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History and Vision: What is Important for Patients with Diabetes?

Owens, David Raymond 2008. History and Vision: What is Important for Patients with Diabetes? Diabetes Technology & Therapeutics 10 (s1) , S5-S9. 10.1089/dia.2008.0015

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Abstract

Up to the mid-1950s, evaluating the degree of glycemic control relied upon determining the concentration of glucose in the urine while acknowledging the inherent difficulties in interpretation. Progress was made from the original Benedict's test, when Benedict's solution was added to the urine sample to be tested, followed by the addition of the urine sample to a reagent tablet (Clinitest) or powder (Gelatest), and finally, in the 1960s, to a variety of urine glucose test strips, i.e., test-tape/Glukotest, Clinistix, Dreypak, and Combur-Test (glucose, protein, and pH value). The quest to produce blood glucose test strips was realized later in the 1960s, with refinements made during the following decade resulting in the introduction of Dextrostix and the Reflotest strips for use with reflectance meters and then the Haemo-Glukotest for visual determination. It was soon realized that patients were capable of using such meters, thereby introducing the concept of self-monitoring of blood glucose (SMBG). Initially, there was considerable opposition by the profession, which soon evaporated when the benefits of SMBG were clearly demonstrated in the mid- to late 1970s by Sînksen et al. (1978), Walford et al. (1978), and Cohen et al. (1980) in their pivotal publications. Early experience of introducing the patient to the concept of self-care using SMBG achieved a dramatic and sustained improvement in glycemic control, being preferred to urine testing in terms of both its execution and meaningfulness of the test result. Despite early concerns, SMBG's value in the management of the pregnant woman with diabetes was quickly realized and universally adopted. Further developments have centered on refining the test strips, blood sampling techniques (thereby reducing the volume of blood samples required), accuracy of glucose determination, and time from sampling to results. Currently there is reasonable consensus, based on evidence, about the use of SMBG in insulin-treated persons with diabetes, whereas considerable debate continues about its role in non–insulin-treated subjects with type 2 diabetes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RM Therapeutics. Pharmacology
Publisher: Mary Ann Liebert
ISSN: 1520-9156
Last Modified: 04 Jun 2017 03:41
URI: http://orca.cf.ac.uk/id/eprint/25019

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