as Penlet
Plus), 10 test strips, 10 lancets, control solution, Owner's
Booklet, Quick Reference, Logbook, and carrying
case.
Specifications.
Blood sample size=1 microliter; time to get a result=5 seconds;
storage capacity=150 test results with date, time, and 14-day and
30-day averages; assay method: glucose oxidase biosensor; assay
range=1.1 to 33.3mmol/L (20 to 600mg/dL); selectable mmol/L or mg/dL
units; operating ranges: temperature =6-44 °C (43-111°F),
relative humidity=10-90%, hematocrit=30-55%; replaceable 3.0V (#2032)
lithium battery life=1,000 tests; data transfer port.
Evaluation.
The LifeScan Ultra kit contains eveything you need to start
testing immediately. I really like the physical design of the Ultra,
in addition to a very modern look (for some reason, it reminds me
of the face of an alien) it is also very functional: it is easy
to hold and it feels very secure in your hand; obtaining a blood
sample is very easy at all times; and the large display makes it
very easy to read test results, even without glasses. Handling test
strips and inserting them into the test port can sometimes be challenging.
The small blood sample size and the new and thinner UltraSoft
lancets equates to smaller holes and less pain. In addition, you
only have to wait 5 seconds to get a result. The UltraSoft
lancets are 28 guage compared to 25 guage for the LifeScan FinePoint
lancets; only the BD Ultra-Fine
II and Latitude
lancets are thinner at 30 and 33 guage and you can use them with
the UltraSoft lancing device. However, even though the lancets
are 28 guage, I find the SoftClix
lancing device the least painful. I occassionaly had problems,
during the winter, in operating the FastTake meter after
only a short, 20 minute, trip into my office; with the wider operating
temperature of the Ultra, I no longer have the problem.
Although you don't get it in
the box, you can also get a new cap, free from LifeScan, for the
UltraSoft lancing device which makes it easier to obtain
blood samples from your arm. The Ultra can store up to 150
test results but this is still not enough to store a month's set
of results if you test more than 4 times/day (I think the Precision
Xtra meter capacity of 450 test results is far superior). The
color of the control solution is red, this makes it very easy to
see that the test strip is working (other manufacturers commonly
use a clear control solution). The User's Booklet is well
organized and written. The Quick Reference omits two common
tasks: using the control solution to perform a quality check and
setting the date and time. The carrying case is also well designed
and holds the meter, a vial of 25 test strips, the UltraSoft
lancing device, about 25 lancets in a zippered mesh pocket, the
Quick Reference and Logbook, and a small pen. Warning:
Whenever the meter loses power for any reason it will enter the
setting mode and stored test result values and sequence can be lost.
Uploading
and viewing test results.
You need an RS232 ONE
TOUCH Interface cable to attach the Ultra to a computer
serial port and the IN
TOUCH® Diabetes Management Software to upload, analyze, and
report test results. The software is free but you have to purchase
the cable; LifeScan directs you to http://www.drugstore.com/
where the cost is US$19.99. The IN TOUCH software has 10 different
pre-formatted charts and graphs to help you analyze your blood glucose
data in detail; I've been using the IN TOUCH software since February
2001 and find it integrates very well with the Ultra, is
very easy to use, and the reports good enough to provide useful
insights into where I need to improve my blood glucose control;
see my test results.
Web
site support. I find the mylifescan.com,
mylifescan.ca,
and lifescan.co.uk
sites very simple to navigate and find detailed product descriptions
and support materials. I also like the feel of the LifeScan sites
and receive the impression that LifeScan is interested in personally
helping me deal with my diabetes more effectively. This same feeling
has been reinforced whenever I've contacted LifeScan.
Conclusion.
I find the LifeScan Ultra very easy to use and think that
it is, with the InTouch cable & software, and the SoftClix
lancing device, the best blood glucose monitoring system currently
available.
Note:
In March 2003, LifeScan introduced a new meter called the UltraSmart
with all the benefits of the Ultra plus electronic logbook
features. LifeScan has also released Version 2.0 of the OneTouch
software that supports all LifeScan meters that include a data port,
including the UltraSmart. A major shortcoming of the new
software is it's inability to print reports in color!
