Managing your diabetes takes a lot of work. It can take less work however depending on which tools you use and how often you use them.

“Should I do shots or a pump?” Doesn’t matter if you are looking for ‘easier’. They both require a commitment although the tasks are different. Also, the typical person with diabetes doesn’t exist. Everyone is unique and therefore it requires the individual or at least someone with intimate 24×7 knowledge of the person with diabetes to have insight into care, actions, analysis of cause and effect, etc… No easy task even for the biggest egghead on the block. Unfortunately, there is no secret formula for one-size-fits-all blood sugar control either.

And don’t confuse collecting data with the act of analysis to understand and finally taking action followed up by further analysis to understand and take action in a never-ending cycle. This is called pattern management in the world of diabetes self-care.

So when it comes to looking at recent blood sugar numbers and potentially reams of other data like carbs, insulin and exercise to name a few, for patterns, very few people do it at all and even fewer do it right. There is more than one way to perform pattern management. And like everything else in life, you have hard ways and easier ways. If we look at the state of diabetes in this country alone, we quickly understand that nobody has solved the problem.
The average person using manual logbooks and PC-based or web upload software must spend 30 - 45 minutes given the complexity of these ‘free’ tools. So is it any wonder there is still a huge opportunity to improve on self-care? One way is to get more people to practice pattern management - on a frequent basis but how if it takes so much time and effort?

In a recent survey of both people with type 1 and type 2 diabetes, less than 10% of the respondents indicated that they performed review of blood sugars on their own. Most people will only review blood sugars during the office visit with their provider if they are lucky enough to even have a provider who practices pattern management.

In contrast, participants in Diabetech trials incorporating our ADMS (automated diabetes management system), over 90% of participants are able and willing to practice self-review of blood glucose patterns weekly or more often week in - week out. What’s the difference?

Simplicity. It’s no extra work via ADMS so why wouldn’t you sneak a peak at your trends and consider where you’ve been, where you’re going and how you might take a different tack to affect a more desirable blood sugar? The other key we’ve found out is that by doing this frequently, like every few days, most of the ‘other data’ behind the blood sugars is still in your mind. If you only look at patterns infrequently of course you would have to use a notebook with lots of other background data. Did I mention yet that nobody likes to keep a notebook?

Tracking insulin and carb data: why? Again, by performing frequent blood sugar reviews for trends, most of the background behind insulin, carb/fat, activity is top of mind. Ultimately, the patient is only going to address a trend at one time of day. Not all of the problems at the same time. As a real world example, one might spot a trend for high blood glucose at 10am and understand that this is cause to perform a 10% tightening of the insulin to carb ratio that got them to that 10am blood sugar trend. For example, that might mean adjusting the breakfast ratio. This scenario is made quick and painless for a person using our ADMS.

Frequent pattern management is key as it makes a simple version of the exercise possible by looking at only the system collected and formatted blood glucose data!

When I talk to patients through our work at clinics or while fielding calls with people in our trials and commercial programs, the most common concern I hear from people who aren’t already using a GlucoMON is that they know they should be reviewing their logbook(s) for patterns more frequently. Lots of guilt in the diabetes patient community. When we talk about how they might increase their practice of pattern management, they are often stuck in the mindset of brute force… “I’m just going to have to force myself to do it more often”, they say.

Another section of that road I was talking about just got paved.

Sadly, we all know too well that virtually nobody is going to brute force their way through this tedious task of assembling blood sugar data and markers to shed light on control. But what if patterns were an automated thing that just showed up in front of your eyes in a visually impactful way? Would that feel like cheating?

The point of this entry is to get more people to commit to regular and frequent pattern management. If you are performing weekly pattern management, is your current level of effort sustainable over the months, years and decades to come? If it’s too hard then consider that maybe you aren’t using the right tools for the job because others are doing it regularly and with success.

The GlucoMON®-PWA training video (if we ever bother to make one) would be about 3 seconds long including the patient (kid w/ type 1) connecting his meter and another 5 seconds to show parents how to read a text message on their cell phone. By the way, kids don’t need to be shown the second part so maybe we should do two separate training videos totaling 8 seconds which coincidentally makes for a qualified rodeo ride.

