20071223
Omron HEM-780 Automatic Blood Pressure Monitor with ComFit Cuff
Omron HEM-780 Automatic Blood Pressure Monitor with ComFit Cuff
Product Description
Not only does the HEM-780 Automatic Blood Pressure Monitor utilize Omron's patented IntelliSense technology, but it also features the innovative Comfit Cuff. The ComFit Cuff is pre-formed for a quick and proper fit that is perfect for both medium and large-sized arms (nine to 17 inches). It's easy to apply the cuff to your arm without any assistance -- simply wrap the cuff around your arm and press start. In seconds your blood pressure and pulse are displayed on the large digital panel. Proven time and time again, Omron's IntelliSense technology ensures accurate, clinically-proven, and comfortable readings. And with a 90-memory recall with date and time stamp, you can track your blood pressure and pulse progress as your work towards a healthier lifestyle.
Q&A - Blood Pressure Monitors
What is IntelliSense?
The IntelliSense Monitor inflates the cuff to the ideal level with each use. No adjustments are required by the user to select an inflation level. This is especially convenient for hypertensive users and for people with certain arrhythmia or heart disorders, because their blood pressure is more likely to fluctuate. The advantage is fast personalized inflation for maximum comfort.
What is a ComFit cuff?
The patented pre-formed cuff expands to fit regular and large arms comfortably and easily.
How is an Irregular Heartbeat Shown?
This advanced monitor can detect irregular heartbeats while your blood pressure is being measured. If an irregular heartbeat is detected, an accurate blood pressure reading is displayed along with the irregular heartbeat symbol.
What is Morning Hypertension?
The American Heart Association (AHA) recommends you take blood pressure readings in the early morning and evening. With the touch of a button you can review an eight week history of your morning and evening weekly blood pressure averages.
What is IntelliSense?
The IntelliSense monitor inflates the cuff to the ideal level with each use -- you never have to make any adjustments to select an inflation level. This is especially convenient for hypertensive users and for people with certain arrhythmia or heart disorders because their blood pressure is so likely to fluctuate. The biggest advantage of using the IntelliSense technology is a personalized inflation every time for maximum comfort. See more details and specification here
20071120
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20071017
Doctors Without Wires
Thirteen million baby boomers are currently caring for their elderly parents, either in-home or overseeing their care from afar, according to Senior Journal. Keeping tabs on the condition and well-being of parents, as well as getting them to doctor appointments, can be a daunting and stressful job- A new technology is seeking to make that job easier.
Introduced by the University of Florida and IBM, this health-care advancement enables home computers and cell phones—via Bluetooth wire¬less transfer—to send real-time readings of vital signs from personal medical devices such as glu¬cose meters, body-weight measuring systems, and respiratory monitoring devices to doctors and families—even many states away.
"Connecting health-care devices into today's range of wired and wireless networks presents us with an opportunity to turn islands of medical information into evolving networks of health-care monitoring and control.” says Scott de Deugd, IBM's director of emerging technology and stan¬dards. He adds that current integrated solutions are inflexible, and that the key to making this new system work is using innovative wireless devices and open standards*
The middleware technology acts as an inter¬mediary to ensure that a glucose monitor generates data in standardized Web-based formats for health-care providers. To accomplish this, the researchers used a service-oriented architecture
In addition, a network of open-standard comput¬ing platforms can be used to develop new solutions with little programming. The regular updates to doctors or family members provide a more unified picture of an individual's health and allow doctors to be more in touch with their patients’ care while reducing appointments.
According to project leader Sumi Helal, many hospitals have already requested the technology It's based on open standards that will make it easy for product developers to tap the technology for new devices, which could be on the market within a year—Tracy McNamara PC magazine October 2007
20070924
FDA Approves Continuous 7-Day Glucose Monitoring System
The U.S. Food and Drug Administration today approved a device that measures glucose levels continuously for up to seven days in people with diabetes.
While a standard fingerstick test records a person’s glucose level as a snapshot in time, the STS-7 Continuous Glucose Monitoring System (STS-7 System) measures glucose levels every five minutes throughout a seven-day period. This additional information can be used to detect trends and track patterns in glucose levels throughout the week that wouldn’t be captured by fingerstick measurements alone. However, diabetics must still rely on the fingerstick test to decide whether additional insulin is needed.
“The STS-7 System supplements standard fingerstick meters and test strips, providing diabetics ages 18 and older with a way to see trends and track patterns,” said Daniel Schultz, M.D., director of FDA’s Center for Devices and Radiological Health. “It can help detect when glucose levels drop during the overnight hours, show when glucose levels rise between meals and suggest how exercise and diet might affect glucose levels.”
The STS-7 System, manufactured by DexCom Inc. of San Diego, Calif., uses a disposable sensor placed just below the skin in the abdomen to measure the level of glucose in the fluid found in the body’s tissues (interstitial fluid). Sensor placement causes minimal discomfort and can easily be done by patients themselves. The sensor must be replaced weekly. An alarm can be programmed to sound if a patient’s glucose level reaches pre-set lows or pre-set highs.
Diabetes is caused by the body’s inability to produce or use insulin, a hormone that unlocks the cells of the body, allowing glucose (sugar) to enter and fuel them.
An estimated 20.8 million people in the United States—7 percent of the population—have diabetes. Most have type 2 diabetes, a condition in which the body does not properly use insulin. An estimated 5 percent to 10 percent of people with this chronic disease have type 1 diabetes, which results from the body's failure to produce insulin. People with type 1 diabetes must take insulin every day.
Diabetes can lead to wide fluctuations in blood sugar levels. Over time, abnormally high levels of glucose can damage the small and large blood vessels, leading to diabetic blindness, kidney disease, amputations of limbs, stroke, and heart disease.
While there is no known cure, studies have shown that patients who regularly monitor and regulate their blood glucose levels have lower incidences of complications associated with the disease.
FDA’s approval of the STS-7 System was based on results of a study conducted by DexCom of 72 patients with diabetes at five clinical sites in the United States. The study demonstrated that the STS-7 System was safe and effective for detecting trends and tracking patterns in glucose levels in adults.
A three-day version of the device, the STS Continuous Glucose Monitoring System, was approved in March 2006.
NEW GLUCOSE MONITORING SYSTEM FOR DIABETICS
FDA approved a new medical device that provides physicians with continuous measures of tissue glucose levels in adults with diabetes. The product is the first of its kind.
The Continuous Glucose Monitoring System, made by MiniMed Inc., of Sylmar, Calif., records tissue glucose levels at five-minute intervals for up to three days. The information is then downloaded on a computer for review by health care professionals.
"Continuous tissue glucose monitoring is breakthrough technology that ultimately could revolutionize the care of diabetics," said FDA Commissioner Jane E. Henney, M.D. "This new system is a first step in that direction. It identifies patterns or trends in the fluctuation of a patient's glucose level above or below the desired range. That information can help the doctor make adjustments in therapy."
Diabetics currently monitor glucose by testing blood samples obtained from finger pricks several times a day. The new system is not intended to replace this standard fingerstick testing.
The continuous glucose monitoring system is currently intended for one-time or occasional testing, rather than ongoing daily use. The information collected is intended to supplement that obtained by standard fingerstick testing. Diabetics must continue to do fingerstick tests while using the system.
Glucose levels can fluctuate widely throughout the day in people with diabetes--from very high to very low. This makes it difficult to determine when it is important to do fingerstick tests. Until now, there has been no way to continuously monitor those fluctuations.
The new system, available only by prescription, consists of a replaceable glucose sensor, a monitor, and a unit with a special program for transferring data from the monitor to a computer.
The sensor, which contains a glucose-sensing mechanism, is inserted under the skin at the abdomen like a tiny needle. The sensor is connected by wire to the monitor, which is worn externally by the patient and is about the size of a pager. The sensor measures tissue glucose every five minutes and stores the data in the monitor's memory.