 Roche
Accu-Chek Compact meter
On November 5 2001, I purchased
for $65 (which my insurance company reimbursed) a Roche
Accu-Chek
Compact blood glucose monitoring kit. The kit comes with the
meter, 2 AAA batteries, 1 drum containing 17 test strips, two bottles
of control solution, 17 lancets, SoftClix
lancing device, protection tube for an extra test strip drum,
carrying case, carrying holster, User's Manual, Quick
Reference Guide, and Logbook.
Specifications.
Glucose level determined by reflective photometry (Ultra
uses an oxidase biosensor); measurement range 0.6 to 33.3 mmol/L;
sample size 3 to 3.5 microlitres (Ultra 1-microlitre); measurement
time 15 seconds (Ultra 5 seconds); test result storage capacity
100 (Ultra 150).
Evaluation.
High-tech looking meter with a flip-up cover looks more like a cell
phone than a glucose meter. It has a solid feeling but is quite
bulky (compared to the Ultra). The carrying holster is gimmicky
and impractical. Standard AAA batteries are used to power the meter
and have a claimed life of at least 500 tests. If you test 6 times/day,
one month of test results needs a storage capacity of about 250;
the meter storage capacity of 100 is simply not enough, even the
150 capacity of the LifeScan Ultra is insufficient. Coding
of test strips is automatic and the excellent 17 test strip drum
is very easy to load and use (especially so if you are arthritic
and have trouble handling test strips). However, I find myself wondering
how reliable the motorized drum will be; I haven't been able to
find any MTBF (mean time between failures) data. I was confused
by the two bottles of control solution having different colored
tops (red and blue) and I thought, incorrectly, that you had to
use both to perform a quality check. Having to clean the optics
system is a turn off. Compared to the LifeScan Ultra, the
Accu-Chek Compact seemed to need a large blood sample and
take a long time to collect it (it seems that holding the test strip
at a 45-degree angle and allowing the strip to only touch the blood,
without allowing pressure on the skin, can speed up the process);
I even had to squeeze out more blood, but the test strip could take
multiple samples and beeped when it had enough. The Ultra
lacks the multi-sample and audible confirmation features; while
I don't think the multi-sample feature is needed, simply because
the sample size required is so small, I do think an audible confirmation
would be useful. I had to wait for what seemed like a long time
to obtain the test result. An infrared port is provided for connecting
to a computer, this means that a cable is not needed to upload test
results to a Windows-based computer. The SoftClix lancing
device is excellent and the least painful of any lancing device
that I've used to date, but you have to use the SoftClix
lancets (which are 28 guage, the same as the LifeScan UltraSoft).
The User's Manual uses
some annoying text layout features which make it difficult to read.
The Quick Reference Guide will not fit in the carrying case
without being folded; in addition, it omits any mention the common
task of using the control solution to perform a quality check. Meter
measurement units were preset on my unit to mmol/L and I couldn't
change the units. I presume that meters for the USA market will
be preset to mg/dL units. Oops! I just discovered that it is very
easy to press the ON button by mistake and waste a test strip because
it can't be retracted back into the drum! The meter also skipped
a beat with the last test strip, the motor whirred but no test strip
appeared! I turned the meter off and back on, the motor whirred
and the last test strip appeared. Signs of possible problems in
the future? Because of the bulk of the meter, getting a blood sample
onto the test strip is a bit awkward, again this is in comparison
to the relative ease of the LifeScan Ultra.
Uploading
and viewing test results. You will need an infrared port
on your computer to upload test results. Connecting by cable is
not an option. You will have to purchase the Accu-Chek Compass
PC-based
or Palm-based
software (US$29.99) to upload, analyze, and report test results.
If you use software like Diabetes
Diary, which requires the manual input of test results, you
don't need the ability to upload.
Web
site support. I find the Roche.com
and Accu-chek.com
sites difficult to navigate and find detailed product descriptions
and support materials. Even though the sites do contain some useful
information, my overall feeling is that their focus is more on marketing
than support. I find the sites very slow even when accessed over
a high-speed connection. My overall impression is that Roche is
only interested in providing minimal product descriptions and support
through their web sites.
Question.
Are there any benefits to using reflective photometry over
an oxidase biosensor for determining blood glucose level? All I'm
seeing at present is a negative-having to clean the optics.
Conclusion.
