During the last decade, systems have been designed that allow the patient with diabetes mellitus to easily measure his or her blood glucose outside the hospital. The availability of this measurement has enabled the person with diabetes to take charge of control of his own blood glucose in a manner previously considered impossible.
Many studies have now documented that, with appropriate training, patients can be taught to measure their own blood glucose accurately and make appropriate adjustment in insulin, food intake, and exercise such that near-normal metabolic function is achieved. Mastery of these systems and blood glucose has been accompanied by a breakthrough in the depressive cycle of hopelessness and helplessness encountered by the person faced wit h chronic illness. The success of blood glucose control programs correlates well with the frequency of blood glucose measurements performed by patients. Programs that have been most successful are those in which patients monitor their own blood glucose five-seven times a day.
Mastery of a program in home blood glucose monitoring and normalization of blood glucose now requires about 40 hours, whether one is a patient or a physician.
A group of physicians in New York have founded the Diabetes Self-Care Program at 344 East 63rd Street, as a resource for patients and physicians where these systems can be learned within a five-day period. This is the first such program in the country. Its success depends on whether insurance companies will support such efforts of diabetes management through teaching programs or continue to wait until the person with diabetes encounters the more devastating problems of long-term diabetes that require hospitalization.