Health Professionals

Updated: October 4, 2009

Insulin Pump Adjustment Click for slides (requires Flash player)

 

The Poor Man’s Carb Counter
A mass of data demonstrates that control of glucose (generally indicated by A1c < 7% or < 6.5%) prevents or delays complications. Getting the patient to target A1c without serious hypoglycemia can be challenging.  At the Diabetes Control Center, we find MDI or pump therapy most efficacious and safe. In the type 1 patient it is a no brainer, MDI or pump therapy. The type 2 patient having progressed to more than one insulin injection daily and still not at target A1c needs intensification. Moving the patient to an intensive program with a combination of basal insulin and rapid insulin for food and correction of hyperglycemia can be time consuming and vexing. Over the past several years we developed a software tool to ease this process. We call it the Poor Man’s Carb Counter. Features:

1. Calculates personalized insulin sensitivity and carbohydrate ratio based on data entered.
2. Prepares a correction scale for elevated blood glucose.
3. Prepares a food list with rapid insulin amounts for each food.
4. Maintains a database of insulin parameters, correction scale and food list for each patient.
5. Creates a summary of parameters that can be copied for paste into EMR.
6. Provides nutritional label reading instructions as related to carbohydrate ratio.
7. Provides hypoglycemia warnings and instructions

With this tool we have been able to move patients to basal/bolus therapy with about 15 minutes instruction. Click here for details.

The Poor Man's Correction Calculator

We have found the Poor Man's Carb Counter™ to be very helpful in moving patients to an intensive insulin program, either type 1 or type 2. Sometimes it just isn't appropriate or we simply need to get the patient on a correction scale (formally called a "sliding scale"). For this we created the Poor Man's Correction Calculator. It is a simple program to rapidly calculate a glucose correction scale and print it for the patient. Click here for details.

SMBG 

Self Monitored Blood glucose remains the most widely used, immediately available tool to monitor blood glucose. The SMBG Link is to the most recent comprehensive review of SMBG technology, potential errors and standards, e.g.  a meter can meet FDA requirements if the error rate is <20% of the reference value when glucose is >100 mg/dL and within 20 mg/dL when glucose is <100 mg/dL.

Title: Self-Monitoring of Blood Glucose (SMBG) in Insulin- and Non-Insulin-Using Adults with Diabetes: Consensus Recommendations for Improving SMBG Accuracy, Utilization, and Research.

Authors: Irl B. Hirsch, MD; Bruce W. Bode, MD; Belinda P. Childs, ARNP-CS, CDE, BC-ADM; Kelly L. Close, BA; William A. Fisher, PhD; James R. Gavin III, MD, PhD; Barry H. Ginsberg, MD, PhD; Charles H. Raine III, MD; Carol A. Verderese, BA
This link to CME on Medscape: http://www.medscape.com/viewprogram/17494

PV Updates on SMBG

Click the button to go to PV UPdates on glucose meters.

Choosing a Glucose Meter That Eliminates the Guesswork
Barry Ginsberg, MD, PhD
President Diabetes Technology Consultants
Wyckoff, New Jersey

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Autocoding Meters: Reducing the Risk for Dosing Error
Charles H. Raine III, MD
Director
Diabetes Control Center
Orangeburg, South Carolina
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Diabetes in the news

VA study suggests no value in tight control diabetes in type 2

Downloadable Tools

Free Diabetes Assessment Flow sheet| Free Excel Correction scale |Poor Man's Correction Calculator

 

 

 

 

 

 

 

 

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