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KITLIVING

continued over

correctly. Because meters were expensive

not everyone had one, many continued to

use the visual colour chart on the bottle

of strips. The 'colour block' range was

different for the various brands.

"The Supreme bg system was one

I co-developed in the late 1980s. This

brand had a scale of Low, 2, 4, 7, 10,

13, 22, High. If the colour was between

13-to-22, the user could estimate a midpoint

of 17mmol/L, for example. The

important point to note is colour charts

had no decimal place and in fact people

were taught to not even estimate any

closer than halfway between two colour

blocks. The very first BG meters, such

as the Eyetone from 1972, displayed

results in a way similar to a volt meter and

needed to be plugged into the electrical

mains supply. Portable, battery-operated

meters were not widely available until the

mid-1980s and became more affordable

in the 1990s."

Very testing

But what was the point of the point?

Avery adds, "I can only guess it's because

of the following reasons. First, meters

were accurate enough to do so. Second,

because of the conversion from mg/dl to

mmol/L units in the UK."

The fact is that not all countries use the

same units of measurement for glucose.

In the UK we use mmol/L, such as

9.4mmols/L, in the USA they use mg/dl,

where 9.4mmols/L would be reported as

170mg/dl. To convert from mg/dl (the big

number) to mmol/L (the smaller decimal

one) you divide by 18; 170 divided by 18

is 9.4 (see more on this over the page).

Avery ventures further, "If the

9.4mmol/L result was rounded down to

9mmol/L, then you are introducing an

error of 4.3% (from 9.4 to 9). Hence, I

would guess that this is the real reason

why we have mmol/L given to one decimal

place. The decimal place in mmol/L units

is also important when the goal is to

meet the clinical performance standards

required for modern glucose systems.

The current ISO15197 standard states

that 95% of the BG meter results above

5.6mmol/L (101mg/dl), when compared

with a lab reference system, must be

within +/- 15%. Therefore, as per the

example above (9.4mmol/L) if rounded

down to remove the decimal place you

have added a 4.3% error not related to

strip performance."

Avery's career path has moved from

blood glucose meters to sensors. His new

concern now is what is the point of five

(on a good day) blood test results put on

a chart during a day? The old log-books

that were used for so long, because that

was all we had. Without those, doctors

had no idea what you were doing with

insulin dosing. A range of single points

doesn't necessarily inform you if glucose

is going up or down.

Says Avery, and I agree with him (as

anyone would). "The direction of travel is

important and is now provided by modern

CGM systems. Traditional SMBG can't

tell you how high or low your glucose

went, unless by chance you test at the

exact time of the peaks. By comparison,

CGM systems capture all of that and

then provide a report giving the user their

Time In Range (TIR), a value that people

with diabetes increasingly prefer over

the HbA1c three-month 'average'. The

question then becomes how valid episodic

testing is when CGM is available?"

Hold on! Not everyone wants sensors.

Then many who do want them do not

have access, they can't afford them or

don't qualify for reimbursement, quite

apart from which even some HCPs don't

quite 'get' their value. The understanding

of 'cost effectiveness' will probably

continue to drive this argument in the

coming years. Yet anyone with any form

of diabetes is likely to benefit from CGM

data and the insights it can give about

their diet and other lifestyle choices. "Portable, batteryoperated meters were

not widely available

until the mid-1980s

and became more

affordable in the 1990s

Index

  1. Free online Desang diabetes magazine diabetes information
  2. Abbott Freestyle Libre, Flash Glucose Monitoring
  3. Desang diabetes, magazine diabetes information, Sue Marshall diabetes
  4. Desang diabetes magazine, diabetes news
  5. BD, Becton Dickinson, injection technique, BD pen needles
  6. Desang diabetes magazine diabetes news
  7. Desang diabetes magazine diabetes news
  8. Dexcom CGM, continuous glucose monitoring
  9. Diabetes technology education
  10. Dexcom CGM, continuous glucose monitoring
  11. Dexcom CGM, continuous glucose monitoring
  12. Intellin, Chris Genders, diabetes health information app, Type 2 diabetes
  13. Medtronic Minimed 670G hybrid closed loop insulin pump
  14. Medtrum A6 Touchcare patch pump and CGM in harmony
  15. Spirit pharmacy national medicines dispensing service and advice for people with
  16. Page 0016
  17. Diabetes and coronovirus, diabetes Covid-19
  18. Diabetes and coronovirus, diabetes Covid-19
  19. Ascensia Contour Next One Diabetes blood test meters
  20. Page 0020
  21. Diabetes UK helpline
  22. Mike Kendall diabetes every day ups and downs, T1 resources
  23. Professor Partha Kar diabetes NHS sugar blog
  24. diabetes tech
  25. diabetes tech, tandem diabetes care, abbott CGM, Tandem t slim insulin pump, medtronic diabetes care
  26. Roche Diabetes Care France, Biocorp Mallya, Tandem diabetes care, Gvoke Hypopen
  27. Medtrum A6 Touchcare patch pump and CGM in harmony
  28. Diabetes Medical ID, MediPal, Bulter and Grace diabetes ID
  29. Diabetes Medical ID, medic alert, MediTag, Universal Medical ID UK
  30. Diabetes skin care
  31. Diabetes skin care
  32. Air Liquide Healthcare UK Tandem t:slim insulin pump with Basal IQ
  33. Air Liquide Healthcare UK Tandem t:slim insulin pump with Basal IQ
  34. sugarBEAT continuous glucose monitoring from Nemaura Medical for Type 2 diabetes
  35. Page 0035
  36. Reporting HbA1c
  37. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
  38. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  39. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  40. Making Carbs Count, Carbohydrate counting for diabetes
  41. Making Carbs Count, Carbohydrate counting for diabetes
  42. Making Carbs Count, Carbohydrate counting for diabetes
  43. : Desang diabetes kitbags, bag for diabetes kit
  44. Free online Desang diabetes magazine diabetes information

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