After up to 72 hours, the patient removes and discards the sensor. The information collected is then transferred to a computer in a doctor's office for review. The patient does not see the tissue glucose information while wearing the device because it is not displayed on the monitor. However, the doctor may review the results with the patient as part of ongoing therapy planning.
FDA based approval of the monitoring system on results of a study involving more than 7,000 glucose readings in 62 diabetic adults who were evaluated at four medical centers in the United States.
The study showed that the system could help identify glucose trends and supplement standard readings obtained with traditional blood glucose fingerstick measurements.
Diabetes mellitus is a chronic disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose to enter the body's cells and be used for energy. There are two main forms of diabetes mellitus: Type I, which occurs mainly in young people and is controlled by diet and daily injections of insulin, and Type II, which usually affects overweight people over 40 and can be controlled in most cases by diet alone.
The MiniMed system was approved for use based on experience in Type I patients. As a condition of approval, FDA is requiring the manufacturer to conduct post-marketing studies to assess its safety and effectiveness in people with other types of diabetes, as well as in children and non-Caucasians.
An estimated 16 million people in the United States have diabetes. While there is no known cure, studies have shown that patients who regularly monitor their blood glucose levels and work closely with their healthcare providers have fewer complications such as blindness, amputation and heart disease.
20070906
Hoodia Diet Pills - Fact Or Fiction?
First some background on the hoodia cactus.
Deep inside the African Kalahari desert, grows an ugly cactus called the Hoodia. It thrives in extremely high temperatures, and takes years to mature.
The San Bushmen of the Kalahari, one of the world"s oldest and most primitive tribes, had been eating the Hoodia for thousands of years, to stave off hunger during long hunting trips.
When South African scientists were routinely testing it, they discovered the plant contained a previously unknown molecule, which has since been christened P 57.
P 57 affects a part of your brain, the hypothalamus. Within that mid-brain there are nerve cells that sense glucose sugar.
When you eat, blood sugar goes up because of the food, these cells start firing and now you are full.
What the Hoodia seems to contain is a molecule that is about 10,000 times as active as glucose.
It goes to the mid-brain and actually makes those nerve cells fire as if you were full. But you have not eaten. Nor do you want to.
When the first animal trials for Hoodia were performed on rats, a species that will eat literally anything, they stopped eating completely.
When the first human clinical trial was conducted, a morbidly obese group of people were placed in a "phase 1 unit", a place as close to prison as it gets.
All the volunteers could do all day was read papers, watch television, and eat.
Half were given Hoodia, half placebo. Fifteen days later, the Hoodia group had reduced their calorie intake by 1000 a day.
It"s hard to diet when you"re hungry. Your body is telling you to eat, so you eat. This is the single biggest factor that keeps people from loosing weight. No matter how strong your will power is, you eventually break down and start eating too much again.
Hoodia tackles every weight problem by the root: it simply stops your craving for food. Do you think you could loose weight if you ate 50% less then you do now? You bet you could. I have taken hoodia supplements and they really do make you feel like not eating.
For more information about hoodia, go to:
http://diet-pills-review.speedylearning.com/
9 Vitamins & Supplements to Improve Your Memory
something, only to get there and forget what you needed? You
often hear “Yes, you already told me about that” or maybe you
thought you told someone, but you never actually verbalized it.
Someone tells you their name and then ninety seconds later you
say, “Ok, tell me your name again.”
Perhaps you’re not as young as you used to be, you have more on
your plate to keep track of or you have a diagnosed or even
undiagnosed medical condition. Whatever the reason, you seem to
be plagued with a bad case CRS – Can’t Remember Squat. First and
foremost if you haven’t had a physical exam in a while, go see
your doctor. You’ll want to rule out anything serious that may
be causing your CRS. Barring any serious findings, you can take
some herbs, vitamins and other supplements to help regain some of
your memory. The vitamins, herbs and supplements listed below
may help.
Essential Fatty Acids, otherwise known as fish oils or EPA-DHA
are well known for their anti-inflammatory activity. Furthermore,
DHA is required for normal brain function in adults. Decreases in
brain DHA content are associated with age-related cognitive
decline, dementia, and Alzheimer"s disease.
Studies suggest that Polyphenol found in the skins of red grapes
and various other plants may protect against inflammation and
cognitive disorders.
Alpha-Lipoic Acid (ALA) is also an excellent antioxidant agent in
neurodegenerative diseases due to the fact that it can interrupt
free radical damage at several points. It has been shown to
elevate antioxidants in various brain regions and improves
memory. Further, ALA supports healthy blood glucose levels and
insulin activity.
Coenzyme Q10 is an antioxidant cofactor that has been shown to
protect the brain. In addition to being a potent free radical
scavenger, CoQ10 has proven to be effective in a wide variety of
age-related conditions.
Vitamin E is the primary antioxidant found in all tissues. Low
vitamin E levels are consistently associated with an increased
risk and occurrence of neurological diseases, including
Alzheimer’s and Parkinson’s. In a study of patients with
Alzheimer’s, treatment with 2000 IU of vitamin E per day for 2
years was beneficial in delaying the primary outcome (time to the
occurrence of death, institutionalization, loss of ability to
perform activities of daily living, and severe dementia) of
disease progression.
Ginkgo biloba extract is an approved treatment for dementia in
Germany, and it is the only nonprescription substance considered
a treatment for dementia in Canada. Ginkgo biloba is one extract
readily available. It enhances mental efficiency in elderly
patients with mild to moderate memory impairment. It is also
shown to improve cognitive function in patients with dementia, to
enhance blood flow to the brain, enhances cognitive performance
in patients with Alzheimer"s disease. Further it is said to
enhance memory in young individuals.
Adaptogenic herbs have been shown to reduce the negative effects
of stress. Due to the decreased ability to handle stress and the
increased levels of glucocorticoids associated with aging and
neurodegeneration, herbs with adaptogenic properties may be
beneficial. Ayurvedic herbs such as ashwagandha, holy basil, and
brahmi have a positive influence on stress response, mental
function, and cognition.
Carotenoids are a class of naturally occurring plant pigments
that provide the bright red, orange, and yellow colors of fruits
and vegetables. A balanced intake of mixed carotenoids, as found
in a healthy diet, provides the best protection against oxidative
damage.
Folate and vitamins B6 and B12 are needed for proper brain
function. Insufficiencies of these nutrients may result in
forgetfulness, memory loss, confusion, depression, dementia, and
mood and sensory changes. One study stated that age-related
impairment of cognitive function is likely related to vitamin
deficiencies, and is "preventable or reversible with improved
vitamins, especially vitamin B6, vitamin B12, and folate."
Additionally, scientists searching for a cure for Alzheimer"s
disease have found a potential ally in the herb sage. Checking
the writings of herbalists working four centuries ago, scientists
in England found a marked improvement in the memory capabilities
of Alzheimer’s patients who took sage oil extract. The finding
was consistent with a discovery by researchers at the
Universities" Medicinal Plant Research Center that sage protects
a key chemical destroyed in Alzheimer"s.
This list is not all inclusive and there could be a number of
other factors (environment, diet, disease) that could be the root
cause of your CRS. However, starting with a few supplements may
help you remember where you left your car keys!
The information contained in this article is for educational purposes
only and is not intended to medically diagnose, treat or cure any
disease. Consult a health care practitioner before beginning any
health care program.
About Author :
Emily Clark is editor at Lifestyle Health News and Medical Health News
where you can find the most up-to-date advice and information on
many medical, health and lifestyle topics.
