Even before the Diabetes Control and Complications Trial (DCCT), people were interested in tight control of their blood sugars. The big problem then, as well as now, was how to keep accurate track of blood glucose levels in order to develop a regimen. Fortunately, in this age of technology keeping track of blood sugars can be done simply and thoroughly using a personal computer.

Several companies have released software packages for home use that are both easy to use and affordable. The programs download information from meters and organize it, allowing the users to see exactly what their blood sugars are doing from hour to hour, day to day, week to week, and month to month. This can be an effective tool for both self monitoring and working with a health care team.

Three companies currently make meters that have downloading capability: LifeScan, MediSense, and Boehringer-Mannheim.

In order to use these meters with a PC it is also necessary to purchase a cable which will connect the meter to the computer. LifeScan offers a cable for its two downloadable meters-the One Touch II and the Profile-for a price of five dollars. This cable actually comes with a utility which will get the information from the meter and put the readings into a text file on a computer. This text file can be organized with only a spread sheet, but more developed software, either by LifeScan or another company, can create intricate graphs and tables.

MediSense's downloadable meters-the Precision QID and MediSense 2-require a much more expensive cable-around $140. The reason MediSense's cable is more expensive is because the MediSense meters do not have a built-in download port. The cable therefore has a microcomputer so it can be directly plugged into the test strip port. MediSense's precision link software (discussed below) is included with the cable.

Boehringer Mannheim only offers its connector cable to doctors, but the cable can be purchased through MetaMedix, for use with its software, for $54.95.

Once information is downloaded, it can be grouped into several different displays for interpretation. Most of the current software programs for blood sugar management have several general features in common.

These features are:

• Data List: This is simply a list of readings as downloaded from the meter.
• Log Book: A log book is the organization of blood sugar readings. The log book shows readings from before and after each meal, at bedtime, and in the middle of the night.
• Line Graph: This is simply a graph of the meter readings showing the time they were taken. Target blood glucose is illustrated, and day-to-day levels can easily be monitored with this graph.
• Pie Chart (Target Range): A pie chart shows what percentage of the time a person's blood sugar is high, what percentage of the time it is low, and what percentage it is on target, for a given period of time.
• Standard Day: A standard day graph puts all the meter readings for a period of time into one 24-hour chart. Like the pie chart, it lets a person know how much of the time blood sugar is high, low or average, but it also can show where in the day the highs, lows and normal readings usually occur. It can also show how readings are grouped indicating trends through-out the average day.
• Glucose to Insulin: This is a daily graph of blood sugar readings to time-of-insulin injection.
• Statistics/Average: This is a table of readings for a given period of time. Average readings from before and after each meal, bedtime, and nighttime for a period of time, e.g., 14 days, can be shown. This lets a person know if there is a particular time of the day when a regimen is not working.
• Summary: This is a one-page report of graphs so they can easily be given to a doctor or other health care professional.

Current programs offer several or all of these features with varying levels of quality.

Here is a list of the most up-to-date software available:

Intouch by LifeScan

• System Requirements: PC 386 or better, 8MB of RAM, Windows, 30MB Hard Disk Memory
• Meters Supported: One Touch, Profile
• Price: $89.95 with cable
• Standard Features: Data List, Log Book, Line Graph, Pie Chart, Standard Day, Glucose to Insulin, Statistics/Average, Summary.

Intouch is one of the most thorough programs available. One drawback is that none of Intouch's charts shows a pump basal rate, which makes this software awkward for pump users.

One unique thing about the Intouch software is that in addition to the blood glucose monitoring system, there is an education program. This offers immediate access to information on monitoring, medications, meals, exercise, lifestyle, illness concerns and support.

LifeScan: (800) 382-7226

Mellitus Manager by Metamedix Inc.

• System Requirements: PC 386, Windows, 4MB RAM
• Meters Supported: One Touch, Profile, Accu-check, Precision QID, Companion 2
• Price: $79.95 (cable not included)
• Standard Features: Data List, Log Book, Line Graph, Pie Chart, Standard Day, Glucose to Insulin, Statistics/Average, Summary

Mellitus Manager has all the same features as Intouch, and in most cases the graphs are more complete. For example, in the statistics/average graph not only are the pre/post-meal average readings shown, but the amount of deviation is also represented. The program's graphs also include a pump basal rate to make the program more pump-user friendly.

