Diabetes Services

Medication adjustments - We work closely with people to get their blood sugars under control. After a visit, patients are instructed to email or text us their readings, and we adjust medications until glucose levels are in a healthy range.

Straightforward follow-up - Follow-up visits are required based on the following:

Treatment approach outlined - Want to know exactly how we treat diabetes? Dr. Crump has written a comprehensive review of our approach to treating diabetes. See diabetes treatment steps for more.

Choosing a Glucose Meter

There is a vast array of glucose meters available to consumers today. Some devices make Bluetooth connections to phones and send readings to apps for charting and sharing. Some meters are thumbnail-sized devices that plug into smartphones for easy transport. The FreeStyle Libre measures glucose levels by waving a smartphone over a patch that is worn for 14 days. Bells and whistles are nice, but unless the meter delivers accurate readings, it is useless.

So how does someone know if the meter they are buying is accurate? The FDA requires that meter manufacturers meet a standard referred to as ISO 15197, which states that 95% of the meter's readings must be within 15% of a reference standard for blood sugars greater than 100 mg/dl and within 15 mg/dl for readings less than 100 mg/dl. Despite this, independent aftermarket testing has found that many meters don't meet the standard.

Fortunately, researchers have performed accuracy testing on a number of devices and published their results. The table below provides data from several larger studies. Cost information is also presented. Most manufacturers charge a nominal fee for the meter and make their money selling strips.

^✝Percent of readings that met the ISO 15197 standard (within 15% of a reference standard for blood sugar readings > 100 mg/dl and within 15 mg/dl for readings < 100 mg/dl)

¹ PMID 29898901, ² PMID 27697848
Accuracy of available glucose meters
Meter	% of readings within standard^✝	Test strip cost
Meters tested across 2 separate studies
Contour Next	97 - 100% ^1,2	$0.38/strip
Accu-Chek Aviva Plus	91 - 98% ^1,2	$0.30 - $0.50/strip
FreeStyle Lite	92 - 96% ^1,2	$0.50 - $0.77/strip
OneTouch Verio	92% ^1,2	$0.52 - $0.63/strip
Walmart ReliOn Micro	62 - 97% ^1,2	$0.18/strip
Walmart ReliOn Prime	62 - 92% ^1,2	$0.18/strip
Meters tested in one study
CVS Advanced	97% ¹	$0.20 - $0.30/strip
FreeStyle Freedom Lite	92% ²	$0.50 - $0.80/strip
Prodigy AutoCode	90% ¹	$0.17 - $0.25/strip
Embrace	88% ¹	$0.15 - $0.20/strip
Nova Max	88% ²	$0.18 - $0.30/strip
TrueTrack	81% ¹	$0.15 - $0.20/strip
Advocate redi-code +	76% ¹	$0.18 - $0.25/strip
Gmate SMART	71% ¹	$0.30/strip
OneTouch Ultra 2	70% ²	$0.44 - $0.90/strip
AgaMatrix Presto	63% ²	$0.25 - $0.35/strip
AgaMatrix Jazz	60% ²	$0.25 - $0.35/strip
Sidekick All-in-one	49% ²	$0.36/strip

One of the first questions many people ask when they are initially diagnosed with diabetes is, "What should I be eating?" The truth is, there are a lot of opinions on this, and there is no one-size-fits-all answer. Most people assume they should immediately cut out all carbohydrates, and while it's true that certain carbohydrates are absorbed rapidly and cause blood sugars to spike, cutting out all carbohydrates is neither sustainable nor recommended. The American Diabetes Association (ADA) says the following about macronutrient (carbs, fats, protein) distribution in diabetes, "There is no single ideal dietary distribution of calories among carbohydrates, fats, and proteins for people with diabetes; therefore, macronutrient distribution should be individualized while keeping total calorie and metabolic goals in mind." See the link below for a complete review of ADA diabetic diet recommendations.

Type 2 diabetics who are overweight should primarily focus on weight loss. The link below gives detailed step-by-step instructions for calculating caloric needs and figuring calorie deficits to achieve weight loss.

Highly-motivated patients who are interested in how certain foods directly affect their blood sugars may want to read about the glycemic index, which is reviewed at the link below.

Diabetics who are on daily multi-dose insulin regimens (e.g. type one diabetics) require more complex guidance available at the links below.