Comparative accuracy of glucose monitors

Background. Self-monitoring of blood glucose levels has become an important instrument for the management of patients with diabetes mellitus. Both patients and physicians expect that monitors will provide reliable results. Numerous environmental, physiologic, and operational factors can affects system performance, yielding results that are inaccurate or unpredictable. Methods. This study examined the effect of one factor -high altitude- on the performance of seven blood glucose monitoring systems. The following monitors were compared. two One Touch II; two One Touch Basic; two Reflolux II (Accu-Chec in the USA); two Glucometer 3; one Glucometer 2, and one Accutrend Alpha. Double blood glucose level values were compared with a cotrolled reference laboratory test values, which was unknown to the investigator until the end of the study because the study was double blind. Blood glucose values were obtained using each of the monitors in 200 patients; 150 with diabetes mellitus, and 50 healthy subjects. Results. The One Touch monitors were the only monitors that reported adjusted straight lines (Y0a+bX) that were very similar for all three techniques. In addition, these adjusted straight lines are those closest to the ideal line, Y=X. These same monitors were the only ones that did not reject the null hypothesis Ho: a=0. The relative deviation index at the 20 percent level was less than 3.5 percent for the One Touch II and One Touch Basic monitors; for the rest of the monitors the index was over 14 percent. The clinically accepted EGA region was similar for all study monitors. Conclusions. In conclusion, the One Touch II and One touch Basic Monitors showed greater accuracy in comparison to the other devices. The evaluation of the clinically acceptable region shows practical reliability for all of the monitor used

Effects of metformin on fibrinogen levels in obese patients with type 2 diabetes

Objetivo. Determinar los niveles de fibrinógeno en obesos con diabetes tipo 2 y valorar las potenciales modificaciones que induce la metformina. Métodos. Fue un estudio abierto, prospectivo, randomizado y comparativo que incluyó a 60 pacientes con diabetes tipo 2 obesos (IMC > 27) durante dos fases. La fase de pretratamiento fue de 4 semanas con un control con dieta. En la fase de tratamiento se les dividió en dos subgrupos de 30. Uno recibió una tableta de metformina de 850 mg, incrementándose la dosis a dos o tres tabletas de acuerdo al control metabólico; el otro subgrupo recibió insulina DNA-recombinante 24 U, subcutánea (dos tercios antes del desayuno y un tercio antes de la cena), ajustando la dosis de acuerdo a la respuesta. Como grupo control se incluyeron a 60 sujetos obesos no diabéticos, que durante las dos fases sólo recibieron dieta. Resultados. Los valores promedio de glucosa, fibriógeno y del índice de masa corporal (IMC) no cambiaron en la fase de pretratamiento de controles y diabéticos ni en la fase de tratamiento de los controles. En cambio los tres parámetros disminuyeron significativamente en el subgrupo de metformina (p < 0.001) y soló el de glucosa (p< 0.001) en el subgrupo de insulina. Conclusiones. La metformina, además de mejorar el control metabólico, demostró ser una buena alternativa para modificar favorablemente los niveles de fibrinógeno en pacientes con diabetes tipo 2