Using Mellitus Manager with the Profile meter gives by far the most complete view of blood sugar activity. The Profile allows the user to enter information in much the same way dates and alarms are set in a digital watch. Mellitus Manager is the only program that can access this information and put it in chart form. While this information can be manually keyed into the program, downloading it from the Profile is the easiest way for the user to include exercise in minutes and carbohydrates in grams on the graphs.

MetaMedix, Inc.: (800) 455-4105

Diabetes Works by ITA

• System Requirements: PC, Windows
• Meters Supported: One Touch II, Profile
• Price: $79.95 (cable not included)
• Standard Features: Data List, Log Book, Line Graph, Standard Day

Diabetes Works is really a package of several software products, the "Glucose Plotter" being the main blood sugar monitoring program. While the program lacks several of the features included in Mellitus Manager and Intouch, Diabetes Works' graphs include a trend line, which neither Mellitus nor Intouch have. The trend line shows progression of blood glucose and makes the graphs easy to interpret.

A diet analyzer comes with the program and acts as a predictive metabolism model for insulin, carbohydrate and exercise interaction. The user can tinker with the program and graphically see the effects of changing medication or diet without having to act as the initial guinea pig.

Diabetes Works also features a list of Internet and Web sites which can help the user get the most up-to-date information on diabetes available.

ITA Software: (800) 510-1024

Precision Link By MediSense

• System Requirements: PC, Windows
• Meters Supported: Precision QID, Companion 2
• Price: $140.00 with MediSense cable
• Standard Features: Data List, Log Book, Line Graph, Pie Chart

This program is designed to simply download data from the Precision QID and MediSense 2 meters. The program cannot log events or expand data, but it stores information in universal comma delimited format so further analysis can easily be done with a spread sheet program. The graphs include hi/low/average, but no statistical reports.

MediSense: (800) 527-3339

Coming Soon

Two soon-to-be-released software packages promise to advance diabetes software to the next level. Both of these products aim to help better control blood sugar by allowing more factors to be considered. These packages can monitor everything from exercise, to food, to stress, to how well a patient is following a regimen. Look for these in your software store later this year:

HealthStats by Health Management Software, Inc.

• System Requirements: PC 486, Windows 3.1 or DOS 3.1, 4MB RAM
• Meters Supported: One Touch II, Profile

HealthStats can be easily tailored to either type I or type 2 diabetes. The program will keep track of meal planning, exercise, weight, and the mechanics of a regimen as well as blood glucose readings.

The meal planning section will have an expandable database of 5000 foods and their nutritional information. It will be able to plan meals for up to two weeks in advance for tight control on carbohydrates and nutrients.

The exercise portion will work in much the same way, with a list of possible exercises. The user punches in the workout, and the program designs daily and weekly regimens. For those trying to lose weight, the program will indicate how much exercise and how many calories are needed (or not needed) to achieve a preferred weight.

In doing this, Health Management Software hopes the program will have the ability to pinpoint exactly what has caused a fluctuation in blood glucose so it can be quickly remedied.

Health Management Software, Inc.: (770) 594-1704

Balance by MediLife

• System Requirements: PC, Windows, CD ROM drive

Like HealthStats, Balance will be able to keep track of diet, exercise, and other factors, including insulin, to give an overall picture of everything that is affecting blood sugar levels.

The diet section will have a library of 14,000 foods and their nutritional breakdown. Diet information can be analyzed by amount of fat, carbohydrates or protein. The program will also feature a 50-recipe cookbook.

In addition to a library of food, Balance will have a list of 5000 prescription and non-prescription drugs, 1000 symptoms and conditions, 200 medical tests, 100 exercises and an encyclopedia on diabetes and general health.

For up-to-date information, the software will contain a link to MediLife Health Network on AT&T WorldNet.

For information contact Nancy Baumgartner at (508) 371-3170.