Wednesday, July 2, 2003

How diabetes patients can easily monitor blood sugar

Incidence of diabetes increases with each decade of life seniors most affected

Diabetes patient Deborah Chase of New York City is well aware that if she controls her blood sugar levels, she can dramatically reduce the risk of experiencing complications of the disease. So she's very careful about what she eats and checks her blood sugar levels frequently.

Thus, she was puzzled by a graph displayed on a new blood glucose monitoring system she was using. The graph showed her after-lunch blood sugar results, and she saw a sharp spike in her sugar levels only on Thursdays. Thinking back, she realized that every Thursday, she stopped into a particular deli to purchase a bowl of lentil soup for lunch. Her nutritionist had told her that lentils were an acceptable food for her to eat, but her blood sugar spikes indicated otherwise.

She spoke to the manager of the deli and learned that the soup actually contained split peas, rather than lentils. The meter had alerted her to two events that were affecting her blood sugar levels the fact that the "lentil soup" didn't contain lentils, and that she should avoid eating split peas.

Chase is one of the first patients to try out the OneTouch UltraSmart Blood Glucose Monitoring System. Prior to now, Chase and the millions of other Americans who have been diagnosed with diabetes, have generally relied on traditional paper logbooks a sort of diabetes "diary" to record their blood sugar test results and other diabetes-related information, such as the type and amount of food consumed, medication taken, activity level, etc.

Unfortunately, paper logbooks can be a burden to maintain. And more importantly, both patients and even their doctors may find it difficult to spot patterns or identify problem areas just by looking at individual entries. It has become an urgent matter for healthcare professionals to find better ways to manage diabetes.

About 17 million Americans have this disease, and the U.S. Centers for Disease Control and Prevention has referred to it as an "emerging epidemic." Furthermore, more than 30 percent of people over the age of 60 have either diabetes or impaired fasting glucose (meaning they have higher than normal blood sugar levels, but not high enough to be classified as having diabetes).

Managing diabetes means keeping blood sugar levels in the near-normal range as much as possible. The more control the patient has over blood sugar levels, the less likely it is for him or her to develop long-term complications of diabetes, such as blindness, kidney failure and limb amputation.

"Blood glucose levels are constantly changing in response to multiple factors, such as time of day, food, exercise, medication and stress," said Chase's doctor, Gillian Katz, M.D., clinical assistant professor of medicine (endocrinology) at New York University School of Medicine. "The key is to understand the impact of these factors on an individual's blood glucose level and make adjustments accordingly. This will help keep blood sugar levels well controlled, and keep the patient healthy."

The new system used by Chase, which is in pharmacies now, can help patients transform blood glucose measurement into more complete diabetes management. The palm-sized device combines a blood glucose meter with an electronic logbook.

It tests blood sugar in five seconds, lets patients enter key information with the touch of a couple of buttons, and then automatically organizes this information into simple charts and graphs right on the screen. These make it easy for the patient and doctor to see and understand how individual blood sugar test results form patterns. Recognition of these patterns, combined with appropriate behavioral changes that address them, let patients focus in on problem areas and correct them.

"The other benefit of the meter is that my doctor is always emphasizing the importance of 'tight control' which means that my blood sugar levels should remain within a safe range at all times," said Chase. "Previously, I found this very difficult to achieve. But with the OneTouch UltraSmart, I feel that this goal is now within my reach."

"A tool like this is a major step forward in empowering people with diabetes to understand how their actions directly affect their blood glucose levels," said Dr. Katz. "It can help pinpoint problem areas in a person's diabetes management program so he or she can focus on making positive changes to stay healthy."

Chase sums it up by saying, "The test result numbers don't just exist in a vacuum. This meter allows me to record what is going on and to match the events in my life to my blood sugar results and then to spot patterns. My doctor will look at these patterns and tell me to work on behavioral changes since my sugar levels go up when I'm stressed.

"I have a pretty high-stress job," Chase admitted. "It's not so easy to change my lifestyle. But it's better to try to address the stress now than to experience the complications of uncontrolled blood sugar levels down the road."

The American Diabetes Association publishes an excellent guide for older people with diabetes. Called "101 Tips for Aging Well with Diabetes," it is available for $14.95 from http://store.diabetes.org or by calling (800) 232-6733.

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