choosing a glucose meter

My father just had a stroke, now part of his medicine included a combination of Metformin/Glitazones for his diabetic condition. Although not required, but we still decided to purchase a glucose meter for self-monitoring at home.
After a few days of searching, I still cannot find a definite answer to finding a good glucose meter. Anyhow, this is what we bought, Abbott’s Optium Omega.

Let me first explain what is included or what is needed. The package normally comes with a meter, a lancing device, some lancets, and test strips.

This is the meter, which is terribly small, and light. The bottom is the opening where you would insert the test strip. The code from each box of new test strips needs to be entered into the meter before use. Of course all these procedures are stated in the instruction book. So read them carefully before use. Omega can only keep 50 records in the memory. More advance model come with software to download to computer.

This is the box of 25 test strip that comes with the package. Note the code 13 that has already been entered into the meter. Optium Xceed has one advantage over the other model. Its test strip is individually packed in separate packaging. This reduces the chances of deterioration of the strips and also possible contamination. But then, considering all other models and brands of glucose meters have been using the strips-in-a-can method for so long that I don’t see that it will make much different to the reading in general as long as proper care is observed when taking the strip.

This is the lancing device and an example of a cheap lancet (rm0.30 /piece). The package come with 10 original lancets that look much higher quality. So basically the consumable items are the lancets and the test strips (rm40/25 box). Accu-chek has a proprietary patented lancing device that claimed to be painless due to the speed of the piercing needle. To be honest, I can’t feel much of anything with this lancing device from Optium Omega with the depth of 3 out of 4. Some may not find it necessary but I do recommend getting some alcohol cotton swatch to disinfect your finger before lancing. And last but not least is that Omega and Xceed only need very little amount of blood sample for test: 0.3 microlitre. I’m not sure how to describe the size, but I believe it is probably about the size of a full stop on this page.

There are certainly a lot of things to consider when buying a glucose meter. At the end of the day, it is always the willingness to pay the extra cost of the expensive meter vs the more affordable but generic model.

From the search around the pharmacy in Kuching, we found these models:
1. Accu-chek by Roche
2 .Optium by Abbott
3. One touch by johnson and johnson
4. Contour by Bayer
5. ? by Braun

Accu-chek is the more common model in the market. My aunt has been using Accu-chek for the past 20 years. Two pharmacies we visited both recommended Optium Xceed over Accu-chek. one cited Accu-chek having bad service (take longer to replace faulty meter, although they didn’t mention there is any, which is a good sign for good meter). Abbott is appeared to be competing with Roche for the glucose meter market share, especially in the government hospitals. Accuracy wise, there is no way to confirm which is more accurate unless the meters are being tested against the lab test at the same time. So using accuracy as a benchmark for choosing a meter is out of the question. All approved glucose meter has to pass a maximum 20% deviation error limit. Such deviation can also greatly increase by mishandling of the test strips and hematocrit(red blood cell count).

In a 2008 published studies of 9 different glucose meter on 80 diabetic patients, Xceed and Contour failed the 20% deviation limit in the test. Abbott claimed poor quality test strips for the result. The second test did fall within the limit. This is just to show that many factors can cause deviation. In the same study, the author also highlighted the effect of hematocrit on the test results to be very significant. Lab test of blood sugar uses only the plasma portion of the blood and thus is not affected by the amount of red blood cell in the body. One pharmacy did claim that Abbott Xceed tests only the plasma of the blood and thus more accurate. I have not been able to find proof of this claim anywhere. Judging by the knowledge level of pharmacists in Kuching, I can only say that is just a load of sales bullshit unless I see some proof.

Most manufacturers did not really talk about their technology on their websites. They put up vague claim statements about their meters and use proprietary names without further explanation. Personally, I don’t see any special advantage nor disadvantage of buying any one particular brand or model. I did consider the lifetime warranty and the company’s commitment to future research in diabetic care. Considering the fact that most meters are pretty affordable. There is no reason to think too much.

今年夏天

A nostalgic song I just came across.

Anecdotes and scientific evidents

Another great articles written by Michael Shermer. I found him in the Scientific American magazine many years ago and I’ve been following his articles ever since. I would compare him to the RPK of Malaysia in a role to spread the truth (of course RPK’s truth is always questionable). But with scientific evidents.

http://www.sciam.com/article.cfm?id=how-anecdotal-evidence-can-undermine-scientific-results

Drift and burning rubber

Ahh, yes… another result of popular culture. The series of manga and anime called Initial D probably set it off. Drifting perhaps is like the subculture of car racing. This type of racing always brings an image of street racing and gang image. I must admit that I love the Initial D series. In fact, that was one of the very first full length 26-episode anime I watched in my life. Very few men, I think, would not find the songs and mountain road racing exciting.