Protein Principles for Diabetes
Proteins are the natural choice of the body when faced with diabetes. In uncontrolled diabetes, muscle protein is broken down into amino acids to be converted into glucose by the liver. If left to fend for itself, this can create a commotion within the body. Since proteins have to supply enough energy to substitute for carbohydrates, proteins are broken down faster than they are made. The body ends up with a protein deficit, a situation with subtle, yet far-reaching effects on normal body functions. Importantly, for diabetics, a protein deficit has been shown to impair resistance to infections (Ganong WF). Replenishing the depleting protein stores is a vital requirement of all diabetic diets.
Importance of proteins in a diabetic has been well documented. The American Associations of Clinical Endocrinologists have made it clear that not much evidence exists to indicate that the patients with diabetes need to reduce their intake of dietary proteins. The AACE recommends that 10-20% of the calorie intake in diabetes should come from proteins (AACE Diabetes Guidelines). It is in fact believed that this is one nutrient that does not increase blood glucose levels in both diabetics and healthy subjects (Gannon et al).
Nutrition therapy for diabetes has progressed from prevention of obesity or weight gain to improving insulin’s effectiveness and contributing to improved metabolic control (Franz MJ). In this new role, a high protein diet (30% of total food energy) forms a very pertinent part of nutrition therapy. One of the most important causes for type II diabetes is obesity. Excess body fat raises insulin resistance and higher levels of insulin are required to bring down blood sugars as the weight increases (Ganong WF). Another problem with excess fat is the clogging of arteries with atherosclerotic plaques that is responsible for a wide range of diabetic complications. Any mechanism that reduces body fat decreases insulin resistance and improves blood glucose control. Parker et al have also shown that a high protein diet decreased abdominal and total fat mass in women with type II diabetes. Other studies by Gannon et al. and Nuttall et al have verified that blood glucose levels and glycosylated hemoglobin (a marker of long term diabetic control) reduce after 5 weeks on a diet containing 30% of the total food energy in the form of proteins and low carbohydrate content. It is speculated that a high protein diet has a favorable effect in diabetes due to the ability of proteins and amino acids to stimulate insulin release from the pancreas. Thus, a high protein diet is not only safe in diabetes, but can also be therapeutic, resulting in improved glycemic control, and decreased risk of complications related to diabetes.
The benefits of a high protein diet do not end here. Individual protein components of such a diet, when aptly chosen, can have other advantages as well. Dietary supplements containing proteins like whey and casein come highly recommended. Casein is a milk protein and has the ability to form a gel or clot in the stomach. The ability to form this clot makes it very efficient in nutrient supply. The clot is able to provide a sustained, slow release of amino acids into the blood stream, sometimes lasting for several hours (Boirie et al. 1997). A slow sustained release of nutrients matches well with the limited amount of insulin that can be produced by the pancreas in diabetes. A protein supplement containing casein can thus increase the amount of energy assimilated from every meal and, at the same time, reduce the need for pharmacological interventions to control blood sugar.
Whey proteins and caseins also contain “casokinins” and “lactokinins’, (FitzGerald) which have been found to decrease both systolic and diastolic blood pressure in hypertensive humans (Seppo). In addition, whey protein forms bioactive amine in the gut that promotes immunity. Whey protein contains an ample supply of the amino acid cysteine. Cysteine appears to enhance glutathione levels, which has been shown to have strong antioxidant properties -- antioxidants mop up free radicals that induce cell death and play a role in aging.
Thus, development of a protein supplement containing casein and whey can provide an apt high protein diet and its health benefits to individuals suffering from diabetes, obesity and hypercholesterolemia.
ABOUT PROTICA
Founded in 2001, Protica, Inc. is a nutritional research firm with offices in Lafayette Hill and Conshohocken, Pennsylvania. Protica manufactures capsulized foods, including Profect, a compact, hypoallergenic, ready-to-drink protein beverage containing zero carbohydrates and zero fat. Information on Protica is available at http://www.protica.com
20070823
Diabetes Awareness: Ill Wait til it Hurts
By the time many type 2 diabetics (and often their doctors)
realize action is necessary, the disease, with its destructive
high blood sugars, has been silently damaging their body for
years.
Complications to the blood vessels and tissues of your eyes,
feet, heart, kidneys, and other organs, are likely well underway.
You visit the doctor because you feel bad, and you wish to feel
better. You react to the symptoms of perceived illness. This is
understandable, but does not allow much room for prevention or
early detection of diabetes.
Of course this idea, "Don't see the doctor 'til it hurts,"
comes from our "busier-then-ever" lifestyles. But to blame, to
point fingers after the damage has started is as pointless as is
the leaping bungee-jumper's complaint that his equipment has just
failed. It's a little late to talk about why. Some problems are
better prevented.
If you have type 2 diabetes, you know most of the time you don't
feel very bad. You might think that because you don't feel very
bad, it isn't very serious, and you don't have to do anything
about it just now. "I'll wait 'til it hurts" ...You couldn't be
more wrong.
Diabetes damages your body with high blood sugars. It doesn't care
whether your sugars are high from type 2, type 1, or some other
cause - if they're up, they're doing damage. Type 2 diabetics
who let their sugars run "because they don't feel bad" are doing
serious damage to their eyes, kidneys, hearts, and nervous
systems.
Suppose you have diabetes, and don't want the complications.
Suppose you don't know you have diabetes, but you're from a
high-risk group (maybe someone in your family has or had diabetes),
and you want to cut the risks. Or, suppose you just want to feel
better.
It's all the same - Your early detection, education, and prevention
work best.
Don't wait 'til it hurts. Ask your doctor about diabetes and have
your blood sugar checked several times a year.
For more information about diabetes, including a Diabetes Quiz and
a Free booklet, visit our website at:
http://hope4diabetes.com/info
This 20 page FREE booklet will provide you with in-depth information
on comprehensive diabetes care. The 7 principles, or steps, will help
you to understand, manage and diagnose your potential diabetes risk.
It could help you live a longer and more active life. The booklet is
Yours absolutely FREE - No Risk! Share it NOW with the people you
love and want to Keep alive!.
David Anderson
Freelance healthwriter at Hope4Diabetes.com
Humulin or Lantus, Which Insulin For Your Child?
Humulin or Lantus? When my daughter, who was 8, was first diagnosed the Children's Hospital that was treating her put her on an insulin program of short acting Humalog NPH and long acting Humalin N. You should have seen me that first day of training after a long night in the emergency room where she was diagnosed. I was a raving lunatic to begin with so my brain was mostly mush at that point. Add to that everything began with "H". Mix this "H" with that "H" but first charge this "H" with air, then draw this "H" first followed by that "H" but make sure you roll this "H" between your palms and for crying-out-loud don't shake that "H". Anyway I guess osmosis worked and all of that information finally seeped in. We were officially diabetic now.
For those of you who may not be familiar with it, Humalog and Humalin (short and long acting insulins) are mixed in the same syringe and injected 3 times a day usually before meals. Your child is allowed a certain amount of carbohydrates for each meal that the doctor figures out based on age, weight, etc., and that's your number. My daughter's was 65 carbs max per meal and 35 max per snack. However your child hits their magic number that's it. Whether it's 65 slices of ham or half a pop-tart. Plus she had to eat 6 times a day at certain times everyday.
Well the time came when she decided she wanted a little more freedom of choice and asked me about trying Lantus. My first thought was if it's not broke don't fix it. But I can have a cupcake whenever I want so I decided my opinion was secondary. So we looked into it. Lantus is a long lasting insulin. One shot at night and she had a 24 hour basal dose of insulin. "One shot" I'm thinking to myself "that's great". But wait, you also have to take a shot of short acting insulin (a bolus) everytime you eat. 10 meals 10 shots, 3 meals, 3 shots. Even I could figure that out. You base the amount of short acting insulin on the number of carbs you are about to eat. Talk about freedom! Compared to what she had been doing it was like being re-born. she didn't care that it would mean more shots. All she heard was she could eat what she wanted when she wanted. Birthday cake, pizza parties, popcorn at the movies, boy she was ready to go. The first thing she wanted to have was a Blizzard from Dairy Queen. I looked at the chart on the wall and it read 125 carbohydrates. That was half a days carbs in a paper cup! After a couple of days of gluttony things got back to normal pretty quickly.
