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Question:

From Syracuse, New York, USA:

I was reading some of the other questions that were posted about the GlucoWatch, and I semi-disagree with one of them. A person asked if the Glucowatch will reduce the amounts of finger pricks, and the Diabetes Team answered yes. However, I was the first to have one (for my eight year old daughter) in this area once it was approved (for my eight year old daughter). While it can reduce the number of finger pricks, if you're looking for better control it also may increase the amount of finger pricks. I too bought the watch with the assumption that it would reduce my daughters finger pricks. However, I quickly learned that to utilize this watch to my daughter's best health advantage was to possibly deal with more finger pricks at times. Let me explain.

If I put the watch on my daughter, and it gives me a high reading, I know that the current insulin in her will never bring her to where I want it quickly. Therefore, for better control, I opt to give her some Humalog. This can never be done simply on the watch count. You must take a finger prick. I have had watch readings that have differed by as much as 100 mg/dl [5.6 mmol/L] from the finger prick, so you cannot rely on the watch for treatment. This scenario also works the other way. Her watch has beeped at night indicating a low count( 90 mg/dl [5 mmol/L] or under), but when I tested her and her count was in the 120s mg/dl [6.7 mmol/L], and I don't which to treat a 120 mg/dl [6.7 mmol/L] reading with more carbohydrates!

The biggest advantage of the watch is the ability to see a pattern, not to reduce finger pricks. I've adjusted her insulin regimen by the watch since, when you see a pattern and adjust the insulin properly, hopefully this will lessen the amount of lows and extreme highs and therefore reduce the amount of extra needed finger pricks.

In the past month, I have not used the watch that much at all. The main reason I have temporarily stopped using it regularly is that the watch has left some small white spots on my daughter's arm. It's been about a month now and they're still there. Secondly, the watch itches my daughter, and she really doesn't like it. Before I continue using the watch a lot I am checking with a plastic surgeon to see if they're permanent. If they are permanent, I will still use the watch on special occasions (i.e., trips, sickness), but I won't use it almost daily, like I was previously. If you have any suggestions about the white spots, I'd appreciate it if you could share them with me. I do put lotion on her arm, but that doesn't seem to be helping.

Answer:

I think that perhaps you have been a victim of overenthusiasm for the GlucoWatch because whilst it is a very significant technical advance, it is not like strapping on a wristwatch. There is the three hour equilibration period and besides that there have been a lot of problems with calibration especially in children. You can exchange the Glucowatch I which I assume is what you have for the smaller Glucowatch II which has a shorter equilibration period and seems to be more manageable for $50. This is a step that you might like to take. The calibration problems seem to relate mostly to how firmly you apply the instrument to the skin site initially.

The skin problems that you describe are characteristic of one of the types of dermatitis that are occasionally a problem with using the Glucowatch, but they should disappear in a few days. Our experience here is that the Glucowatch has a role in illness and in times of change as when looking for nocturnal hypoglycemia, but that it may be easier to use an almost painless monitor like the FreeStyle or One Touch® Ultra for day to day use.

DOB

Additional comments from Dr. David Schwartz:

What a wonderful testimony to the usefulness and pitfalls of the GlucoWatch. I do not know what the original commentary was through this forum, but I agree that the GlucoWatch is not the panacea that people hope, and I do not encourage my patients to get one. In the couple that have decided to pursue, we discuss at length the realities and pitfalls similarly to what you have described. When this device is advanced, then we'll really have something, I think!

DS

DTQ-20021115132123
Original posting 10 Jan 2003
Posted to Blood Tests and Insulin Injections

  
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Last Updated: Tuesday April 06, 2010 15:09:42
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