The parking lot at the Bukit Jalil stadium has been the venue for drift racers to practice for the past few weeks now. And living so near to the place, the sound of screeching tyre is terribly annoying. Anyway, I dropped by in the afternoon to have a peek at the team competition final. I am always ambivalent about car racing. On one hand, it is a perfectly interesting sport but on the other, it really encourages people to speed. Safety, I think, is never really a highlighted issue in amateur car racing. I am happy to see that all drivers wore proper full-faced helmet and reenforced their car accordingly. There are one or two drivers who did go on to the track without a crash helmet. One thing I really hate to see is that most drivers did not use a truck to transport their car to and from the venue. I see most of these racing cars (obviously not fit for the normal road) just sped off after the event. I really feel that the racing drivers should be aware of the importance of safety in their line of work and should constantly demonstrate such consciousness in their conduct in front of the audience. As for me, I took tons of lousy pictures and just not ready to be a race car photographer just yet…

Onion Magazine and Richard Dawkins’ facebook photo

I was just taking a break from serious work and stumbled upon these two sites that really sent me laughing until tears came out. The Onion Magazine is a series of brilliantly well-designed, mock magazine covers with powerful sarcastic and satirical headlines that would keep you laughing all the way. In a book on magazine cover called the onion style as ‘counter-culture’ magazine cover. In a way it is. The news on the website are purely satirical and pretty much useless stuff as facts but can really keep you entertain. While you’re laughing it out, the important thing is that it shows us a different way of seeing our present day culture. If you’re not laughing, it is a sign that you’re not living in the mainstream culture.

On a different note, I just found out that Richard Dawkins has a facebook group as well. And the photo collection in the group is seriously not for the religious bunch. But this just goes to show that atheists are good comedians too.

Wikipedia’s backstage

Recently I found myself becoming more and more dependent on this amazing internet product called Wikipedia. It does not really give you all the facts, of course because anybody can update the information. But it does provide a good starting point for anything you would like to find out further. A sort of like getting a table of content of the subject you want to study. My next two steps are always going for the search under google scholar and google books. A few things I always do when looking at Wikipedia information. One is always check the citation at the bottom. Any claims without a citation is almost worthless but it can still serve as a good starting point to find out whether that particular claim is true by searching from other resources. Then I would look at the discussion and history tabs on top of the article to find out what are the disputed points in the articles and what have been changed recently. If you use wikipedia frequently, you would probably realise how often the content of an article is being changed. So remember to check out the backstage of the articles you read before believing what is there.

Blog as performance

Blog can never be categorised as a subset of diary writing. Diary is private and personal. We do not write diary for anybody’s gaze but our own. How private and personal do you think your diary going to be if you know that your diary will be displayed on the family bookshelf for the reading pleasure of other family members and visitors. Blog is different. We consciously are aware that there is an audience out there. We may even feel disappointed if there is no audience. Blog requires somekind of interaction to function. It is like a less active form of chat, or a personalised message board. Still, interaction is what makes them interesting. A speaker without an audience can never form a speech.

The activity of stage drama or theatre as we know it, is a combination of scripted, prearranged, performances at a designated space. Our life performances may seem spontaneous but it is far from that. They are strips of behaviors that we repeat so often that we can do it so reflexisely as we wish. The authors of our script of life are our general knowledge, beliefs, needs, past experience, values and goals. That is mostly what we know of as ‘culture’. Culture is a system of meaning by consensus of the people. We of course are individuals that contribute continuously to that general system of meaning. Many society develops similar culture. We just cannot take for granted that all cultures are the same. It is within this system of meaning that we learn how to behavior, how to see and how to act.

And those meanings, consciously or unconsciously, we translate into words in our blogs. Performing is often connected with the display of skills, i.e. playing piano; or acting out culturally coded behaviour, i.e. rituals or everyday life behaviour. It is important to note also that performance can be efficacious(in terms of rituals) and/or entertaining(musical performance). Blogs often provide both depending on the author’s intention. Some offer their skills in various subjects. Some just gripe about their life and hoping somebody would find them entertaining to read. Some share their experiences of travel and the sorts.

Blog becomes meaningless if there is no reader. It would be like having a stage performance without an audience.

Singing Archaeologist

I came across an old New Scientist magazine, 23 feb 2008, recently. The cover story was about music.  Something that only relevant to me as an audience. One of the articles featured an archeaologist, Steven Mithen (author of “the singing neanderthals”) with an interesting experiment on singing. 

I want to relate this to my own experience of why I never learn to sing. Even when I was young, I was never encouraged in anyway to learn to sing or play musical instruments. Now that I recall, I have played an instrument called ‘bell lyre’ before when I was a scout in school. I never knew it was called the glockenspiel. It was taught almost like a mechanical skill then. I have sung in classes during primary schools. There were no teaching of pitch or breathing exercises. We just sang with what we have. So may be there were encouragements but I just didn’t have any ‘talent’ to impressed the teachers.