Remember that freedom I mentioned, it came at a price. This insulin regime is a lot of shots. Add those to the required blood tests and your talking about a lot of holes per day in a little girl. One more thing, her nighttime Lantus shot was 19 units. that's a lot of insulin all at once. In her case it went in like battery acid. These shots are no fun. However, after several months on the Lantus regime her life and the rest of my family's lives are pretty close to pre-diagnosis normal. All in all it was the right thing to do. If your doctor is suggesting Lantus or your child is asking about it, consider all of the above. We're glad we did it.
Russell Turner is the father of a 10 year old diabetic daughter. He realized early on that he could find all the medical information about diabetes he could ever need on the internet. What he couldn't find was information that told him how to keep his family's life normal after the diagnosis. He started his own website dedicated to just that. Visit http://www.mychildhasdiabetes.com Prepare you child for life with diabetes!
Insulin and Diabetes
Insulin has two critical roles in the body that we cannot live without, yet it can be the root of many health problems, including diabetes. Insulin carries sugar (glucose), fat and protein into your cells where they are used for energy and the repair of your cells. When you eat, a certain amount of the food will be converted into glucose and enter the bloodstream. As the sugar levels rise, the body senses it and the pancreas secretes insulin to lower the sugar. This is insulin's second main function.
If you eat too much of any food, especially carbohydrates (starch and sugar) the levels of glucose in the blood rise to very high levels. In turn this triggers a large release of insulin from the pancreas. Your cells will take what they need and then insulin will begin the process of converting the excess glucose, fat and protein into fat and then put it all away in your fat cells. By combining foods the right way for your body, you will maintain optimum levels of insulin throughout the day.
The best way to control insulin and fight sugar cravings is to eat protein snacks when you are hungry or when you have severe "sweet" cravings. Also, try to limit yourself to three carbohydrate-containing meals per day and try to eat vegetables with most meals and snacks.
A particularly good snack is non-fat cottage cheese and salsa. The only vegetables to avoid in the evening are corn, yellow or orange squash, peas, beets and carrots. They have high simple carbohydrate (sugar) content.
Good natural sources of protein for meals or snacks are:
Chicken breast
Turkey
Fish
Lean Pork
Lean Steak
7% or less Ground Beef
Egg whites
Egg Beaters
Tofu
Non-fat cottage cheese
Non-fat cheese
Non-fat cream cheese
Non-fat sour cream
Fat-free Ham or Canadian bacon
You can also try protein powder and protein bars.
I recommend Labrada ProPlete Protein powder. It is low fat, low carb and high protein. It comes in several flavors and you can probably get it at GNC stores or any vitamin store. It does not have artificial sweeteners. It is sweetened with Stevia, which is all-natural and it made from the root and leaves of the Stevia plant.
Labrada also makes good low-carb, sugar free protein bars. Other good protein bars are Ultimate Lo-Carb, Ultimate Lo-Carb2 and Premiere Elite. These are good as a "pretend candy bar" when you're having a craving. Just don't over do it. The last three bars I mentioned do have artificial sweeteners. You can find them at GNC, Trader Joe's and many vitamin stores.
The key is to eat frequently throughout the day and also have a real sweet treat once a week if that will help you stay away from sweets the rest of the week.
My fat loss and fitness plan "Every Body Loses" will give you the tools you need to begin a healthy weight loss program. The style of eating and exercising outlined in my book is one that you can follow for life without feeling deprived. If you're serious about losing fat and getting fit go to www.aim4nutrition.com and get started TODAY!
Good Luck and Be Well,
Aimee Deak
Personal Trainer & Nutrition Analyst
AIM 4 NUTRITION
www.aim4nutrition.com
20070803
Causes of Hypoglycemia
by Timothy Gower
Keeping blood sugar from rising too high is the goal for anyone with any variety of diabetes. But hypoglycemia (high po gly see me uh) is, in a sense, the result of too much success. This term for very low blood sugar is a combination of three Greek words: Hypo = under, glykys = sweet, and haima = blood. Anyone can become hypoglycemic, but for people with diabetes, curbing the threat of nose-diving blood sugar is part of daily life.
When glucose levels drop off, cells throughout much of the body can adjust by living off fat and protein, at least temporarily. But one very important organ -- the one located between your ears -- can't use fat and protein for energy. Since the brain needs glucose to survive, it regards a sugar shortage as a crisis. Early symptoms are no big deal. You feel hungry and a little shaky and nervous, like you had too much coffee. But soon you begin to feel woozy and need to sit down. Your heart thumps, and you break into a cold sweat. Unless you take the proper steps, you may become confused and talk incoherently. Your vision blurs and your head feels ready to burst. In a sense, it is: In extreme cases, hypoglycemia causes convulsions and even comas.
What causes a plunge in blood sugar? In a person who does not have diabetes, hypoglycemia is fairly uncommon, since the body comes equipped with an efficient system that keeps blood sugar levels balanced. When blood sugar begins to drop, the pancreas senses trouble and slows down insulin production, so the body doesn't use up glucose so quickly. For an added boost, the pancreas makes the hormone glucagon, which signals the liver to convert some glycogen to glucose, then release the sugary stuff into the blood. It all happens so quickly that a dip in blood sugar is brief and goes unnoticed.
This system can get out of whack if you have diabetes, making it tricky to maintain balanced blood sugar. That's especially true if you inject insulin or take sulfonylureas or meglitinides, two widely used medications that perk up insulin production in the pancreas. Getting the proper dose of these therapies exactly right is something of an art. To avoid frequent bouts of hypoglycemia, you must become expert at tweaking your dosage when necessary and knowledgeable about the steps you can take to help keep your blood sugar from plummeting.
Using insulin or insulin-stimulating medications increases the risk for low blood sugar, but the problem can be triggered by other conditions and circumstances. If you develop symptoms but your glucose levels appear to be safe (and you know your glucose meter is working properly), talk to your doctor. Hypoglycemia can also be caused by:
-Other medications, including aspirin, sulfa drugs (for treating infections), pentamidine (for serious pneumonia), and quinine (for malaria)
-Alcohol, especially if you go on a bender. Heavy doses of booze interfere with the liver's ability to release glucose.
-Other illnesses, including diseases of the heart, kidneys, and liver. Also, rare tumors called insulinomas produce insulin, which would raise levels of the hormone too high, causing blood sugar to drop.
-Hormonal deficiencies. More common in children, a shortage of glucagon, as well as other hormones (including cortisol, growth hormone, and epinephrine) can cause hypoglycemia.
ABOUT THE AUTHOR:
Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.
20070711
Choosing a Glucose Meter
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Choosing a Glucose Meter
At least 25 different meters are commercially available.
They differ in several ways including
Amount of blood needed for each test
Testing speed
Overall size
Ability to store test results in memory
Cost of the meter
Cost of the test strips used
To search FDA's 510(k) database for glucose meters available over-the-counter (without a prescription), use the following link:
FDA 510(k) Database Search (Over-the-Counter Glucose Meters)
Newer meters often have features that make them easier to use than older models. Some meters allow you to get blood from places other than your fingertip (Alternative Site Testing). Some new models have automatic timing, error codes and signals, or barcode readers to help with calibration. Some meters have a large display screen or spoken instructions for people with visual impairments.
