You may have seen companies offering free glucose meters although these offers may not be available all the time. When considering these offers, its important to weight what your obligations are in return for getting the the free glucose meter. The idea is that these companies reward individuals for becoming long term customers. It may or may not make economic sense in your particular situation.

The following are some facts & resources on glucose meters:

en.wikipedia.org

A glucose meter (or glucometer) is a medical device for determining the approximate concentration of glucose in the blood. (source: http://en.wikipedia.org/wiki/Glucose_meter)

A small drop of blood obtained by pricking the skin with a lancet is placed on a disposable test strip, which the meter reads and uses to calculate the blood glucose level. (source: http://en.wikipedia.org/wiki/Glucose_meter)

There are a number of meters available from different manufacturers which all support home blood glucose monitoring. (source: http://en.wikipedia.org/wiki/Glucose_meter)

There are several key characteristics of glucose meters that may differ from model to model:. (source: http://en.wikipedia.org/wiki/Glucose_meter)

www.fda.gov

Glucose meters help people with diabetes check their blood sugar at home,. (source: http://www.fda.gov/diabetes/glucose.html)

Diabetes Information – Glucose Meters and Diabetes Management. (source: http://www.fda.gov/diabetes/glucose.html)

Instructions for Using Glucose Meters. (source: http://www.fda.gov/diabetes/glucose.html)

Factors that Affect Glucose Meter Performance. (source: http://www.fda.gov/diabetes/glucose.html)

Home Healthcare MEdical Devices: Blood Glucose Meters – Getting the Most Out of Your Meter. (source: http://www.fda.gov/cdrh/cdrhhhc/bgm.html)

Although blood glucose meters are simple to operate, many things can go wrong. (source: http://www.fda.gov/cdrh/cdrhhhc/bgm.html)

Watch and practice with an experienced blood glucose meter user, a diabetes. (source: http://www.fda.gov/cdrh/cdrhhhc/bgm.html)

Some blood glucose meters can use blood samples. (source: http://www.fda.gov/cdrh/cdrhhhc/bgm.html)

www.realitycheck.org.au

After reading your review on Blood Glucose Meters, I decided to buy. (source: http://www.realitycheck.org.au/glucometers_test.htm)

www.diabetesnet.com

Blood Glucose Meters Current Continuous Monitors Comparison of Available Monitors Various Future Monitors Improving Today’s Meters Other Monitors. (source: http://www.diabetesnet.com/diabetes_technology/blood_glucose_meters.php)

www.diabetes.org

Choosing A Blood Glucose Meter – Youth Zone – American Diabetes Association. (source: http://www.diabetes.org/youthzone/choosing-a-bg-meter.jsp)

www.childrenwithdiabetes.com

While not as precise as blood glucose meters, they can be less expensive than test strips for meters and therefore can be an alternative for people who find meters and strips difficult to afford. (source: http://www.childrenwithdiabetes.com/d_0i_000.htm)

The Food and Drug Administration (FDA) reported May 27, 2005 that it is investigating reports that four men who had been using Cialis experienced blind allegedly from the impotence medication. Similarly 38 men taking Viagra reported blindness as well.

While one of the published side effects of Cialis is changes in vision, blindness either full or temporary is not listed as a side effect. The maker of the drug warns that some men may experience blurred vision, however, this was the first report of Cialis-related blindness. While still under investigation, the findings were culled from research conducted in 2003 by Dr. Robert Egan, associate professor ophthalmological neurology and neurosurgery at Oregon Health and Science university’s Casey Eye Institute.

The blindness, according to Dr. Egan, is caused by nonarteritic anterior ischemic optic neuropathy, or essentially a stroke which occurs in the eye. This condition is known to affect people with high blood pressure and diabetes.

Cialis should be taken exactly as your physician or other health care professional prescribes it. This includes staying within your physician’s guidelines for the proper dosage. Clinical trials were conducted using no more than 20 mg of tadalafil. For many men, a dose of 20 mg is, indeed, appropriate, but the exact dosage is best determined by a visit to your prescribing physician.

Cialis may be taken at most once a day by most patients. Again, your doctor will provide you with these details.

Cialis, unlike some prescription medications for impotence, can be taken even if the man is eating a high-fat food. The absorption of this substance is not affected by food. Nor is the absorption affected by liquids.

If a man should experience an erection that lasts longer than four hours, he should seek immediate medical attention.

The presence of Type I or II diabetes had no effect on the effectiveness of this drug, according to clinical studies and posed no additional side effects.

If you are taking nitrates – a substance prescribed for angina or chest pains – you are not a candidate for Cialis. The two drugs combined may cause an unsafe and sudden drop in your blood pressure.

While you are using tadalafil, do not drink alcohol to excess or get inebriated. The presence of alcohol in your system, combined with this medication puts you at a greater risk for experiencing dizziness, and a sudden drop in blood pressure.