I just watched a 2 minute and 13 second training video of yet another phone based diabetes data management service over at DiabetesMine. I know I’ve been preaching simplicity for many years now and yet the message is hard for most technologists and especially the online community to understand.

Health2.0 shouldn’t be about how fancy you can make things given the advanced state of the web and the power inherent in even the cheapest cell phones today. The challenge is to make technology work FOR us to simplify those tasks that need to get done… not to add extra work to something that is already a tremendous burden requiring several hours each day just to stay out of trouble.

In the world of diabetes self-care, guidelines published by the experts tell us that people with diabetes should be keeping a logbook and reviewing their blood glucose for patterns every 4 to 7 days. The only approach that I’m aware of that makes this practical is with people who use our GlucoMON and the automated pattern management logbook from ADMS.

While we haven’t yet sent out the obligatory press release, the commercial version of the GlucoMON-RT service is now commercially available to everyone in the USA for $29.95/mo or for a limited time through a $299.95 special offer ($60 savings) for a full year of keeping it simple. We also have a shared device model designed for schools that will allow multiple kids with type 1 diabetes to use a centrally located GlucoMON (ie - school nurses office or class room) at a discounted monthly subscription rate of $19.95/mo. Adults who attend support groups might also be interested in this shared device model. Please contact us first to inquire regarding the shared device subscription option.

Our new patient community website is up (and in its infancy) at http://mygluco.com The site so far has only taken over the job of taking orders and payments via the web. Very soon however it will expand to add self-service features and other clear value-adds.

If you live outside of the USA, the good news is that our GlucoMON-PWA already operates worldwide. We just need some time to establish business contacts in each country where we plan to serve people with diabetes. Please contact me if you would like to accelerate having the GlucoMON and our programs in your country.

On this very important day known as World Diabetes Day, I’m very pleased to announce the expansion of our Certified Diabetes Educator (CDE) Staff at Healthcordia to include a past President of the American Association of Diabetes Educators (AADE) as well as several very experienced pediatric and adult Registered Dietitians. I would also like to salute all diabetes educators everywhere. Their job is often difficult, frustrating and sometimes rewarding. I see them as the people on the front lines of this terrible and growing epidemic who every year are becoming more and more outnumbered and with insufficient reinforcements filling their ranks.

In a twist on diabetes technology and diabetes care, two phrases not often mentioned in the same sentence, our CDEs work with patients remotely including access to our ADMS (Automated Diabetes Management System) and use email, chat, phone and even video conferencing to communicate with their patients enrolled in our modernized version of an annual diabetes management program known as HomeCheck-365.

When as a person with diabetes you’re doing all you can do and it’s still not enough, it’s time for a Shout-Out for guidance on nutrition, troubleshooting, etc… Many people with diabetes feel isolated and feel they don’t have anywhere to turn that’s convenient and also with an expert who is in a position to consider their health profile including an accurate history of blood sugar control. Our staff has been working on these programs with patients for many years now and we really believe this is what makes the difference between throwing technology at people vs. walking people through a process including CDEs who happen to access data automatically from patients who use leading edge technology. When you focus on technology by itself or diabetes education in isolation, you’ll come up short every time. However, by blending the two we are able to efficiently drive improved patient outcomes through behavioral change.

This program does not subscribe to the typical disease management approach of making scheduled phone calls to the patient only to run them through a checklist or survey. Rather, a HomeCheck-365 educator working with a technology-enabled HomeCheck-365 patient typically knows why the patient’s calling even before the call.

To borrow from a cliche, ‘If you keep on doing what you’ve always done, you’ll keep on getting what you’ve always gotten’. So on this Diabetes Day of Days, my wish is for more people to truly think past the old ways of doing things and think smarter from the perspective of Outcomes. Stop thinking more technology or more office visits. Start with the end (outcomes) in mind then fill in the gaps with a plan to get there. That’s HomeCheck-365 working with patients in concert with their diabetes physician.