Self‑Monitoring Devices

In the human body, in every single cell, complex chemical transformations take place: some substances are formed, others are broken down. The conversion of food into energy and heat is one of the most important processes. Metabolism transforms food into energy for muscle work, heat production, and the renewal or repair of billions of cells. Digestion means the breakdown of food into simple nutrients. The pancreas secretes enzymes into the intestine, which act as auxiliary elements in the process of food digestion. When nutrients reach the required size, they enter the blood vessels. In this way, nutrients reach the cells of our body.

The hormone insulin, produced by the pancreas, helps food substances (in this case, glucose) enter the cells. Insulin enters the bloodstream and then binds to the surface of cells. When insulin is on the cell surface, glucose can freely pass from the blood into the cell. Afterwards, food substances are transformed into energy, or they are stored inside the cell as energy products. Insulin, as an auxiliary element for converting glucose into energy, increases when we consume food and blood sugar levels rise. Thus, even a large amount of sugar is quickly absorbed by the body.

During work or physical exercise, the body has an acute need for energy, which is very rapidly converted from carbohydrates (sugar). This means that the brain and the nervous system are entirely dependent on sugar. When a person consumes few carbohydrates, the liver helps raise blood sugar to normal levels by releasing part of the sugar stored in reserve. After a meal, when blood sugar has risen, the liver begins to store sugar in reserve for future use, and excess sugar is converted into fat by fat cells.

Either due to the absence of insulin or because cells cannot fully use insulin, the carbohydrate part of food is not absorbed by the cells. This disrupts both sugar metabolism and other metabolic processes. Such abnormalities develop in diabetes mellitus. Two forms of diabetes have been identified: type 1 diabetes (insulin‑dependent) and type 2 diabetes (insulin‑independent).

Insulin‑dependent diabetes is more common in young people and children. Pancreatic cells stop producing insulin; as a result, the body’s cells cannot absorb sugar, and blood sugar levels remain high.

Insulin‑independent diabetes in most cases develops in adults or elderly people. Pancreatic cells produce insulin, but fat and muscle cells use it only partially. Most of the sugar in the blood remains unprocessed.

Normally, the pancreas slowly produces the amount of insulin a person needs, depending on the food consumed. In diabetes, insulin must be injected subcutaneously, but the patient must know exactly how much to administer. Glucometers come to the rescue — portable devices that quickly and conveniently measure blood sugar levels in the human body. Typically, in patients with type 1 diabetes, self‑monitoring of blood glucose is performed at least 4 times a day. In type 2 diabetes, it depends on the insulin injection regimen. With multiple injections, blood sugar should also be measured at least 4 times a day. If long‑acting insulin is used, measurements are recommended 1–2 times a day. When using mixed insulin, self‑monitoring should be performed at least 2 times a day. Additional measurements should be performed during periods of intense stress (psychological, emotional, or mental strain).

Everyone adapts to life with diabetes in their own way. But if we turn to research results, they are striking. With intensified blood sugar control and correct insulin dosing, the likelihood of complications is significantly reduced: eye disease by 74%, nerve disorders by 63%, kidney disease by 45%, and heart disease by 40%.

Now an important question arises about choosing a glucometer. There are several parameters that can influence the choice. Let us examine them.

The very first method determined sugar in urine using test strips, which were dipped into a container of urine and the result was read from a scale. The same working principle was used for blood testing. This method is called photometric. A portable glucometer now converts the result into a more convenient digital form.

This measurement method has been replaced by a more accurate and reliable electrochemical method. It is based on the chemical reaction between glucose in the blood and chemical substances on the test strip. An oxidation process occurs, leading to a change in the electrical resistance of the device’s circuit, which is instantly detected by the device’s sensors and converted into the familiar values in mmol/L.

Correctly coding a glucometer is very important, as it affects the accuracy of the measurement and, consequently, the choice of the correct medication dose. The first coding method is manual. Each time the device is turned on, the user is prompted to enter a combination of numbers indicated on the test strip packaging. The second method is much simpler. In each tube of test strips there is a coding chip, which should be inserted into the glucometer before measurement; it then automatically performs the coding.

There are also glucometers without coding, but unfortunately, in this case accuracy decreases and medication dosing becomes inaccurate.

In terms of this parameter, most modern glucometers are similar. They provide a result within 5–10 seconds. However, there are also glucometers that require 20–30 seconds.

Often, the treating physician needs a large volume of results for proper treatment adjustment. Now there is no need to remember or write down the results; you can forget about this completely. Modern glucometers will do this for you. They can also show you the average result over 7, 14, 21, or 28 days.

The main indicator of measurement comfort is the required blood volume. Modern manufacturers strive to make this value as small as possible without loss of accuracy. Depending on the model, it ranges from 0.7 to 2 µL.

The cost of modern devices ranges from 1,000 to 2,500 rubles. But this amount is spent only once, whereas consumables must be purchased continuously. Therefore, close attention should be paid to the cost of test strips for the device and of lancets. And here, prices from different manufacturers begin to differ significantly.

Pay attention to the device warranty as well. Usually, 6–10 years is enough for the device to prove its worth. But some manufacturers confidently offer a lifetime warranty.

The main outflow of money is due to the purchase of test strips. But there is another important parameter that many do not mention. These are lancets for pricking.

To avoid infecting a patient with diabetes and to protect against unpleasant diseases, hygiene during measurement must be observed.

Lancets play an important role here; a new lancing device should be used each time. On the Russian market, only one manufacturer of consumables under the iCheck brand includes an equivalent number of lancets in the test strip packaging.

Oleg Potorokin