Cholesterol
If you have diabetes, you have a higher risk of heart and blood vessel disease (cardiovascular disease). One way to limit this risk is to measure your cholesterol routinely and control it by changing your lifestyle or taking prescription drugs. A cholesterol test usually shows your total cholesterol, total triglycerides, and high-density lipoproteins (HDLs). The Centers for Disease Prevention and Control (CDC) has set up a National Reference System for Cholesterol Testing and many manufacturers verify their test through certification with this method.
For more information about cholesterol testing, use the following link:
Medlineplus Healthline Health Information, Medical Encyclopedia, Cholesterol Test
http://www.nlm.nih.gov/medlineplus/ency/article/003492.htm
Microalbumin
One common and extremely serious result of diabetes is kidney failure. Under normal conditions, the kidneys filter toxins from the blood. When the kidney's filtering processes begin to become impaired, protein (microalbumin) begins to spill into the urine. Testing urine for small, yet abnormal amounts of albumin (microabluminuria) is a common way to detect this condition early, before it can damage your kidneys.
Many urine dipsticks are used to test for large amounts of albumin. To measure a small amount of albumin, which may show an early stage of kidney disease, your health care provider may use specific tests for low levels of albumin (microalbumin tests). To do this test, you may have to collect your urine for several 24-hour periods.
The ADA recommends that adults with diabetes be tested for microalbumin every 3- to 6-months. The ADA recommends testing in children with type 1 diabetes at puberty or after having diabetes for 5 years.
Early detection of microalbumin is important because it indicates increased risk for both renal and vascular disease. Fortunately, early detection allows for treatments that may delay the beginning of a more serious disease.
For more information about microalbumin tests, use the following link:
Medlineplus Healthline Health Information, Medical Encyclopedia, Microalbuminuria
http://www.nlm.nih.gov/medlineplus/ency/article/003591.htm
Urine and Blood Ketones
When the body does not have enough insulin, fats are used for fuel instead of glucose. A by-product of burning fats is the production of ketones. Ketones are passed in the urine and can be detected with a urine test.
If you do not have diabetes, you usually have only small amounts of ketones in your blood and urine. If you have diabetes, however, you may have high amounts of ketones and acid, a condition known as ketoacidosis. This condition can cause nausea, vomiting, or abdominal pain and can be life threatening.
You may use urine dipsticks to rapidly and easily measure the ketones in your urine. You dip a dipstick in your urine and follow the instruction on the package to see if you have a high amount of ketones.
If you have type 1 diabetes, are pregnant with preexisting diabetes, or who have diabetes caused by pregnancy (gestational diabetes), you should check your urine for ketones. If you have diabetes and are ill, under stress, or have any symptoms of high ketones, you should also test your urine for ketones.
Results of ketone testing should be interpreted with care. High ketone levels are found when patients are pregnant (in the first morning urine sample), starving, or recovering from a hypoglycemic episode.
There are now tests for measuring ketones in blood that your doctor may use or you can use at home. Some measure a specific ketone (beta-hydroxybuyric acid) that patients with diabetic ketoacidosis may have.
It is still not known which type of ketone test -blood or urine-- offers more aid to people with diabetes.
For more information about ketone tests, use the following links:
Medlineplus Healthline Health Information, Medical Encyclopedia, Ketones-Urine
http://www.nlm.nih.gov/medlineplus/ency/article/003585.htm
Medlineplus Healthline Health Information, Medical Encyclopedia, Serum Ketones
http://www.nlm.nih.gov/medlineplus/ency/article/003498.htm
Urine Glucose
Only patients who are unable to use blood glucose meters should use urine glucose tests. Testing urine for glucose, which was once the best way for patients to manage their diabetes, has mostly now been replaced by self-monitoring of blood glucose. There are three major drawbacks of urine glucose testing compared to blood testing. First, urine glucose testing will not tell you about low (below 180 mg/dl) glucose levels, since at lower levels glucose does not enter your urine. Second, urine glucose readings change when the volume of your urine changes. Third, your urine glucose level is more of an average value than your blood glucose level. There are several dipstick tests available on the market.
For more information about measuring glucose in urine, use the following link:
Medlineplus Healthline Health Information, Medical Encyclopedia, Glucose-Urine
http://www.nlm.nih.gov/medlineplus/ency/article/003581.htm
Glycosylated Serum Proteins
Serum proteins, like hemoglobin, combine with glucose to form glycosylated products. Testing these glycosylated products can give information about your glucose control over shorter periods of time than testing glycosylated hemoglobin.
One common test is the fructosamine test. It gives information on your glucose status over a one- to two-week period. High values mean your blood glucose was high over the past two weeks. This test is good for watching short-term changes in your glucose status during pregnancy or after major changes in your therapy. There is no general guideline for when to use this test. Talk to your doctor about whether this test is right for you.
If you have any other disease that can change your serum proteins or if you have large amounts of Vitamin C (ascorbic acid) in your diet, these tests may give wrong values.
For more information about the fructosamine test, use the following link:
Technical and Clinical Evaluation of Fructosamine Determination in Serum.
(Scroll Down)
http://www.cdc.gov/diabetes/pubs/economics/biblio_1-2.htm
Other Diabetes Management Tests
Glycosylated Hemoglobin
There is hemoglobin in all red blood cells. Hemoglobin is the part of the red blood cell that carries oxygen to the tissues and organs in the body. Hemoglobin combines with blood glucose to make glycosylated hemoglobin or hemoglobin A1c.
Red blood cells store glycosylated hemoglobin slowly over their 120-day life span. When you have high levels of glucose in your blood, your red blood cells store large amounts of glycosylated hemoglobin. When you have normal or near normal levels, your red blood cells store normal or near normal amounts of glycosylated hemoglobin. So, when you measure your glycosylated hemoglobin, you can find out your level of blood glucose, averaged over the last few months.
Doctors have used the glycosylated hemoglobin test for patients with diabetes since 1976 (1,2). The test is now widely used in the routine monitoring of patients with diabetes mellitus. Your doctor may use this test to see how well you respond to treatment. If you have low test values you probably have lowered risk for having complications from diabetes mellitus.
It is good to have your glycosylated hemoglobin tested at least two times a year if you meet your treatment goals or up to four times a year if you change therapy or do not meet your treatment goals. There are now many different ways to measure glycosylated hemoglobin. These tests vary in cost and convenience and you can do some at home. The values (glycosylated hemoglobin index) these tests give can vary too. Talk to your doctor about what your glycosylated hemoglobin index should be.
Patients with diseases affecting hemoglobin, such as anemia, may get wrong values with this test. Vitamins C and E, high levels of lipids, and diseases of the liver and kidneys may all cause the test results to be wrong.
References
1. Bunn HF, Haney DN, Kamin S, et al: The biosynthesis of human hemoglobin A1C: slow glycosylation of hemoglobin in vivo. J Clin Invest 57(6):1652-9, 1976.
2. Fabbay KH: Editorial: Glycosylated hemoglobin and diabetic control. N Eng J Med 295(8):443-4, 1976.
For more information about the glycosylated hemoglobin test (HbA1c), use the following links:
Medlineplus Healthline Health Information, Medical Encyclopedia, Glycosylated Hemoglobin
http://www.nlm.nih.gov/medlineplus/ency/article/003640.htm
National Diabetes Education Program--HbA1c Quiz and Answers
http://ndep.nih.gov/materials/pubs/HbA1c/HbA1c-checkIQ.htm
Glycosylated Hemoglobin
http://www.healthy.net/library/books/textbook/section2/glyhem.pdf
Review Criteria for Assessment of Glycohemoglobin (Glycated or Glycosylated) Hemoglobin In Vitro Diagnostic Devices
http://www.fda.gov/cdrh/ode/odecl658.html
The National Glycohemoglobin Standardization Program (NGSP)
http://www.missouri.edu/~diabetes/ngsp.html
A Brief History of Self-Monitoring of Blood Glucose with Glucose Meters
Anton Hubert Clemens received the first patent for a blood glucose meter called the Ames Reflectance Meter on September 14, 1971. Richard K. Bernstein, an insulin dependent physician with diabetes, was one of the first patients to monitor his blood glucose at home using a glucose meter. He published a report on his experiences in an early volume of the medical journal, Diabetes Care. He has also written a book on this subject "Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars".