I like the look and feel of the Roche Accu-Chek Compact but
think it is misnamed especially when compared to the LifeScan Ultra
which is about half the size. I also really like the 17 test strip
drum and how easy it is to use, especially so if you currently have
trouble handling individual test strips. I also love the SoftClix
lancing device. However, I find the meter and software too expensive,
the blood sample required too large, getting the sample awkward,
and time to get results too long. I think the LifeScan Ultra
system (with the SoftClix lancing device) is the best choice
for most people because it is cheaper, more practical, and easier
to use.
 Precision
QID pen model meter
On November 22, 2001, I saw
an advertisement at a local pharmacy for a free Abbott
MediSense Precision
QID blood glucose meter. For some time I'd been considering
buying the QID pen model simply because of its convenient size.
The advertisement was for a regular-sized meter but the pharmacist
agreed to give me the pen model instead.
Specifications.
Blood sample size=3.5 microliters; time to get a result=20 seconds;
viewable capacity=10 results; assay range=1.1 to 33.3mmol/L; strip
operating temperature range=18-30 degrees Centigrade; non-replaceable
battery life=4,000 tests. Test results are automatically adjusted
for common medications, vitamins and endogenous substances including
up to 100 micrograms of acetaminophen, 20mg/dL uric acid, 3mg/dL
ascorbic acid, 500mg/dL cholesterol, 3000mg/dL triglycerides. Test
results may be too low if you are severely dehydrated or hypotensive,
in shock, or in a hyperglycemic-hyperosmolar state. Test strips
can accept multiple blood samples within a 30-second period.
Evaluation.
The most attractive feature of this meter is that it looks like
and is the same size as a pen! The meter comes with a lancing device,
10 lancets, quick reference guide, user's manual, journal, and carrying
case. My first disappointment came when I realized that I couldn't
use the meter! Why? Test strips are not included with the meter,
you have to buy them separately. In addition, you will also have
to purchase control solution to test meter performance. Contrast
this with the LifeScan, Roche and TheraSense meters that come with
everything you need to get started. The meter is calibrated for
mmol/L with no way to change, I presume that mg/dL will be used
for the USA model. The User's Guide and Quick Reference
Guide do not show or even mention the QID pen model! The carrying
case has space for the meter, lancing device, 6 lancets, journal,
and up to 25 individually foil-wrapped test strips; it will not
fit in shirt or pant pockets, but it will fit easily in a jacket
pocket or a small purse. I find the meter display rather small and
difficult to read. A blood sample size
of at least 3.5 microlitres is required and getting a result takes
20 seconds. Contrast this with 1-microlitre and 5 seconds for the
LifeScan Ultra. Compared to the LifeScan Ultra, getting
enough blood onto a MediSense Precision Plus test strip is
really difficult; I find this factor alone reason enough to avoid
this or any other meter that uses this kind of test strip.
Uploading
and viewing test results.
The QID pen version does not have a data port. The regular-sized
QID meter does and results can be uploaded and viewed with the Precision
Link cable and software.
Web
site support. Meter information and support from the
MediSense
site is difficult to find and is clearly focused on supporting their
marketing efforts. For example, I couldn't find any information
on the QID pen version or the MediSense lancing device.
Conclusion.
I like the small size of the QID pen model meter and the individually
foil-wrapped test strips; if you have good eyesight, it is an excellent
choice if portability is your primary concern. However, although
the LifeScan Ultra is larger, it is a better choice. I exchanged
my Precision QID meter for a TheraSense
FreeStyle meter in August 2002.
 MediSense
Precision Xtra meter
On
January 16 2002, I exchanged a spare LifeScan Ultra meter
for an Abbott MediSense
Precision Xtra meter kit. The kit comes with the meter, 2 AAA
batteries, 10 "True Measure" test strips, 10 lancets,
an adjustable lancing device, carrying case, user's manual, quick
reference guide, and data log; 30-day money-back guarantee; 4-year
warranty; no control solution is included.
Specifications.
Glucose level determined by an oxidase biosensor; glucose measurement
range 1.1 to 27.8 mmol/L (20 to 500mg/dL); sample size 3.5 microlitres
(Ultra 1-microlitre); measurement time 20 seconds (Ultra
5 seconds); blood ketone measurement range 0 to 6.0 mmol/L; test
result storage capacity of 450 (Ultra 150) with 7-day, 14-day,
and 28-day averaging; backlit display with a test-strip light and
an illumination button; glow-in-the-dark case.
