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Hardware and Software in Diabetes Mellitus: Performance Characteristics of Hand-held Glucose Testing Devices and the Application of Glycemic Testing to Patients’ Daily Diabetes Management

Departments of
¹ Psychiatry and
² Pathology, Immunology & Laboratory Medicine,, Pediatrics, and Molecular Genetics & Microbiology, University of Florida Health Science Center, Gainesville, FL 32610
^a Address correspondence to this author at: University of Florida Health Science Center, Department of Pathology, Immunology & Laboratory Medicine, Box 100275, Gainesville, FL 32610-6249. Fax 352-846-2149; winter@pathology.ufl.edu.

A current definition of evidence-based medicine is given in the British Medical Journal from 1996: evidence-based medicine is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" (1). Interpretation of laboratory data requires that an appropriate reference interval be defined by studying a healthy population. Subjects with laboratory results that consistently fall outside this interval may not be healthy. This is clearly the case in individuals with diabetes mellitus whose mean blood glucose concentrations in the untreated state are above the reference-population random, fasting, and/or post-glucose challenge blood glucose concentrations (2).

In the 1990s, in the Diabetes Control and Complications Trial (DCCT) (3) and United Kingdom Prospective Diabetes Study (UKPDS) (4), an important question was answered: glycemic control does make a difference in the development of microvascular complications. Healthcare professionals are now focusing their efforts on improving the glycemic control of their patients. Diabetes is likely the best example of a disease whose outcome is predominantly determined by the daily actions of the affected individual. The DCCT and UKPDS results demonstrated that improved glycemic control lowers the frequency of retinopathy, nephropathy, and neuropathy and also likely lowers the long-term risk of developing macrovascular disease. The challenge now is to implement improved diabetic therapy that lowers mean blood glucose into or near to the reference interval reflected in a hemoglobin A_1c <7% (5).

To achieve improved glycemic control, patients with diabetes must measure their blood glucose several times per day and adjust their antidiabetic medications (e.g., insulin dose, formulation, and timing), diet, and exercise in . . . [Full Text of this Article]

References

The following articles in journals at HighWire Press have cited this article:

				W. E. Winter A Rosetta Stone for Insulin Treatment: Self-Monitoring of Blood Glucose Clin. Chem., June 1, 2004; 50(6): 985 - 987. [Full Text] [PDF]

				S. Skeie, G. Thue, and S. Sandberg Interpretation of Hemoglobin A1c (HbA1c) Values among Diabetic Patients: Implications for Quality Specifications for HbA1c Clin. Chem., July 1, 2001; 47(7): 1212 - 1217. [Abstract] [Full Text] [PDF]