The first articles in the medical literature on the home blood glucose monitoring were published in 1978 (references 1-5). These demonstrated that patients could reliably measure their blood glucose levels at home and improve control of their glucose levels.
In November 1986, the American Diabetes Association, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health convened a Consensus Conference on Self-Monitoring of Blood Glucose. The results of that conference was that self-monitoring of blood glucose was an exciting and important tool for effective management of patients with diabetes (reference 6). It was recommended that SMBG be used by patients to accomplish the following goals:
(a) Keep track of their glucose levels over time,
(b) Help make day-to-day decisions for managing glucose,
(c) Recognize emergency situations, and
(d) Educate themselves on how to manage their blood glucose levels
SMBG was first used because health care providers and researchers believed that its use would help with glucose control and that better glucose control would reduce or prevent diabetes complications. In other words, if hyperglycemia (too much glucose in the blood) and hypoglycemia (too little glucose in the blood) could be controlled, people with diabetes would remain healthier.
This expectation was shown to be true in 1993, when the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) published results of a large and conclusive study called the Diabetes Control and Complications Trial (DCCT), which involved patients at 29 medical centers in the United States and Canada. In this study, SMBG was an important part of the glucose control strategy.
This study showed that for persons with type 1 diabetes, intensive treatment to keep blood glucose levels close to normal reduced the rate of diabetic complications. In fact, the risk reduction was 76% for eye disease, 50% for kidney disease, and 60% for nerve disease.
These benefits of tight control of glucose were not problem-free however. Patients in the intensive treatment group had an increased risk of hypoglycemia.
In September 1993 the American Diabetes Association held a second Development Conference on Self-Monitoring of Blood Glucose. This conference noted that SMBG was an important component of the treatment plan of patients with diabetes mellitus and four major reasons for using SMBG were discussed:
(a) Controlling glucose at a specific, healthy level,
(b) Detecting and preventing hypoglycemia, and severe hyperglycemia,
(c) Adjusting care in response to changes in life-style for individuals requiring medication, and
(d) Determining the need for starting insulin therapy in gestational diabetes mellitus (temporary diabetes that happens during pregnancy).
Currently, the market for blood glucose meters is several billions dollars per year worldwide and growth continues.
References
1. Danowski TS and Sunder JH: Jet injections of insulin during self-monitoring of blood glucose. Diabetes Care 1:27-33, 1978.
2. Skyler JS et al: Home blood glucose monitoring as an aid in diabetes management. Diabetes Care 1:150-157, 1978.
3.Sonksen PH, Judd Sl, and Lowy C: Home monitoring of blood glucose- method for improving diabetic control. Lancet 1: 729-732, 1978.
4. Walford S et al: Self-monitoring of blood glucose -- improvement of diabetic control: Lancet 1: 7320735, 1978.
5. Peterson et al: Feasibility of tight control of juvenile diabetics through patient-monitored glucose determinations. Diabetes 27(suppl 2): 437, 1978.
6. Ikeda Y et al: Pilot study of self-measurement of blood glucose using the Dextrostix-Eyetone system for juvenile-onset diabetes. Diabetologia 15:91-93, 1978.
Performance Goals for Glucose Meters
Deciding performance standards for glucose meters has been controversial and challenging. In spite of effort in the late 1970s and 1980s by both FDA and CDC, no universally accepted standards or testing methods have been developed for the measurement of glucose. CDC (Centers for Disease Control and Prevention) recently held a standards conference and is exploring the possibility of developing a standard reference material for whole blood.
The ADA has recommended accuracy goals twice over the past twenty years, once in 1986 (target accuracy of +/- 15%) and once in 1993 (target accuracy of +/- 5%) No company that manufacturers glucose meters has developed a cost-effective system to meet these goals. A number of alternative standards have been suggested by national standards organizations in the U.S., Canada, and Europe. An international standard ISO DIS 15197 is currently under development that recommends accuracy of +/- 20 mg/dl for glucose values under 100 mg/dl and +/- 20% for higher glucose values.
Although data on glucose meters continue to show variable performance, the newest generations of meters are simpler to use and more accurate than older models. Improvements in the chemical, mechanical and software components of glucose meters are continuing to help with the management of diabetes.
How FDA Regulates Glucose Meters
FDA reviews all glucose meters and test strips before they can be marketed to the public. This FDA "premarket" review process requires the manufacturer of the meter to show that the meter system provides acceptable accuracy and consistency of glucose measurement at high, medium and low levels of glucose as compared to glucose meters already being sold. The quality of software is an increasingly important feature of glucose meters since it controls the testing and data storage and controls the displays that the user sees and uses when testing.
FDA also considers possible interference from over-the-counter medications, prescription medications, and vitamin supplements.
FDA also asks for data showing how well the meter has performed during actual use (a type of human factors study). These studies ensure that users understand the labeling, achieve good results, and avoid experiencing problems that could affect their health.
For an outline of the FDA review process for glucose meters, use the following link:
Review Criteria Assessment of Portable Blood Glucose Monitoring In Vitro Diagnostic Devices Using Glucose Oxidase, Dehydrogenase or Hexokinase Methodology (Draft Document)
http://www.fda.gov/cdrh/ode/gluc.html
For information about the application of human factors to the design of medical devices, use the following link:
Medical Device Use Safety: Incorporating Human Factors Engineering into Risk Management
http://www.fda.gov/cdrh/humfac/1497.pdf
FDA quality system regulations require that manufacturers who make glucose meters follow the same quality standards every time. In this way, users can be assured that new meters and strips perform as well as older models.
FDA's responsibility for medical devices does not end when the devices enters the market. To monitor the quality of products, FDA routinely inspects manufacturing facilities. It also receives information from the manufacturers, health providers and the general public through the MedWatch system.
Minimally Invasive and Non-Invasive Glucose Meters
Researchers are exploring new technologies for glucose testing that avoid fingersticks. One of these is based on near-infrared spectroscopy for measurement of glucose. Essentially, this amounts to measuring glucose by shining a beam of light on the skin. It is painless. There are increasing numbers of reports in the scientific literature on the challenges, strengths, and weaknesses of this and other new approaches to testing glucose without fingersticks.
FDA has approved one "minimally invasive" meter and one "non-invasive" glucose meter. Neither of these should replace standard glucose testing. They are used to obtain additional glucose values between fingerstick tests. Both devices require daily calibration using standard fingerstick glucose measurements and both remain the subject of continuing studies to find how they are best used as tools for diabetes management.
MiniMed Continuous Glucose Monitoring System. The MiniMed system consists of a small plastic catheter (very small tube) inserted just under the skin. The catheter collects small amounts of liquid that is passed through a "biosensor" to measure the amount of glucose present.
Minimed is intended for occasional use and to discover trends in glucose levels during the day. It does not give you readings for individual tests and therefore you can't use it for typical day-to-day monitoring. The device collects measurements over a 72-hour period and then must be downloaded by the patient or healthcare provider. Understanding trends over time might help patients know the best time to do their standard fingerstick tests. You need a prescription to buy MiniMed.
For more information about MiniMed, use the following link: [This document is in PDF format and requires Adobe Acrobat to read.]