Evaluation.
The main attractions of this meter for me were the backlit display
with test-strip light, illumination button, a case that glows in
the dark, the 450 test results storage capacity, and the ability
to test for blood ketones. The backlit display is excellent and
the lights make it very easy to read test results which is very
important for many diabetics whose eyesight is typically less than
optimum. If you test 6 times/day, one month of test results needs
a storage capacity of about 250; the meter storage capacity of 450
is far superior to the 150 capacity of the LifeScan Ultra.
The ability
to test for ketones
is certainly an added benefit and the main reason I was interested
in this meter. Just like glucose testing, blood is applied to special
Ketone test strips and the meter takes 30 seconds to process the
sample to produce a Ketone test result. The Ketone test measures
Beta-hydroxybutyrate which is normally less than 0.6 mmol/L; this
level may increase with illness, increased stress, or uncontrolled
blood glucose levels. If your level becomes greater than 1.5 mmol/L
you may be at risk of developing diabetic
ketoacidosis (DKA)
and you should contact your doctor. A Ketosis test should be performed
every 2-4 hours whenever you are sick, when your level of stress
has increased significantly, or when your blood glucose level is
16.7mmol/L (300mg/dL) or greater. Also see the MEDLINEplus
Serum
ketones article.
Standard AAA alkaline batteries
are used to power the meter and have a claimed life of at least
1000 tests. The meter has to be coded for each new box of blood
glucose or ketone test strips using a calibration strip provided
with the strips. Each test strip is individually wrapped in foil.
The meter automatically detects the type of strip inserted. Compared
to the LifeScan Ultra, the Precision Xtra needs a
large blood sample (3.5 compared to the Ultra's 1-microlitre)
and a long time to collect it; I even had to squeeze out more blood,
but the test strip could take multiple samples and the meter verifies
that the blood sample is large enough. I had to wait a relatively
long time to obtain the test result (20 compared to the Ultra's
5 seconds ). Meter measurement units can be set to mmol/L or mg/dL
units. Removal of the lancet from the lancing device is inconvenient,
you have to unscrew the top and manually pull out the lancet. A
special cable is needed to upload test results.
The User's Guide is
well designed and easy to use. The User's Guide states that
control solution is required to perform a quality check but none
is provided. The Quick Reference Guide fits in the carrying
case but lacks information on Ketone testing or performing a quality
check using the control solution. While the shape of the
the carrying case is trendy, it is impractical; lancets and test
strips have to be stored together and removal of them is awkward,
also because of its shape you can't store the provided Logbook
in it.
Uploading
and viewing test results.
Results can be uploaded and viewed with the Precision
Link cable and software. The cost of the software and cable
is US$69.99. I tried to convince the MediSense representative to
provide me with the software free just like LifeScan does and by
stating that I wouldn't use the meter on an ongoing basis if I couldn't
upload and view my results online. After 7 months, I received an
email from a MediSense representative and met with him in September
2002; he supplied me with a free cable and software. I was not impressed
with the software; in comparison with the LifeScan software it looks
very unprofessional, don't waste your money. If you decide to use
the meter and you need electronic record keeping and analysis capability,
I recommend you enter your data manually and use the BalancePC
program.
Web
site support. Meter information and support from the
MediSense
site is difficult to find and is clearly focused on supporting their
marketing efforts. In other words it is not focused on supporting
the end users of their products. For example, I couldn't find information
on the operating temperature range or what the blood test sample
size was.
Conclusion.
Overall, this is an excellent meter with many well thought out and
useful features and a very good choice as your main blood monitoring
meter. I find the cost of the Precision Link cable and software
too expensive and unprofessional, and Web-site support weak. This
meter is worth having just for the ability to test your blood ketone
levels. Overall, I still think the LifeScan Ultra (with the
SoftClix lancing device) is easier to use and the best system
overall for monitoring your blood glucose levels.
Note:
In September 2002, the MediSense representative stressed the superiority
of True Measure test strips over other strips leading to
more consistent and accurate test results. He also asked me to try
the Sof-Tact
meter. The meter is large, getting a blood sample, while painless
from my arm, was awkward and very slow, it needs to be cleaned on
a regular basis, and getting test results is very slow; overall,
I found it very impractical. However, if you have problems getting
blood from your fingers and must have a meter with the ability to
get blood from an alternative site, the Sof-Tact is probably
the best choice (full
review). The MediSense representative also mentioned that MediSense
is bringing out a new meter later this year that requires a smaller
blood sample and produces a test result in 5 seconds.
