Welcome to Round 2 of my new blast-from-the-past series here at DiabetesMine. Once again, I note how little things have changed in four years! This post originally appeared exactly four years ago to the day, but if I didn't tell you that, you might not notice. That's because using the standard deviation for evaluating glucose results remains a much-discussed but not universally accepted method. Enjoy...
Standard Deviation Buzz
There seems to be a lot of buzz about the fact that it's not just about A1C's anymore; rather, it's about using the Standard Deviation to evaluate the success of your diabetes management. If you think about it, it's common sense really: a simple average of your blood glucose over the past three months doesn't tell you how far you've strayed from the ideal range. You may get an excellent "average" number that is nothing but a middle point between the highs and lows you've been experiencing.
At an informational meeting a few days ago, I learned where all the buzz started. The idea of concentrating on Standard Deviation is not entirely new, but has found an avid proponent in Dr. Irl Hirsch, a Type 1 diabetic himself, who is medical director of the University of Washington Diabetes Care Center.
He apparently presented his initial paper on the Power of the SD at the Clinical Diabetes Technology Meeting last April, and his definitive article on the subject is slated to appear in next month's Diabetes Technology and Therapeutics Journal. This publication is interesting in itself, as it is driven by the Diabetes Technology Society, a group which I've discovered is headquartered here in the California Bay Area very near me! This group organizes two annual conferences, the clinically focused April meeting mentioned, and also the Annual Diabetes Technology Meeting in November. Both are intimate events for the movers and shakers in D-technology.
SD formula for diabetes: A1c x SD/100. Find that confusing? Try the online Standard Deviation Calculator here. Also, if you can manage to export your downloaded BG montior data into Excel, that program will calculate the SD for you.
The theory is that the greater the deviation in your blood sugars, the more likely you are to experience mircovasular damage in eyes, kidneys, etc. Dr. Hirsch suggests that diabetics should aim for an SD of one-third of their mean blood sugar. So, if your mean blood sugar were 120 mg/dl, you would want your standard deviation to be no more than 40 mg/dl, or one-third of the mean.
Anyone out there using the SD formula successfully yet? Has it helped you improve your control just knowing how much you are "all over the map"? Do share!
I'm ashamed to admit that I don't download my glucose meter results — maybe I'm too lazy, but heck, the rest of my life is already tracked by a half-dozen other spreadsheets (kids' appointments, nanny schedule, work deadlines, dinner menus, and so on). So just haven't had the impetus to fuss with D-Math. (You might say I prefer telling D-stories )
Thoughts? View the comment stream from 2005 here.
btw, this year I've actually been invited to participate in the fall Diabetes Technology Society Conference, in a panel talking about the most-needed types of "technologies to improve adherence and control of diabetes." Any ideas on that angle are also very welcome.