Mimimed Continuous Glucose Monitoring System (CGMS)
http://www.fda.gov/cdrh/pdf/p980022b.pdf
Cygnus GlucoWatch Biographer. GlucoWatch is worn on the arm like a wristwatch. It pulls tiny amounts of fluid from the skin and measures the glucose in the fluid without puncturing the skin. The device requires 3 hours to warm up after it is put on. After this, it can provide up to 3 glucose measurements per hour for 12 hours. Unlike the MiniMed device, the GlucoWatch displays results that can be read by the wearer, although like the MiniMed device, these readings are not meant to be used as replacements for fingerstick-based tests. The results are meant to show trends and patterns in glucose levels rather than report any one result alone. It is useful for detecting and evaluating episodes of hyperglycemia and hypoglycemia. However, you must confirm its results with a standard glucose meter before you take corrective action. You need a prescription to buy GlucoWatch.
For more information about GlucoWatch, use the following link:
Cygnus GlucoWatch Automatic Glucose Biographer http://www.fda.gov/cdrh/mda/docs/p990026.html
New Technologies: Alternative Site Testing
Some glucose meters allow testing blood from alternative sites, such as the upper arm, forearm, base of the thumb, and thigh
Sampling blood from alternative sites may be desirable, but it may have some limitations. Blood in the fingertips show changes in glucose levels more quickly than blood in other parts of the body. This means that alternative site test results may be different from fingertip test results not because of the meter's ability to test accurately, but because the actual glucose concentration can be different. FDA believes that further research is needed to better understand these differences in test values and their possible impact on the health of people with diabetes.
Glucose concentrations change rapidly after a meal, insulin or exercise. Glucose levels at the alternative site appear to change more slowly than in the fingertips. Because of this concern, FDA has now requested that manufacturers either show their device is not affected by differences between alternative site and fingertip blood samples during times of rapidly changing glucose, or alert users about possible different values at these times.
Recommended labeling precautions include these statements:
Alternative site results may be different than the fingertip when glucose levels are changing rapidly (e.g. after a meal, taking insulin or during or after exercise).
Do not test at an alternative site, but use samples taken from the fingertip, if
you think your blood sugar is low,
you are not aware of symptoms when you become hypoglycemic, or
the site results do not agree with the way you feel.
In October, 2001, FDA held a public meeting to discuss the types of information and labeling needed for glucose measuring devices if the blood sample is taken from alternative sites rather than the fingertip. Presenters included manufacturers of blood glucose meters, healthcare providers, people with diabetes, and parents of children with diabetes.
For more information about the panel meeting on alternative site testing, use the following link:
Clinical Chemistry and Clinical Toxicology Devices Panel Meeting Summary for October 29, 2001
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfAdvisory/details.cfm?mtg=260
User Experiences with Glucose Meters
The FDA's Center for Devices and Radiological Health (CDRH) held a series of focus groups on blood glucose meter use in 2001. The twenty-two members participated in six groups. They were all government employees, mostly from CDRH. They were either people with diabetes or family members of people with diabetes who were familiar with the use of glucose meters.
Most of the participants in these groups were satisfied with their meters. Some were quite enthusiastic about the new models. A few had some concerns about meters. One such participant stated: "The first meter I got I couldn't use because it was too difficult."
Repeating Tests. Most users repeated tests now and then because they believed the first test result was incorrect. Users questioned test results based on their expectations about what the results should be. If the glucose level seemed "off," they repeated the test.
The ability to judge whether or not a test seemed accurate appeared to come from the users' experiences with their meters. These experiences helped them know how they felt when their glucose level was high, when it was low and when it was about right. They also were aware of what and when they had eaten, exercised, slept, or taken insulin, and they learned to anticipate the effect these activities have on their glucose levels.
Comments users made about their results include the following:
I sometimes get a reading of perhaps 300 and then 180 on a retest. This happens in about 1 in 50 tests.
Glucose tablet residue on my finger can throw results way off.
I get some inaccurate readings - especially when the meter is new.
Sometimes I get higher readings than I expect, probably because the meter was left out of the case or food got on it.
The date wears off of the vial and I end up using expired strips.
Humidity around the bathroom seems to affect performance of the strips.
If I have wet hands, my results tend to be higher than expected.
Besides repeating tests because of a suspected inaccuracy in the first test, a frequent reason to repeat a test was that the meter indicated "insufficient blood" on the test strip and would not complete the test on the first attempt. When this happens, users needed to do another fingerstick. Users whose meters required less blood did not have this problem as often.
Feelings about Fingersticks. Surprisingly, most of the participants stated that fingerstick discomfort was not a big concern - even with children: "At first, fingersticks were a real problem, but now it doesn't bother her."
Most participants stated that discomfort was an issue when they first started to use the meter; this was especially true for children, but that the discomfort grew less important after a few weeks or months of use.
However, one participant of a "fragile" child with diabetes stated: "We test 8 to 10 times a day. He was losing sensitivity in his fingertips [from the frequent fingersticks]. We prefer the meter that allows testing in alternative sites."
Use of Test Solution. Most users did not use test solution often. Some never used it. They stated that the solution was difficult to use because it expired in a month, it was difficult to order, and they were not convinced that it helped.
Important Features. Users discussed and rated aspects of meters such as accuracy, ease-of-use, cost of the meter, cost of test strips, size, whether it was recommended by a friend etc. The most important consideration in this group was accuracy. This was followed by "ease of use" and then affordability.
Making Sure Your Meter Works Properly
You should perform quality-control checks to make sure that your home glucose testing is accurate and reliable. Several things can reduce the accuracy of your meter reading even if it appears to still work. For instance, the meter may have been dropped or its electrical components may have worn out. Humidity or heat may damage test strips. It is even possible that your testing technique may have changed slightly. Quality control checks should be done on a regular basis according to the meter manufacturer's instructions. There are two kinds of quality control checks:
Check Using "Test Quality Control Solutions" or "Electronic Controls". Test quality control solutions and electronic controls are both used to check the operation of your meter. Test quality control solutions check the accuracy of the meter and test strip. They may also give an indication of how well you use your system. Electronic controls only check that the meter is working properly.
Test quality control solutions have known glucose values. Essentially, when you run a quality control test, you substitute the test solution for blood. The difference is that you know what the result should be.
To test your meter with a quality control solution, follow the instructions that accompany the solution. These will guide you to place a certain amount of solution on your test strip and run it through your meter. The meter will give you a reading for the amount of glucose in the sample. Compare this number to the number listed on the test quality control solution. If the results of your test match the values given in the quality control solution labeling, you can be assured the entire system (meter and test strip) is working properly. If results are not correct, the system may not be accurate--contact the manufacturer for advice.
Manufacturers sometimes include quality control solution with their meter. However, most often you must order it separately from a manufacturer or pharmacy.
Some glucose meters also use electronic controls to make sure the meter is working properly. With this method, you place a cartridge or a special "control" test strip in the meter and a signal will appear to indicate if the meter is working.
Take Your Meter with You to The Health Care Provider's Office. This way you can test your glucose while your health care provider watches your technique to make sure you are using the meter correctly. Your healthcare provider will also take a sample of blood and evaluate it using a routine laboratory method. If values obtained on the glucose meter match the laboratory method, you and your healthcare provider will see that your meter is working well and that you are using good technique. If results do not match the laboratory method results, then results you get from your meter may be inaccurate and you should discuss the issue with your healthcare provider and contact the manufacturer if necessary.
Factors That Affect Glucose Meter Performance
The accuracy of your test results depends partly on the quality of your meter and test strips and your training. Other factors can also make a difference in the accuracy of your results.
Hematocrit. Hematocrit is the amount of red blood cells in the blood. Patients with higher hematocrit values will usually test lower for blood glucose than patients with normal hematocrit. Patients with lower hematocrit values will test higher. If you know that you have abnormal hematocrit values you should discuss its possible effect on glucose testing (and HbA1C testing) with your health care provider. Anemia and Sickle Cell Anemia are two conditions that affect hematocrit values.
