Com pass software. Strips occasionally wasted unintentionally when turning on meter
Accu-Check 4.4 Complete (Roche Diagnostics)
10â €“600
26
Snap-in code key
3
Store and analyze up to 1,000 values plus information on insulin, information on insulin, activity, meals, ketones, A1C results, and event markers. Uses Compass software for data management
Accu-Check 1.8 Advantage (Roche Diagnostics)
10â €“600
26
Snap-in code key
3
100-test downloadable memory. Rubber grips on meter for easy handling
PC, personal computer; A1C, glycated hemoglobin . P.326 Before using a new meter, patients must make certain that the date and time on the device is correct for accurate downloading. Patients can purchase the software for meter downloading directly from the meter companies or download the software from the meter Web sites. The data could then be presented to the physician at the time of the visit. Most meter companies would be pleased to install their software free of charge in physicians' offices and train the staff on data interpretation. Although many meter companies would love to have the physician's business, one should find two or three that would offer the practice not only software support but free meters and starter strips to give to patients. Pharmaceutical representatives who detail glucose meters are well trained in installing and maintaining their company's software as well as in-servicing the staff on interpreting the data. Optimal management of diabetes is not possible without SBGM. The motivation that drives most physicians and patients toward optimal control is their desire to prevent or delay the progression toward short- and long-term diabetes-related complications. Acute complications, such as hypoglycemia or diabetic ketoacidosis, can be reduced with the use of frequent monitoring, assuming the patient is able to interpret and correctly act on the results of the test. Long-term complications are linked not only to the patient's A1C but to the degree of daily glycemic variability he or she may be experiencing. Frequent wide glycemic swings in patients, that is, from 50 to 320 mg per dL, induce a cascade of events triggered by superoxide formation, which appears to be the flashpoint for driving the multiple pathogenic mechanisms associated with complications. Although A1C testing is the “gold standard†for predicting the likelihood of developing complications, using other techniques such as SBGM and continuous glucose monitoring systems (CGMSs) may be helpful in reducing glycemic variability within a given A1C range. Familiarity with all monitoring modalities allows physicians to fine-tune diabetes management and offer their patients the best possible short- and long-term outcomes. The Link between Glycemic Variability and Long-term Diabetes-related Complications Although the short-term goals of diabetes management include avoidance of hyperglycemia and hypoglycemia, physicians must also direct their treatment strategies toward surveillance for and avoidance of diabetes-related complications. Microvascular complications (neuropathy, nephropathy, and retinopathy) are likely to occur in patients with long-term exposure to Unfiled Notes Page 4