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[IP] plastic

Anyone remember The Graduate ?

Diabetes Care 1999 Aug;22(8):1252-7 

Use of a plastic insulin dosage guide to correct blood glucose levels 
out of the target range and for carbohydrate counting in subjects with 
type 1 diabetes.

Kaufman FR, Halvorson M, Carpenter S

Childrens Hospital Los Angeles, Department of Pediatrics, University of 
Southern California, School of Medicine, California, USA. 
email @ redacted 

[Medline record in process]

OBJECTIVE: To improve glycemic control, a hand-held plastic Insulin 
Dosage Guide was developed to correct blood glucose levels outside of 
the target range. RESEARCH DESIGN AND METHODS: Protocol 1: Some 40 
children (mean age 10.6+/-4.6 years) were randomly assigned for 3 months 
to use a written-on-paper algorithm or the Insulin Dosage Guide to 
correct abnormal blood glucose levels. Mean HbA1c and blood glucose 
levels and time to teach insulin dosage correction were compared. 
Protocol 2: The Insulin Dosage Guide was used by 83 subjects (mean age 
11.4+/-4.3 years) for 1 year, and mean HbA1c levels, blood glucose 
levels, and number of consecutive high blood glucose values taken before 
and after the year were compared. Protocol 3: Some 20 patients (mean age 
10.1+/-3.7 years) using rapid-acting insulin and 64 patients (mean age 
15.9+/-3.6 years) using an insulin pump and rapid-acting insulin used 
the Insulin Dosage Guide and had mean blood glucose levels, HbA1c, and 
percentage of blood glucose levels outside of the target range 
determined. RESULTS: Protocol 1: There was a significant reduction in 
mean HbA1c (P = 0.04) and blood glucose levels (P = 0.05) and in the 
time needed to teach how to correct blood glucose values using the 
Insulin Dosage Guide compared with the paper algorithm. Protocol 2: 
There was a decrease in mean HbA1c levels (P = 0.0001) and a decrease in 
the mean number of consecutive blood glucose levels (P = 0.001) over the 
1-year time period. Protocol 3: With rapid-acting insulin, there was a 
significant increase in the percentage of blood glucose levels within 
the target range (1 month, P = 0.04; at 3 months, P = 0.03). With the 
insulin pump, there was a high rate (90%) of blood glucose levels in the 
target range during pump initiation when the Insulin Dosage Guide was 
used. CONCLUSIONS: This inexpensive hand-held plastic card, which is 
portable and easy to use, may help patients improve glycemia and 
successfully manage diabetes. 

PMID: 10480766, UI: 99408643 
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