The use of recreational drugs, such as amyl nitrite and butyl nitrite – commonly known as “poppers” – is not recommended while on this medication.

Known temporary side effects of Cialis include headaches, back pain, muscle aches, indigestion, flushing, and a stuffy or runny nose. These will disappear within a few hours. Both the back pain and muscle aches usually appear within 12 to 24 hours of taking the medication and do not last longer than 48 hours. Be sure to notify your doctor if any side effects refuses to go away.

Cialis helps to temporarily provide men with the ability to get and keep an erection by increasing blood flow to the penis. A man’s erection depends on the body delivering – and trapping – the blood in the penis long enough to provide the stimulation and satisfaction for sexual activity. Cialis, in clinical trials, has proven to do this for men who suffer from mild to moderate ED.

The penis contains two chambers – the corpora cavernosa – which runs the length of the organ. These chambers are filled with a spongy tissue containing smooth muscles, fibrous tissues, some spaces, veins and arteries. The urethra, which is the channel for both urine and ejaculation, runs along the underside of the chambers.

An erection begins with either mental or physical stimulation, or both. Impulses sent from the brain and the local nerves cause the this vein filled chamber to relax which allows an increased blood flow to the area. Obviously, this increase in blood expands the penis and then the blood is trapped in the organ, which is what sustains the erection. The erection is not reversed until the penis contracts to stop the inflow of blood and opens the outflow channels, which then releases the blood.
Cialis works through its ability to help trap the blood flow through the inhibition of a substance called PDE5, which in turn stimulates the creation of a second substance cyclic GMP – cGMP – which is responsible for the relaxation of the muscles in this area causing an increase in the blood flow.

The advantage of Cialis is the ability of the medication to linger in the man’s system for up to 36 hours. This allows him and his partner to choose the proper time and place for the love-making to take place.

Cialis is the first joint product of Lilly, an Indiana based pharmaceutical company and ICOS, a biotechnical firm located in Washington state. The search for an effective erectile dysfunction drug began in 1993 when ICOS began researching IC351, a compound which inhibits the PDE5 enzyme. The following year ICOSS receives the first patent on IC351 and in 1995 clinical trials start.

Two years later in 1997, ICOS conducts its first study in patients with impotency problems and by 1998, a partnership between Lilly and ICOS is formed. The goal: to commercialize drugs for the treatment of erectile dysfunction.

The following year, 1999, saw the initiation of the Phase III clinical studies on the patented compound.

The newly formed company did not file a new drug application with the Food and Drug Administration until 2001. At this time, the manufacturer names the drug Cialis.

In April of 2002 the FDA reviews the application, but declines to approve it. The government agency wants to see more clinical studies, the resolution of some manufacturing issues and the complete labeling for the product.

In May of that year, Lilly ICOS reports that Phase III test results for Cialis are positive. In fact, data demonstrate that Cialis stays in the male’s system for up to 36 hours, providing a larger window for sexual activity than with Viagra. These findings are presented in Orlando, Florida to the 97th meeting of the American Urological Association.

Meanwhile, in July 2002, the European Committee Proprietary Medicinal Products recommends the approval of the drug in Europe. Approval comes in November of 2002 for European sales, with marketing of the product following in February 2003.

The FDA approves the sales of Cialis in the United States in November 2003.

The three major erectile dysfunction drugs on the market, are all different types of drugs, but all work using similar methods of trapping blood in the penis. As with any medication, though, each person experiences different results with different drugs. Many men have switched to Cialis because Viagra or Levitra did not work well enough for them. Some men received good results with Viagra but switched to Cialis because of the larger window of opportunity – the advantage of having the ability to make love in a time frame as long as 36 hours.

It is important to note that there have been no official studies comparing these ED drugs. The following comparison is anecdotal and as such should be treated with caution. The quotes used here are from men who have used Cialis and were gathered from message boards on the world wide web:

One man writes: “I used Cialis for the first time tonight. After using both Levitra and Viagra, I am amazed at how well it works. Levitra and Viagra did not work for me at all. Cialis has been unbelievable. The intensity of the erections and frequency is mind-blowing. My wife is still in shock … the side effects are substantially less [than with Viagra and Levitra] as well.”

Another gentleman, however, discovered that the side effects of Cialis were greater than with Viagra: “I noticed that I was feeling ‘tingly’ down there within 15 minutes with a little lightheadedness. I also noticed that with Viagra I simply could NOT have an orgasm during the 5 or 6 hours that it was my system. Cialis did not impede my orgasm.
However, I will switch back to Viagra after this test of a 20 mg dose of Cialis. The next morning, about 4 a.m., I woke with a real bad headache. I had no other drugs or even alcohol in my system. The headaches persisted until the afternoon with lower back muscle soreness. I am disappointed with Cialis for this reason. Also my inability to have an orgasm with Viagra also meant that I had incredible staying power, which was more important to me in pleasing my partner.”
But another posting on a web site indicated a distinct pleasure with the product: “It works. On a recent vacation, my girlfriend and I had sex every day … for a week and I think her head is still spinning. My confidence is through the roof now. Try it.”

