Updated: September 16, 2013
There is an epidemic of diabetes in the world. Uncontrolled diabetes can result in heart attack, kidney failure with the need for dialysis, amputation, stroke and many other problems. IT DOESN'T HAVE TO HAPPEN. Control of blood sugar (glucose), high blood pressure and blood fats (cholesterol, triglycerides, etc.) prevents these problems. We specialize in diabetes to help our patients avoid or minimize these devastating problems.
The Diabetes Control Center uses the latest and best of modern medicine and technology in our efforts to prevent or minimize diabetic complications. But, most important is the patient. Control of diabetes requires more patient involvement than perhaps any other medical problem. Patient involvement requires: 1) Information, which we provide. 2) Taking ownership of the disease, denial must vanish. 3) Willingness to adhere to a prescribed program. 4) Use of tools provided. The cooperation between the diabetologist and the patient invariably brings good results.
Glucose Meters. The invention of the glucose meter (frequently called a "Glucometer™" which is a Trade Mark of the Bayer Cooperation, the earliest leader in glucose meters) revolutionized diabetes therapy. Patented in 1971, improved versions continue to be the mainstay of glucose monitoring. The glucose meter is the only tool available to the patient and the diabetes team that can be used to immediately alter treatment. Blood sugar is constantly changing. It is affected by food, activity, mood, illness, and medicines among others. These things may be poles apart every day and even change during the day. If one is to control the glucose, one will have to monitor it.
It is great to have a meter, but then it must be used and the information gotten from it must be interpreted. We download meter data into computers for analysis. Click here for details on blood sugar testing.
Here is an example of a patient whose meter indicates good control of glucose. Blood glucose readings are represented by the small circles. The graph reflects all sugars done in 2 weeks, separated by time of day.
Below is an example of fairly good glucose (sugar) control in the morning but high sugars in the evening. If this patient tested only in the morning, one would wrongly think there is good control. In uncontrolled diabetes, frequent monitoring is crucial. This is especially true if taking insulin. This patient needs medication adjustment for high daytime sugars, likely needing adjustment for mealtime sugars. We frequently see this pattern in patients taking several oral medications but no insulin for diabetes. One approach is the have the patient test 2 hours after the largest meal of the day in addition to or instead of the morning tests. Our patients are provided free meters for glucose testing, that was we cane insure of proper instructions in meter use and know that we will be able to use computer technology as an aid in controlling the diabetes.
By definition CGM is a method of continuously measuring the level of glucose (sugar) in body fluids. If one can determine moment to moment changes in blood glucose, one can tailor medicines to control glucose as needed. Several methods have been tried. The most successful, so far, is the use of a probe under the skin that measures glucose in fluid in that space (subcutaneous fluid). Since subcutaneous glucose closely follows blood glucose, an accurate measure in this area can give a good (if not perfect) reflection of blood glucose.
Designed and Copyright by Charles H. Raine, III, M.D.