TheraSense FreeStyle meter
On
August 16 2002, I exchanged my Precision QID pen model blood
meter for a TheraSense
FreeStyle meter kit at my local Pharma Plus Pharmacy. The
kit comes with the meter, 2 pre-installed AAAA batteries, 5-year
warranty, 10 test strips, 10 lancets, an adjustable lancing device
with dark blue (finger) and clear (off-finger) caps, control solution,
carrying case, Getting Started Guide, Owner's Booklet,
Quick Reference Guide, and Logbook.
Specifications.
Blood sample size=0.3 microliter (Ultra 1 microliter); time
to get a result=15 seconds (Ultra 5 seconds); storage capacity=250
test results with date, time, and 14-day average; assay method:
coulometric electrochemical sensor; assay range 1.1 to 27.8 mmol/L
(20 to 500mg/dL); selectable mmol/L or mg/dL units; operating
ranges: temperature=5-40 °C (41-104°F), relative humidity=5-90%,
hematocrit=0-60%; replaceable AAAA battery life=1,000 tests; data
transfer port.
Evaluation.
The main attractions of the FreeStyle for me were the smaller
blood sample required and the 250 test results storage capacity.
If you test 6 times/day, one month of test results needs a storage
capacity of about 250; so the FreeStyle meter storage capacity
of 250 is about right and superior to the 150 capacity of the LifeScan
Ultra. Another attraction was the lower cost of the test
strips and lancets over those used with the meter I currently use
daily (LifeScan Ultra).
The meter has to be coded to
match the code number on the test strip vial. The meter automatically
turns on when a test strip is inserted. The FreeStyle uses
a small blood sample (0.3 compared to the Ultra's 1-microlitre);
test strips can take multiple samples and the meter verifies that
the blood sample is large enough by beeping once. The meter processes
the blood sample and after 15 seconds beeps twice when it has produced
a result. Compared to the LifeScan Ultra, getting a blood
sample and test result is not as convenient. The reasons for this
are: although a smaller blood sample is required, it takes longer
to get a blood sample; sampling at the edge of the test strip is
not as convenient; there is no visual indication of the blood being
acquired by the test
strip; and having to
wait a relatively long time to obtain the test result (15 seconds
compared to the Ultra's 5).
Initially, I thought the meter's
screen was faulty because it was difficult to read because of ghost
images. I even returned the meter and replaced it with another one.
It turns out that the problem only occurs under a very bright halogen
light (which I have on my desk); under normal incandescent and fluorescent
lighting there are no problems reading the meter.
The carrying case is well designed
and holds the meter, a vial of 25 test strips, control solution,
the lancing device, about 25 lancets in a zippered mesh pocket,
the Quick Reference and Logbook, and a small pen.
The Owners's Guide
is poorly designed; for example, one of the first, and frequent,
tasks you need to do is to set the test strip code number, this
is not even mentioned until page 16 which references pages 27-28.
The Quick Reference Guide fits in the carrying case but lacks
information on performing a quality check using the control solution
or on setting the test strip code number.
Note: TheraSense
also market a palm-based version of the FreeStyle, called
the Tracker.
Uploading
and viewing test results.
Results can be uploaded and viewed with the FreeStyle
Connect Data Management System cable and software. The cost
of the software and cable is US$75.00 and the cable alone costs
US$60.00! This is very high when compared to the US$19.95 for a
cable with a free software download for a LifeScan Ultra!
Review comments on the FreeStyle software include "amateurish"
and "cheesy"
which don't encourage me to buy it at any cost! Since I need to
upload my test results to my computer and web site on a monthly
basis, the cost of the cable and software alone will prevent me
from using the FreeStyle on a daily basis as my main meter.
Web
site support. Meter information and support from the
TheraSense
site is weak but excellent phone support is provided at 1-888-519-6890
(Canada) and 1-888-522-5226 (USA). For example, online copies of
the user manuals are not provided and online support for the FreeStyle
Connect software is not provided. I couldn't find any mention at
all on the Canadian site about the FreeStyle cable or software.
Conclusion.