Cost of having professional music and singing lessons is probably the main reason for the absence of music and singing in average income family. Then, of course there is the “how-can-you-make-a-living-out-of-that” mentality. It is like a tug-of-war with my parents’ generation. And also, my parents are not very ‘musical’ themselves. It is difficult for them to understand why anybody would want to pursue these activities without an obvious ‘talent’ in the first place. Ahh yes, now we come to the unshakable idea about creative arts and ‘talent’. Drawing is one good example. Many gave up trying to draw at a very young age. There are no structured method of instruction to learn how to draw. In class drawing still life, the facts of life is either you get it or you don’t. Those who manage to draw some likeness with the real thing are considered ‘talented’ while the others will have to accept their fate that they have no talent in arts. And there is no future in pursuing art if you have no talent. But some still do so because they are also terrible in science (although I believe that is due to their own preference to learn than ‘talent’ in science). Science does not discriminat based on ‘talent’. You get what you work for.

So we come back to the singing archaeologist. He admitted to be terrible in singing. He was given some initial lesson and was asked to sing some tunes while under the MRI scan of his brain. So then began the one-year grueling singing lessons for him, which he described as stressful and dissatisfying. Ironically enough, he argued in his own book that singing is a means for achieving well-being through social bonding(in his book “the singing neanderthal”).  Nevertheless, the results of the scan one year later, was far more encouraging then the learning experience. It was obvious that his brain activities has not only increased but changed to support this new activity of singing.

Personally I always believe that we are all born with a brain with exactly the same capabilities (effect of disease and mutation notwithstanding). It is what we do during our life time that will determine our best ‘talent’.

Cultural icon

There are certain things you do so ritualistically that you probably think that it is as natural as peeing in the toilet. I packed my lunch sometimes. Not as often as I used to. And on this particular day I just happen to stop and examine this iconic symbol of Malaysian student life. The red semi-transparent plastic bag with the white polystyrene foam food container inside. And not to forget the plastic little spoon to go with it. If there is a cultural icon that can best represent the Malaysia’s kopitiam culture, this would be it.

I remember a few months ago I heard China was going to ban the use of such plastic bag. And Bangladesh is the first country in the world to ban such plastic bag. Not really because they are any environmentally conscious than us but the plastic bag in their landfills were preventing the water to drain away, thus causing more flood. Disaster is always a good way to raise our consciousness.

This also reminded me of a photograph by Ismail Hashim (I believe still with the Balai Seni Lukis), showing the front yard of his house with some kind of fruit tree where he used plastic bag to protect the unripe fruits. My parents did that all the time. My parents are those who still believe in planting our own food. I’m a carrefour person.  I remember the time when my friends and I used to go buy our food with our own reusable plastic container. I wonder if students nowadays still do that… 

Fitna – how to offend a religion

“The God of the Old Testament is arguably the most unpleasant character in all fiction: jealous and proud of it; a petty, unjust, unforgiving control-freak; a vindictive, bloodthirsty ethnic cleanser; a misogynistic, homophobic, racist, infanticidal, genocidal, filicidal, pestilential, megalomaniacal, sadomasochistic, capriciously malevolent bully.” – Richard Dawkins.

Well, I have yet to see any righteous religious apologetic in this country boycotting UK’s product. Or to see the book taken off the shelf of Malaysian bookstores. Or to see Malaysian students boycotting the Oxford University. And perhaps we should. That must have been the most evil accusation of the century against a religion. Why didn’t we see UK flag burning or protest on the street? I’m sure there must be somebody on this earth being offended by that statement in his book? May be we don’t read that much. But then he repeated again in his BBC documentary “the root of all evil” on tv. And of course we don’t get to see that in Malaysia. Our minds are too fragile for such controversial issues.

So what’s with the Fitna film and the cartoon? How is that compare to Richard Dawkin’s statement? A columnist in NST used “bigot and zealot” to describe Geert Wilders. And added that his film is all “lies and half-truths”. Whose truth are we talking about? I definitely have no right to validate this. For one thing, I’m not a muslim. How am I to know what is true and not true in the film. I would hope that somebody can give me a good answer. Rather than spending time burning flags and boycotting Dutch products, Muslim should spend more time explaining to non-muslims what is wrong with the film. And then again, does it really matter what non-muslim really think? I don’t have an answer. There are no one truth that can speak for all, just like how we know that we are not supposed to stereotype Muslim nor the people of Netherlands as a whole. Today, I read that Indonesian internet service providers are blocking youtube for this issue. It is a sad news indeed. We’re really going back to the stone age.