To the editor:

Medical professionals are taught that stress (in this instance, emotional) raises blood sugar levels in diabetics. I have seen multiple diabetics (I and II) in multiple facilities have high readings at times of stress that are seemingly “unexplainable.”

Someone I know well has been fighting to get their AIC down for years, but it stubbornly stays high. I can attest to the efforts this individual has made in watching diet, checking frequently, etc. Recently I bought this individual a second glucose meter; this individual since checked with both meters side by side. Sure enough, both meters (the two-year-old one and the brand-new one, both machines from different brands) sometimes were near identical (say 121 and 123 — certainly close enough), but just as often sometime wildly apart (say 152 and 247).

This individual keeps a meticulous daily log of the readings. I quickly correlated high sugar readings on the school day mornings the kid in the house had to get ready for school. The pattern was immediate and obvious on retrospective review.

Diabetics are trained and educated to “count carbs”. I suspect this is not enough. I believe we may need to expand how we try to handle diabetes. Perhaps in addition to counting carbs, looking at stress and if the darn machine/strips (often a $19.95 machine issued by the insurance company) is working as designed. “Test solutions” only verify one aspect of the inner workings of the testing system.

This might be a great project for the local nursing students, high school New Visions students, etc. It’s an opportunity to explore diabetes while teaching the basics of clinical epidemiology.

Here is a general plan of action:

1. Identify those diabetics in the Tri-Lakes area who are willing to be part of this small study (type I and II).

2. See who in the test group has a meter older than one year. (insurance companies have the record of when the meter kits were shipped.)

3. Issue new, totally different meters. Verify both new and old meters have good batteries, calibrations done, strips are valid, etc.

4. Have test participants “double check” (use both new and old meters) each time they test their blood and record the results.

5. Have test participants record their stress level since the last reading in addition to No. 4 above. The Glasgow-Coma scale for pain is a good model for a similar stress scale.

All the data can be analyzed with Minitab SASS, etc. An auto-regressive model could even be built on a spread sheet.

Just a thought.

Ira Weinberg

Saranac Lake