March 9, 2012

SMBG – A Right Being Denied

Why are our insurance companies, doctors, and medical researchers focusing so heavily on self-monitoring of blood glucose (SMBG) and trying to discredit the good that it can do? I may not have the answer, but I will propose at least two possible theories.

Most people associated with the medical field including insurance are supportive of prescribing medications on top of medications. This I did not understand until I remembered Big Pharma and the ACCORD studies. Are our doctors so comfortable in bed with Big Pharma that they will not consider other approaches? Are the payoffs so great for them that the patients' well being is put on the back burner? Is the American Diabetes Association (ADA) so beholden to Big Pharma that they do not want to back potential patient centered aids that could reduce dependence on medication?

Is the above reason enough that doctors for the ADA want to do nothing about pushing a clear status for prediabetes and clearly recommending a strong course of action? Alternatively, is it our medical insurance companies that are pushing for inaction to keep current profits up in hopes that the profits will continue to go up? It is plausible, but not as sound as the above paragraph.

My second theory is that the current generation of doctors is so intrenched in the past and only want to treat something that is clearly a disease, that they do not want to promote preventive medicine. They want patients that are sheep, and not capable of thinking for themselves. When patients with diabetes do self-monitoring blood glucose (SMBG) they are not taught what the readings can mean or how to interpret the readings, or even when to test.

It is no wonder that knowledgeable people with type 2 diabetes become alarmed with these doctors. They search the internet for information that will assist them to learn how the test, when to test, and how to interpret the readings. Some will become successful at SMBG. The rest will become discouraged and continue testing, but not understand why. Then when their doctor ignores the readings, they may look further or give up completely.

The people that give up completely or are not interested in SMBG are the group that studies look for to participate and give the insurance companies and Medicare reasons to reduce the testing supplies. As a patient and a person with diabetes, I consider this criminal and demeaning toward patients.

While it may seem that I am overstating the above, please read this study, which clearly states the same accusation. I quote “The Cochrane review is a review of previously run studies, across a number of different countries, which have analyzed self monitoring and its effect on HbA1c levels. People with type 2 diabetes have previously noted the various limitations of the studies included in the review. Studies, included in the Cochrane review, have notably excluded participants who had previously demonstrated interest in self monitoring.” I added the emphasis. Please read the short article for further revelations.

Even though I write about some of the problems on diabetes forums, there is much good that can be had on some of the better forums. The problem is that you cannot be a timid participant on these forums. You must ask questions, but be sure to give enough information for people to make reasonable answers. If you do not, some will ask for additional information. Others will make assumptions and try to answer based on what their experience is.

The following are web sites that may be of value to you. They are not in a particular order or personal preference.

Please remember that these forums are not chat rooms and you cannot expect an immediate answer. It may take several hours to receive several answers. I think a couple of the forums may have chat rooms, but finding people using them that will answer your questions may be problematic. Normally chat rooms are used by several people that invite each other and they want to discuss one topic among themselves.

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