Other Substances. Many other substances may interfere with your testing process. These include uric acid (a natural substance in the body that can be more concentrated in some people with diabetes), glutathione (an "anti-oxidant" also called "GSH"), and ascorbic acid (vitamin C). You should check the package insert for each meter to find what substances might affect its testing accuracy, and discuss your concerns with your health care provider.
Altitude, Temperature and Humidity. Altitude, room temperature, and humidity can cause unpredictable effects on glucose results. Check the meter and test strip package insert for information on these issues. Store and handle the meter and test strips according to the instructions.
Third-Party Test Strips. Third-party or "generic glucose reagent strips" are test strips developed as a less expensive option than the strips that the manufacturer intended the meter to be used with. They are typically developed by copying the original strips. Although these strips may work on the meter listed on the package, they could look like strips used for other meters. Be sure the test strip you use is compatible with your glucose meter.
Sometimes manufacturers change their meters and their test strips. These changes are not always communicated to the third-party strip manufacturers. This can make third-party strips incompatible with your meter without your knowledge. Differences can involve the amount, type or concentration of the chemicals (called "reagents") on the test strip, or the actual size and shape of the strip itself. Meters are sensitive to these features of test strips and may not work well or consistently if they are not correct for a meter. If you are unsure whether or not a certain test strip will work with you meter, contact the manufacturer of your glucose meter.
Important Features Of Glucose Meters
There are several features of glucose meters that you need to understand so you can use your meter and understand its results. These features are often different for different meters. You should understand the features of your own meter.
Measurement Range. Most glucose meters are able to read glucose levels over a broad range of values from as low as 0 to as high as 600 mg/dL. Since the range is different among meters, interpret very high or low values carefully. Glucose readings are not linear over their entire range. If you get an extremely high or low reading from your meter, you should first confirm it with another reading. You should also consider checking your meter's calibration.
Whole Blood Glucose vs. Plasma Glucose. Glucose levels in plasma (one of the components of blood) are generally 10-15% higher than glucose measurements in whole blood (and even more after eating). This is important because home blood glucose meters measure the glucose in whole blood while most lab tests measure the glucose in plasma. There are many meters on the market now that give results as "plasma equivalent". This allows patients to easily compare their glucose measurements in a lab test and at home. Remember, this is just the way that the measurement is presented to you. All portable blood glucose meters measure the amount of glucose in whole blood. The meters that give "plasma equivalent" readings have a built in algorithm that translates the whole blood measurement to make it seem like the result that would be obtained on a plasma sample. It is important for you and your healthcare provider to know whether your meter gives its results as "whole blood equivalent" or "plasma equivalent."
Cleaning. Some meters need regular cleaning to be accurate. Clean your meter with soap and water, using only a dampened soft cloth to avoid damage to sensitive parts. Do not use alcohol (unless recommended in the instructions), cleansers with ammonia, glass cleaners, or abrasive cleaners. Some meters do not require regular cleaning but contain electronic alerts indicating when you should clean them. Other meters can be cleaned only by the manufacturer.
Display Of High And Low Glucose Values. Part of learning how to operate a meter is understanding what the meter results mean. Be sure you know how high and low glucose concentrations are displayed on your meter.
Instructions for Using Glucose Meters
The following are the general instructions for using a glucose meter:
1. Wash hands with soap and warm water and dry completely or clean the area with alcohol and dry completely.
2. Prick the fingertip with a lancet.
3. Hold the hand down and hold the finger until a small drop of blood appears; catch the blood with the test strip.
4. Follow the instructions for inserting the test strip and using the SMBG meter.
5. Record the test result.
FDA requires that glucose meters and the strips used with them have instructions for use. You should read carefully the instructions for both the meter and its test strips. Meter instructions are found in the user manual. Keep this manual to help you solve any problems that may arise. Many meters use "error codes" when there is a problem with the meter, the test strip, or the blood sample on the strip. You will need the manual to interpret these error codes and fix the problem.
You can get information about your meter and test strips from several different sources. Your user manual should include a toll free number in case you have questions or problems. If you have a problem and can't get a response from this number, contact your healthcare provider or a local emergency room for advice. Also, the manufacturer of your meter should have a website. Check this website regularly to see if it lists any issues with the function of your meter.
New devices are for sale such as laser lancets and meters that can test blood taken from "alternative sites" of the body other than fingertips. Since new devices are used in new ways and often have new use restrictions, you must review the instructions carefully.
20070611
What is jet lag?
- What is jet lag?
This passage was taken from AmericanHospitals.com website. Hope you find the information below useful…
It is nothing more than a confused body “clock”. The more time zones your body crosses, the further behind your body clock lags. Some symptoms include dizziness, headaches, and sore muscles, and physiological processes are out of sync. For example, you may be wide awake at 3:00 a.m. and hungry at 3:00 in the afternoon.
What factors influence the severity of jet lag? - The direction you travel: Traveling east usually produces more severe jet lag than west.
- The number of time zones you cross; each time zone you cross multiplies the effect of jet lag.
- Stress
- The quality of your flight: low humidity, excessive noise and vibration, turbulence, sitting for long periods, and a warm, stuffy atmosphere can compound the effects of jet lag.
- How much you drink: If you drink or eat more than you normally would before, during or after your flight, you may be asking for discomfort.
- How much caffeine you consume; the caffeine in coffee and soft drinks can ward off the initial fatigue, but will only intensify the effects of jet lag later on.
- How can I prepare my body for jet lag?
- Try to schedule your flight according to the direction you are traveling. Book an early flight if you are traveling east, an afternoon or evening flight if traveling west.
- Adjust your schedule before you leave. Go to bed earlier and get up earlier three days before your trip if you are heading east, and later if heading west.
- Consult your physician about a jet lag diet. Also, many health food stores sell special “anti-jet lag” vitamin and amino acid products, but there is no clinical evidence that proves their effectiveness.
- During your flight, you can minimize the effects of jet lag by drinking plenty of fluids, eating light meals, wearing loose-fitting clothing to reduce stress, avoiding caffeine and alcohol, doing simple isometric exercises, and, if all else fails, keeping your home schedule while traveling.
Happy Travelling…
Using Your Glucose Meter
Diabetes care should be designed for each individual patient. Some patients may need to test (monitor) more often than others do. How often you use your glucose meter should be based on the recommendation of your health care provider. Self-monitoring of blood glucose (SMBG) is recommended for all people with diabetes, but especially for those who take insulin. The role of SMBG has not been defined for people with stable type 2 diabetes treated only with diet.
As a general rule, the American Diabetes Association (ADA) recommends that most patients with type 1 diabetes test glucose three or more times per day. Pregnant women taking insulin for gestational diabetes should test two times per day. ADA does not specify how often people with type 2 diabetes should test their glucose, but testing often helps control.
Often, self-monitoring plans direct you to test your blood sugar before meals, 2 hours after meals, at bedtime, at 3 a.m., and anytime you experience signs or symptoms. You should test more often when you change medications, when you have unusual stress or illness, or in other unusual circumstances.
Self-Monitoring of Blood Glucose
The process of monitoring one's own blood glucose with a glucose meter is often referred to as self-monitoring of blood glucose or "SMBG."
Portable glucose meters are small battery-operated devices. For a picture of a portable blood glucose meter, use the following link:
Blood Glucose Meter--Medical Encyclopedia--Illustration
http://www.nlm.nih.gov/medlineplus/ency/presentations/100220_1.htm
To test for glucose with a typical glucose meter, place a small sample of blood on a disposable "test strip" and place the strip in the meter. The test strips are coated with chemicals (glucose oxidase, dehydrogenase, or hexokinase) that combine with glucose in blood. The meter measures how much glucose is present. Meters do this in different ways. Some measure the amount of electricity that can pass through the sample. Others measure how much light reflects from it. The meter displays the glucose level as a number. Several new models can record and store a number of test results. Some models can connect to personal computers to store test results or print them out.