The table below provides a quick comparison of the 3 drugs:

Diabetes is a common cause, with approximately one-half of all diabetic men experiencing erectile dysfunction at some point in their lives. Since diabetes has adverse effects on both blood vessels and nerves, the erectile dysfunction is likely a result of both. Maintaining optimal glucose control minimizes the risk of erectile dysfunction.

Erectile dysfunction affects both the sufferer and the partner. The disorder has been associated with a decreased quality of life and health. Self-esteem is decreased. It is associated with an increased conflict in relationships. The NHSLS study had important findings regarding impact on patients, reporting that men with erectile dysfunction had low physical/emotional satisfaction and low general happiness.

Treatments
Treatment of erectile dysfunction has advanced significantly. It has moved out of the urologist’s office, and family physicians are now often the first-line management for many cases. Part of this advance has been the advent of PDE5 inhibitor medications which are well-tolerated, have a good safety profile and work well. The PDE5 inhibitor medications are described in detail in following sections.Viagra, Levitra and Cialis are PDE5 inhibitors.

Traditional treatments
Herbal medications for erectile dysfunction have existed for centuries. Sometimes they are marketed as general aphrodisiacs, others are advertised more directly as treatments for erectile dysfunction.

The FDA (the USA Food and Drug Administration) does caution that many of the herbal remedies for erectile dysfunction haven’t had the same level of testing as some of the other pharmacological agents.

That said, some of the medications for erectile dysfunction are derived from natural sources. For example, Yohimbine is a classic drug for erectile dysfunction and is derived from the bark of a tree in Africa. Yohimbine is described in more detail in a later section.

Analysis of some of the compounds in other herbal products for erectile dysfunction have shown interesting results. When the compounds are studied with spectrometry, some contain traces of chemicals that are similar in structure to the PDE5 inhibitor medications such as Viagra or Cialis.

The treatment methods for diabetes are numerous. Although diet and weight loss are imperative, as well as insulin injections for many patients, drug therapies, alternative therapies and even the future of genetic therapies can all be considered. Any or all of these methods will be appropriate and a physician should be consulted before any major decisions are made.
Today, the orally prescribed drug therapies for diabetes can be organized into five classes: sulfonylureas, meglitinides, biguanides, thiazolidinediones, and alpha-glucosidase inhibitors. These five types of drugs all work in different ways to lower the patients blood glucose levels. Sulfonylureas stimulate the pancreas to release more insulin. All sulfonylurea drugs have similar effects on blood glucose levels but are different in terms of side effects. Meglitinides also stimulate the pancreas to release insulin. Biguanides are different in that they lower blood glucose levels by decreasing the glucose in the liver. Thiazolidinediones are drugs that help insulin work in the muscle and fat and they also reduce glucose in the liver. Because this particular type of drugs can have a rare but serious effect on the liver, the doctor will perform blood tests to monitor the health of the liver. Finally, alpha-glucosidase inhibitors help the body to lower blood glucose levels by blocking the breakdown of starches, such as bread and pasta in the digestive tract. Their action slows the rise in blood glucose levels after a meal. Because the drugs listed above act in different ways to lower blood glucose levels, they may be used together.
There are many orallly prescribed medications that are available to help diabetics use insulin more effectively. These medications are only effective, however, for Type II diabetics who are at least producing SOME insulin on their own. In the more serious cases of Type II diabetes or in the case of Type 1 diabetes, insulin injections are needed.
Alternative treatments are also gaining popularity for diabetic patients. Among the most popular of these are acupuncture, biofeedback, chromium, ginsing, magnesium and vanadium supplements. Many scientists, especially in Asia, believe that acupuncture triggers the release of natural painkillers in the body. For this reason, acupuncture is often used by people with neuropathy, the painful nerve damage that comes about with diabetes. Biofeedback is also a popular therapy for diabetics. This therapy uses relaxation and stress-reduction techniques along with guided imagery to control or even cure chronic diseases such as diabetes. Chromium for diabetes may improve glucose tolerance factor, which helps insulin improve its action. Studies have also shown some glucose-lowering effects with ginsing. A deficiency in magnesium may also be a factor contributing to diabetes. Researchers think that a deficiency of magnesium may interrupt insulin secretion in the pancreas and may also increase insulin resistance in the body. This may lead to diabetes complications. Finally, some studies showed that the supplement Vanadium normalized blood glucose levels in animals with diabetes. It was also found that people with diabetes who were given vanadium developed a small increase in insulin sensitivity. They were able to decrease their insulin requirements through the use of this supplement.
Genetic research is at the cutting edge of treatment plans for the diabetic and is the real hope for the future. Once researchers know which genes are involved in bringing about diabetes, they will hopefully be able to develop a test to screen people. This may help to identify high-risk people who may require preventative action. Knowing what genes cause diabetes can also help scientists understand what drugs can counteract the disease.
A recently discovered gene, Calpain-10, has been found to increase the risk of Type 2 diabetes and has given scientists new hope of understanding this terrible disease. However, the researchers who discovered this gene say that they still need to learn more about how the gene influences diabetes. Scientists now know that the double-stranded DNA that makes up a gene only has to be off by one nucleotide to cause a problem in the patient. This lapsing nucleotide results in what is called a “single nucleotide polymorphism” or SNP. Some SNPs reduce the amount of protein that is produced in the body and therefore can lead to a diabetic condition. Researchers still don’t know how this decrease in protein increases a person’s risk for diabetes but there are certain associations that have already been made.
Obviously, this gene research is the future of the treatment methods for diabetics. Once scientists can understand the way in which these genes affect the patient with diabetes, the treatment plans will improve drastically. There is great hope for all diabetics that is just over the horizon. Because of this, it is more important than ever to maintain a healthy lifetyle and to think positively in terms of this increasingly manageable disease of diabetes.

