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 (less than 100 attendees) 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.