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Monitoring patient glucose levels and determining the diabetic patient’s response to intervention is critical to the long-term health of the patient with diabetes. Large U.S. and U.K. clinical trials have shown that intensive treatment of diabetes improves the outcomes of patients with either type 1 or type 2 diabetes.1 Nevertheless, despite the dramatically increased prevalence of diabetes in the U.S. and the availability of treatments and technologies that allow for achieving glycemic goal levels, a large majority of patients with type 2 diabetes have not reduced their hemoglobin A1c (HbA1c) to the target level.1
Targeting the HbA1c Level
Patient self-monitoring of blood glucose (SMBG) and supportive health-care systems are considered essential to treating to target. SMBG and paying attention to the data provided by glucose monitoring systems are considered especially important for identifying post-prandial blood glucose spikes and for patients with brittle diabetes, hypoglycemic unawareness, and multiple-dose insulin therapy.
Diabetes Management Software
The improvement of patient compliance has been a goal of many glucose-monitoring systems.
- Painless or nearly painless blood and fluid sampling systems such as Medtronic’s (Northridge, CA) continuous glucose monitoring system, the MiniMed Paradigm® REAL-Time Revel™ System, now include therapy management software that provides the patient with insight into glucose patterns and the effect of certain foods on glucose levels. Medtronic’s software also allows the physician to remotely view the patient’s therapy management data and make needed adjustments.
- Roche Diagnostics Corporation (Indianapolis, IN) offers the ACCU-CHEK® 360° diabetes management system, which allows the patient to collect self-care data and analyze results with easy-to-read, comprehensive graphs. It can be used by patients who have little computer experience. A device, the ACCU-CHECK Smart Pix instrument reader, is placed near ACCU-CHEK blood glucose meters or the ACCU-CHEK Spirit insulin pump and automatically downloads data directly into a computer. Reports can be printed, e-mailed, or faxed to the health-care provider.
- LifeScan, Inc. (Milpitas, CA) offers OneTouch® Diabetes Management Software, which can be used with its OneTouch meters. The software allows the patient to track his or her diabetes management over time. The software is installed on the patient’s computer, and data can be downloaded via the data port on the meter. The software can evaluate the data and provide 10 different report formats so that trends and patterns in glucose levels can be spotted. Reports can be printed for the healthcare provider.
- AIDA (www.2aida.net) is a freeware educational software program that can be downloaded from the web onto IBM PCs or compatibles, or run via the WEB from AIDA on-line. It contains a simple model of the interaction of glucose and insulin in the human body, and is intended for simulating the effects on the blood glucose profile of changes in insulin and diet for a typical insulin-dependent (type 1) diabetic patient. It is only for education or demonstration. It comes with 40 case scenarios and a list of suggestions of insulin dosage adjustments that can be used in the simulator program.
- Abbott Laboratories (Abbott Park, IL) offers the CoPilot Health Management System, which allows the patient and health-care provider to review and evaluate key diabetes data. The CoPilot Health Management System 4.2 is a free, user-friendly PC-based software application that is compatible with the FreeStyle Lite and FreeStyle Freedom Lite blood glucose monitoring systems. Abbott also offers FreeStyle Auto-Assist software, which visually displays information on blood glucose and insulin data from the FreeSyle InsuLinx blood glucose meter in six different easy-to-read report formats. The software is both Mac and PC compatible.
- Bayer HealthCare LLC (Tarrytown, NY) offers three options of diabetes management software for the patient, in addition to a management tool for health-care professionals. The GLUCOFACTS® DELUXE software connects to Bayer's CONTOUR® or BREEZE® meters, or DIDGET® (pending regulatory clearance) meter with a cable from Bayer, and the intuitive interface leads the patient through the process. Some key features include storing data on the PC; a full menu of reports, which can be printed out for the health-care provider; and on-line help. The GLUCOFACTS™ Express offers a simpler solution to blood glucose tracking. It connects to the CONTOUR™, CONTOUR TS, or BREEZE™ meters with a Bayer cable. However, data are not automatically saved on the computer, but can be saved as a pdf file. The WinGLUCOFACTS™ software downloads test results from the CONTOUR, CONTOUR TS, BREEZE™2, or ELITE™XL monitoring systems and provides feedback and allows the patient to send data to a health-care provider via fax or e-mail. The WinGLUCOFACTS Pro software allows health-care professionals to track blood glucose levels with their patients. Bayer says that the WinGLUCOFACTS Pro software V. 3.04 has an intelligent data interpretation function that not only transfers data from compatible Bayer glucose meters to the provider’s computer, but also analyzes the data to find patterns in the blood glucose readings. Bayer claims that a peer-reviewed published study showed that the use of this software by physicians led to a 0.5% decrease in HbA1c levels in their patients, compared to control patients.
- NuMedics (Tigard, OR) offers Diabetes Partner™, an easy-to-use web application (www.DiabetesPartner.com) that allows downloading of data from most meters and insulin pumps, as well as input of other important data such as medications, food intake, exercise, stress, or illness. The data then can be easily added to an electronic medical record for evaluation by the health-care provider. NuMedics also offers Clinipro®, an electronic-medical-record disease and practice management software for improving practice work flow and patient care. Clinipro was originally designed by a software programmer with diabetes to aid in communicating with his physician. He created a telemedicine component that would allow him to send the glucose readings to his physician’s office by e-mail, and the first version of Clinipro was born. Clinipro still includes a strong diabetes management and education module.
Reference
- Lebovitz, H.E.; Austin, M.M. et al. ACE/AACE Consensus Conference on the implementation of outpatient management of diabetes mellitus: consensus conference recommendations. Endocr. Pract.2006, 12 (Suppl 1), 6–12.
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