What causes diabetes
The incidence of diabetes is increasing all around the world and becoming an alarming situation. The number of existing cases and the number of new cases are both increasing. Most of this increase is not due to the growing population of the elderly but rather to a middle aged population and the youth. According to WebMD, “There has been a 10-fold increase in the number of children with Type 2 diabetes during the past five years.” Over 85% of the children with Type II are also overweight.
Between 1980 and 1996, the number of persons with diagnosed diabetes increased by 2.7 million and the age-adjusted prevalence of the disease increased 19%. This percentage is compared with an increase of 26% in the crude prevalence or “non-age adjusted” prevalence. This difference in percentage increase indicates that less than 30% of the increase in prevalence is due to the aging of the U.S. population.
In the UK, diabetes numbers leapt to 1.8 million. The figures are part of a report by Diabetes UK which predicts that the number of people with the condition will continue to rise as the population ages and becomes more overweight. Similar statistics revealed that three per cent of the population, equivalent to the combined population of Liverpool, Birmingham and Manchester had diagnosed diabetes. This reflected an increase of 400,000 people in just eight years! It was also predicted by a study in the UK that the number of people with the condition would continue to rise as the population aged and also tended toward a higher incidence of obesity. “The number of people with diabetes is increasing at an alarming rate,” said Douglas Smallwood, Chief Executive of Diabetes UK. The increase in the number of people who suffer from obesity may begin to give us an explanation for why this incidence continues to rise.This increase in both the UK and the United States appears to be a recent trend. From these statistics, there are certain conclusions that can be drawn about the increased incidence of diabetes.
In the case of Type 2 diabetes, we now know that it is caused by a combination of genetic disposition, insulin abnormality, glucose production, fat breakdown and defective hormones. The recent dramatic increase in cases of diabetes may be mostly due to lifestyle factors such as overweight condition and a non-active lifestyle. These factors may also be significant in the triggering of the genetic elements of Type II diabetes.
To explain this condition more scientifically, we must first look at how the levels of fatty acids and hormones create “insuilin resistance” in the body. The two hormones “resistin” and “leptin” may be involved in setting up “insulin resistance” but it is not known if their elevated levels are just a biproduct of obesity or whether they play a more fundamental role in diabetes. Some proteins called calpains may also play a big role in insulin secretion and insulin action. How these hormones contribute to Type II diabetes is still being researched.
Genetic factors have been identified as the possible cause for increased incidence of diabetes. In terms of the impairment of beta cell function and an abnormal response to insulin, scientists have identified a number of genetic possibilities. Certain genes associated with maturity-onset diabetes in youth (MODY), may be responsible for inherited cases of type II diabetes. A fatty-acid protein known as “FABP2″ gene may also contribute to higher levels of fat which may be responsible for insulin resistance. Another gene known as “lipoprotein lipase” or “LpL” may be a culprit in both coronary artery disease and Type II diabetes. Yet another gene is being researched which reduces the activity of a protective substance found in visceral fat cells near the midsection of a persons abdomen. The result of this reduced activity is a slow-down in the persons metabolism and an increase in weight. As these genes propogate in humans, the incidence of diabetes may also be going up.

Whether it be lifestyle causes or genetic causes, the incidence of diabetes is definitely on the increase. As scientists continue to research these different suspected causes, they will likely gain new insights into the nature and likelihood of diabetes in certain individuals.