symptoms of pre diabetes

Capillary blood glucose measurements performed by patients themselves, as outpatients, are extremely useful. In type 1 patients in whom "tight" metabolic control is attempted, they are indispensable. A portable battery-operated glucometer provides a digital readout of the intensity of color developed when glucose oxidase paper strips are exposed to a drop of capillary blood for up to 45 seconds. A large number of blood glucose meters are now available. All are accurate, but they vary with regard to speed, convenience, size of blood samples required, and cost. Popular models include those manufactured by LifeScan (One Touch), Bayer Corporation (Glucometer Elite, DEX), Roche Diagnostics (Accu-Chek), Abbott Laboratories (ExacTech, Precision, FreeStyle), and Home Diagnostics (Prestige). One Touch Ultra, for example, requires only 0.3 mL of blood and gives a result in 5 seconds — and illustrates how there has been continued progress in this technologic area. Various glucometers appeal to a particular consumer need and are relatively inexpensive, ranging from $50.00 to $100.00 each. The more expensive models compute blood glucose averages and can be attached to printers for data records and graph production. Test strips remain a major expense, costing 50-75 cents apiece. In self-monitoring of blood glucose, patients must prick a finger with a 28-gauge lancet (Monolet, Ames Co.), which can be facilitated by a small plastic trigger device such as an Autolet (Ames Co.), SoftClix (Boehringer-Mannheim), or Penlet (Lifescan, Inc.). When used for multiple patients, as in a clinic, physician's office, or hospital ward, disposable finger-rest platforms are required to avoid inadvertent transmission of blood-borne viral diseases. Some meters such as the FreeStyle (Abbott Laboratories) have been approved for measuring glucose in blood samples obtained at alternative sites such as the forearm and thigh. There is, however, a 5- to 20-minute lag in the glucose response on the arm with respect to the glucose response on the finger. Forearm blood glucose measurements could therefore result in a delay in detection of rapidly developing hypoglycemia.
The accuracy of data obtained by glucose monitoring requires education of the patient in sampling and measuring procedures as well as in proper calibration of the instruments. Bedside glucose monitoring in a hospital setting requires rigorous quality control programs and certification of personnel to avoid errors.