Letters to the Editor
Don't Forget Alabama
I have a 12 year old daughter who has had diabetes since Sept. '91. She does really well and has a good positive attitude. We try to keep up with all the latest information.
I noticed in your list of camps that Alabama's camp wasn't listed. My daughter has gone there for the last three summers and it is an excellent camp. This is the only diabetes camp in Alabama. The address is:
PO Box 21
Jackson's Gap, AL 36861
I'm looking forward to the next issue of DIABETES HEALTH.
[Editor: Thank you for catching this oversight; we couldn't find a listing for Alabama among our source materials. We apologize to any Alabamians who may have suffered indignation at this oversight.]
DIABETES HEALTH is my favorite of all the diabetes publications I receive!
Can't Wait For The First Copy
I've read a few of your newspapers and absolutely love them-I can't wait to get my first copy. Thanks for your service and honesty.
Colorado Springs, CO
Clarification Is Required
I want to offer an explanation for the glucose meter blood volume requirements printed in the article titled "Blood Requirements for Modern Meters" which appeared in your May '94 issue. The glucose meter blood volume requirements mentioned in the Miles Inc. figures, which you have quoted were obtained in two ways. First, manufac-turer's inserts or user's manual information was complied. The volumes listed for Accu-Chek¨ III, Accu-Chek¨ Easy, and Companion 2 were those in manufacturer's literature. Second, these volume requirements, and those for the other glucose meters (Gluco-meter¨ Elite, One Touch¨ II, One Touch¨ Basic, and Tracer¨ 2), were evaluated and confirmed in a study in Miles Inc. laboratories. All meters were used according to manufacturer's instructions and eight replicate readings were taken on a whole blood specimen (approximately 200 mg/dl glucose) with each of four to eight glucose meters at each of several volumes. For example, the Glucometer Elite was tested using eight replicates on each of eight meters at volumes of 2, 3, 4, and 5 microliters for a total of 64 glucose measurements per volume. In our studies care was taken to insure that the reagent areas of the glucose strips or sensors were covered with blood. With respect to actual practice, it is critical that manufacturer's recommendations be followed with each specific meter system in order to insure acceptable performance.
In the study by Dr. Yale and his colleagues the key factor is that the blood samples were very carefully placed on the reagent pads of the individual glucose strips with scrupulous, and rigorous, attention to detail and laboratory technique. Significant care had to be observed in placing the blood volumes mentioned exactly over the optical window reading point or across the electrodes of amperometric meters using laboratory micro-pipettes. In the case of the two systems where two microliters appeared to work, the reagent areas could not have been completely covered.
Without seeing all of Dr. Yale's data, it is not possible to be certain how he mathematically arrived at the published figures, but extremely careful laboratory technique and averaging or statistical data treatment techniques were applied. The result is that these volumes in no way reflect performance obtainable by diabetics. The data are also inconsistent with manufacturer's recommendations which are based on extensive performance data and represent use volumes which provide consistent results in the hands of all users.
I strongly recommend that great caution be exercised when reading data of the sort which you included in DIABETES HEALTH. The information, as printed, could mislead your readers into believing that they can also obtain acceptable or consistent results with these small volumes. Diabetics will not be able to obtain acceptable or consistent results with their meters at these volumes with most glucose meters. The Glucometer Elite sensor chamber holds three microliters of blood and is the only system listed which will consistently work at these low volumes in the hands of diabetics. If you have additional questions, please give me a call.
Donald R. Parker, PhD
Director of Clinical Trials, Miles Inc.
Too Sweet For Me
For the past couple of years after the diagnosis of my diabetes, I have eaten every morning a bowl of Kellogg's Nutri-Grain whole wheat cereal. For about two months my trips to several grocery stores to locate my favorite cereal "without sugar" were met with great disappointment. Kellogg's "added sugar" to this cereal, which previously had no sugar. My wife even called Kellogg's, and they said words to the effect tough luck and we really do not care if you have diabetes. The box now carries the word "new improved taste." It is tough to find foods without sugar, but when a major corporation like Kellogg's starts adding more garbage, we need to take a stand.
Oklahoma City, OK
Fighting Over DIABETES HEALTH
Thank you very much for the complimentary issue of DIABETES HEALTH.
Your publication is very interesting and informative: the clients that come into our diabetes education program are fighting over the one copy we have.
Judith Casingal, ARNP, CDE
Administrator, Patient Services
Why Are There Two?
You guys are doing a great job,
but I do have one question: why do I get 2 issues of DIABETES HEALTH at a time?
La Habra, CA
[Editor: Until the company has grown and we have the support staff to enable us, we have decided to mail two issues at a time. However, we are looking forward to returning to a monthly mailing schedule next year.]
Thanks for your very informative newspaper. I'm newly diagnosed and have just started on insulin. There is no active ADA chapter here. It's nice to have a connection with other people who have diabetes.
Carol C. Meares