John Walsh PA, CDE

Due to complaints about glucose meter inaccuracy, the Food and Drug Administration (FDA) is currently developing a new standard for glucose meter accuracy. This update is driven by ongoing improvements in meter accuracy, the need for better accuracy with today's pumps, bolus calculators, and continuous glucose monitors, reports of hospital and out-patient deaths, consumer complaints, and research studies showing that several approved glucose meters failed to meet FDA or International Standards Organization (ISO) standards in post-approval testing.(^1-3)

You don't have to be a math genius to try this test. This little bit of diabetes math offers great secrets about controlling your blood sugars, especially if you have Type 1 or Type 2 (on over 30 units of insulin a day) and are on an intensive management program.

John gives great presentations on various diabetes technologies all over the country. Here is his current speaking schedule for this year:

Advanced Pump Trainers Workshop
Presented by the Diabetes Care Centre
June 22, 2012 - 8:30 am to 3:15 pm
St. Michaels Hospital - Toronto, ON

Flu: Flu Symptoms | Prevention | Flu Vaccine | Flu Treatment
Cold: Cold Symptoms | Treating a Cold | Prevent An Early Demise

From STOP the Rollerocaster
Copyright © 1996 by Diabetes Services, Inc.

What is Hepatic Activation?

The theory behind the procedure is that diabetes is a complex metabolic process gone awry. Traditional diabetes therapy attempts to normalize blood sugar levels without considering the complexity of the problem. The simple strategy of most therapy is, "Give insulin when glucose is high and don't give insulin when glucose is low or normal." In contrast, Hepatic Activation attempts to reestablish the normal biochemical and physiological relationships between the gastrointestinal tract, liver and muscle.

The Dexcom STS and the Paradigm RT continuous monitors are currently available in the U.S. with a prescription. In this study, they are compared head to head while being worn by one person with Type 1 diabetes. Over 33 days, 262 simultaneous readings were compared between a One Touch meter and the two continuous monitors. The meter was used to calibrate both monitors and as the standard against which their accuracy was evaluated.

Current basal-bolus thinking says that 50% of the total daily dose of insulin works best as basal, and that a change in basal insulin delivery should occur several hours before a rise or fall in the blood sugar is desired. These ideas need to be rethought as newer, intelligent pumps begin to appear.

View the Super Bolus Presentation as a Slideshow

By John Walsh, PA, CDE and Ruth Roberts, MA
Authors of Pumping Insulin and Using Insulin

By John Walsh, PA, CDE
Author of Pumping Insulin and Using Insulin