Diabetes Forecast

Putting New Diabetes Tools to Work

By Henry Rodriguez, MD, Associate Editor ,

People with diabetes need to be active participants in managing their disease. That's a message that many of us on the Diabetes Forecast editorial board often stress. And impressive advances in technologies have made it more possible than ever for people with diabetes to improve their blood glucose control.

Unfortunately, though, many people are failing to use these advances to their fullest. Large research studies have begun to document what most diabetes care providers have long suspected: Only a small minority of people with diabetes routinely review their blood glucose.

Blood glucose meters can now store hundreds of readings. Many let users download the data on to home computers, using software that also aids in analyzing the information and recognizing blood glucose patterns. For diabetes treatment to be tailored to the individual, this process of analysis is key. Diabetes educators emphasize how important it is to review blood glucose readings. But, by and large, it just is not happening. Clearly, we need novel, innovative programs to help people track and review their blood glucose regularly.

Consistent blood glucose monitoring is a challenge for anyone with diabetes. All diabetes centers ask patients and their families to collect blood glucose readings for review. Just after diagnosis, the review is conducted with the health care team. Gradually, the person with diabetes assumes more control over the process, learning how to adjust medication dosages between office visits to address everyday variations in activity, diet, stress, and health. These adjustments are critical to achieve good blood glucose control and minimize the risk of diabetes-related complications.

Chronic diseases such as diabetes present a host of everyday challenges. Addressing them requires a team approach. The most important team members are the person with diabetes and those at home who help with his or her daily life. Whatever the technological advances in blood glucose monitoring, we diabetes care providers must not only share our knowledge of diabetes but also help motivate our patients and their partners in care to make regular monitoring and thoughtful review of the data a part of their routine. True, insurance reimbursement is limited for phone and e-mail follow-up with patients. Despite that, we must make ourselves available to people who need help with data review, all the while empowering them to assume a greater role in managing their disease.

Until research results in a cure for diabetes or a "closed-loop" system of blood glucose monitoring and insulin delivery (the so-called artificial pancreas), both patients and providers must rely on the "open loop": routine self-monitoring followed by scheduled review of blood glucose readings. Working together, we must use the tools available today to achieve the best glucose control possible. Nothing less is needed to promote the long and healthy lives for people with diabetes that we all desire.



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