Training materials have been developed for patients using CSII to interpret the graphical displays, which enable them to independently make adjustments to their treatment algorithms (for example, basal rate, meal bolus insulin, and doses to correct for glycemic excursions) without the need for consultation with their physician. The Accu-Chek® Smart Pix (Roche Diagnostics GmbH, Mannheim, Germany) information management system (IMS) is a device that directly downloads data from metered SMBG measurements to a computer and produces graphical representations of patients’ glycemic fluctuations, including variations in circadian blood glucose patterns. However, these consultations are only scheduled at 6- to 12-week intervals, and an earlier opportunity to react to blood glucose excursions and make therapy adjustments should improve glycemic control and reduce the risk of diabetes-related complications.
The mechanics of keeping an accurate written logbook are, however, complex and conducive to errors in recording data, which need to be interpreted correctly to make accurate decisions on adjustments in insulin doses at specific points in time, as well as adjustments to fundamental insulin requirements.3 Although patients can be trained to make these adjustments, it is quite often the treating physician who interprets the readings during consultations and makes the decisions on changes to the patient’s regimen.
Accurate adjustment of insulin doses during continuous subcutaneous insulin infusion (CSII) therapy is essential in order to achieve and maintain tight glycemic control in patients with type 1 diabetes mellitus (T1DM).1 Detection of recurrent, reproducible variations in blood glucose levels outside the target range is critical to the success of self-management.2 Although the practice of downloading information is becoming more common, glycemic data are usually collected as patients’ handwritten entries in diabetes logbooks, recorded from self-monitored blood glucose (SMBG) measurements.
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