Continued from page 12
home, go over the material, and the
Your magazine has answered so many
questions, and I can read it over and over.
Better still, I can see my doctor with a list of
better questions. After reading your
magazine, I am feeling quite encouraged.
J.L. (Jo) Johnson
IN “HAPPY FEET” in your April issue [p. 60],
you gave this advice: “If feet are dry, apply
lotion (but not between the toes).” Neither
my doctor nor I can figure out the last part.
Isn’t between the toes exactly where you
need the lotion?
Steve Katz, Vail, Colo.
Lee Sanders, DPM, responds: Creams and
lotions used between the toes may trap excessive
moisture in those spaces. Unfortunately, a warm,
moist environment is favorable for the
development of bacterial, yeast (candidal), and
fungal infections of the skin. This is referred to
as an “intertrigo,” and it occurs more often in
people who are overweight and those with
diabetes. So it’s important that toes and the
spaces between them be kept dry.
I JUST READ a post in Forecast about insulin
pens. I’ve been trying to figure out if any pen
for rapid-acting insulin offers half a unit.
As an insulin-sensitive type 1, I often
only need half a unit. Can you advise?
Riva Greenberg, Brooklyn, N. Y.
Associate Editor Erika Gebel, PhD, responds:
The reusable HumaPen Luxura HD allows
doses starting at half a unit, according to a
spokesperson for Eli Lilly & Co., which makes
the pen. Scientists at Lilly published a March
2010 study in the Journal of Diabetes Science
and Technology showing that the pen delivered
half-unit doses with high accuracy. The pen
works only with Humalog insulin.
An Island Far, Far Away
WHAT A PLEASANT surprise to see the
name of Majuro appear in the May issue of
14 august 2012 Diabetes Forecast
Why Not Compare Meters’ Accuracy?
Manufacturers of blood glucose meters and diabetes
organizations seem reluctant to provide a ranking of
the various meters’ accuracy. Why? I might even pay
more for a meter that exceeded the minimum standard.
Tony Trevino, Cedar Park, Texas
Sue Kirkman, MD, the American Diabetes
Association’s senior vice president for medical
affairs and community information, responds:
The American Diabetes Association has a long-standing interest in the accuracy of home blood glucose
meters and is part of coalitions that are advocating for
strengthening international and Food and Drug Administration (FDA)
standards for accuracy. It looks as if the requirements will tighten up in
the near future, which can only be good news for people with diabetes,
although we don’t know what the final recommendations will be.
The ADA would love to be able to provide comparisons of meters’
accuracy for our readers, but there are a number of reasons why we
cannot do so. We are a nonprofit organization without a laboratory or
expertise in laboratory comparisons of products. Such testing would
be very complicated (as a meter company executive explains on p. 15)
and beyond our capabilities. Consumer Reports, the magazine of an
organization that does have expertise in rating products, ranked 17
common blood glucose meters in its November 2011 issue. The article
says that the meters were compared to “a standard laboratory
analyzer,” but it doesn’t otherwise provide details of the methods used.
CR ranked eight meters as “excellent” for accuracy, six as “very good,”
and three as “good,” and noted that all the meters were well within the
current standards for accuracy.
Meters sold in the United States are required to describe their
accuracy under “Performance Characteristics” in the package insert
that comes with test strips and in the meter’s instruction manual.
Check the website for the meter brand, and call the customer service
line if necessary.
However, even with this information, a comparison among meters is
difficult because the results aren’t reported in the same way for each
meter. Some meters report their accuracy results as a “regression line,”
with a correlation coefficient, slope, and Y-axis. (Yikes! Shades of
forgotten algebra!) Other companies report in a table format the
percentage of readings above 75 mg/dl that are within plus or minus
5 percent, plus or minus 10 percent, and so on. It would be difficult to