The TheraSense FreeStyle is an excellent meter for monitoring
your blood glucose levels on a daily basis. The FreeStyle
cable and software are expensive; they cost more than the meter!
In addition, the FreeStyle meter display is difficult to
read under certain lighting conditions and it is not as convenient
to use as the LifeScan Ultra. There are some indications
that the FreeStyle produces more consistently accurate test
results than any other meter. However, I think the LifeScan Ultra
(with the SoftClix lancing device) is the best meter choice
for most people especially if you need to upload your results to
a computer.
Diabetes tracking software
For
reviews of diabetes tracking software, see http://www.mendosa.com/software.htm.
I personally use the LifeScan
InTouch software and cable to upload, analyze, and report my
test results. I also
tried, but didn't continue with, the Glucose32
software and uploaded my results to the GlucoWeb
site.
I
feel the need to gain more control over what I eat. After reviewing
the software products currently available for setting up a diet
plan and tracking what you eat, I decided that Diabetes
Diary and BalancePC/LightenUP
offered the best set of features and ease-of-use to help me gain
greater control over what I eat on a day-to-day basis; so I purchased
all three. I started using Diabetes Diary in January 2002
(see my Nutrition Reports)
but didn't use it much during 2002. For tracking and analyzing your
blood test results and diet on a Windows-based computer I highly
recommend BalancePC.
I've
used a Sharp
Zaurus ZR-5800FX digital organizer for many years but
have now changed, in September 2002, to a PalmOS-based
organizer (a Sony
Clie SJ-22 and now a Sony
Clie SJ-33) and am investigating
software that runs on a Palm
Pilot for tracking my blood glucose results and diet;
the current Palm-based software that look most promising
to me are: Accu-Chek
Pocket Compass, Diabetes
Pilot, Diet
& Exercise Assistant, CarbCheck,
GlucoPilot,
BalanceLog,
CalorieKing
Diet Diary, RMRdiet,
UltimateCalorieMeter,
and USDA
National Nutrient Database for SR15. Also see the John Hughes
review
of various palm-based software packages. I'm also considering creating
a database for tracking my diabetes using SmartList-To-Go
(formally thinkDB). In February 2003, to help me select
low glycemic index and glycemic load foods, I've created a Glycemic
Lists database. I've also decided to continue tracking my
blood glucose readings using the Windows-based Lifescan
InTouch software and to start tracking my diet, using my Sony
Clie SJ-33 as the main input device, using Diet & Exercise
Assistant
and transferring results to my PC for analysis and report creation
using Microsoft
Excel.
Using your meter
I use my meter as a tool to
help determine what, the amount, when, and if, I eat. How?
- Set a premeal
blood glucose level to determine when you eat. The premeal blood
glucose level for normal nondiabetics is 3.8-6.1mmol/L (68.5-109.9mg/dL);
the optimal premeal goal for diabetics is 4-7mmol/L (72-126mg/dL).
Personal Guideline: My premeal
blood glucose target level is below 6mmol/L (108mg/dL); I don't
eat until it is below 6 and I'm trying for below 5 (90).
- Set a postmeal
blood glucose level (2 hours after meals) to help you determine
the type of food and amount to eat. The postmeal blood glucose
level for normal nondiabetics is 4.4-7.0mmol/L (79.3-126mg/dL);
the optimal postmeal goal for diabetics is 5.0-11.0mmol/L (90-198mg/dL).
Personal Guideline: My postmeal blood glucose
target level is below 9mmol/L (162mg/dL); I adjust what and the
amount I eat to keep below 9, and I'm trying for below 8 (144).
- Eat whenever your blood
glucose level is below 4mmol/L (72mg/dL). Clinical hypoglycemia
is diagnosed when your blood glucose level is 3.3mmol/L (59.5mg/dL)
or below.
- Have your HbA1c
and lipid
levels checked every 3 months to check how well you're doing
(see mine). Target levels:
HbA1c < 6; LDL
< 2.5mmol/L (45.1mg/dL); Total Cholesterol/HDL
< 4; Triglycerides < 2mmol/L
(36mg/dL).
Reference:
Canadian Medical Association's 1998
Clinical Practice Guidelines for the Management of Diabetes
in Canada and Canadian
Diabetes Association’s 2003
Clinical Practice Guidelines for the Prevention and Management
of Diabetes
in Canada.
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