April 9, 2012

When Talking About SMBG – Researchers Rig Results

When I was diagnosed with type 2 diabetes, I wondered what was ahead. Experiences in my life have been varied, but in my research on self-monitoring of blood glucose (SMBG), I experienced something unlike anything else. I did not realize that whole industries and governments rely on and participate in funding studies fabricating false and misleading information to demean and direct fraudulent intent at a group of people with type 2 diabetes on no medications or oral medications.

These fabricated studies have been reported in trusted reviews, belying the truth in the way the studies were assembled and carried out. The editor of leading diabetes community website Diabetes.co.uk, Benedict Jephcote states: “There are a number of problems with the way results are presented within the Cochrane review. For instance, in the UK, there are many people with type 2 diabetes that are actively interested in self-testing and significant numbers of these people have to buy test strips from their own income. Studies which exclude these people cannot therefore give a fair representation of people with type 2 diabetes in the UK."

Cracks along the above line are already showing evidence to prove just that. In addition, in the future, researchers that are more honest will begin to refute these false studies. What is astounding is that the US Government has participated in this cover-up of studies that are done to show patients with type 2 diabetes do not need to self-monitor their blood glucose levels. The National Institute of Health leads the way and the Center for Medicare and Medicaid Services follows by cutting testing supplies for people needing them. By not educating Medicare and Medicaid patients about the value of self-monitoring of blood glucose and showing them how and when to test, they can support many studies proving that people with type 2 diabetes do not need the testing supplies.

This study by Roche shows that when a study is properly organized and follows the Structured Testing Protocol (SteP) standards, the results are more accurate and SMBG does help people with type 2 diabetes and not on insulin obtain lower A1c's and better glycemic control without harming the quality of life.

Other writers proclaim that the studies are right and say that the results beyond a year do not hold up. I can understand this because these study participants are no longer given the supplies with which to self-monitor blood glucose. Many of the study participants probably are unable to afford the testing supplies and therefore without them the results would be expected to not hold up. That is one reason to have long-term studies of three to five years.

The key in studies is the education which I blogged about here. Whom do you think will obtain the best results? Those just handed a meter and testing supplies and told to test are not likely to understand the results or possibly even care? My bet would be on people that were handed a meter and testing supplies and required to attend classes where they learn when to test, the reasons for testing, how to interpret the test results, and the overall benefits in watching for trends. Better results and longer-term results will be obtained when additional education is done to reinforce good habits and find and attempt to eliminate bad habits.

Although it would be great to have physicians trained at the same time, patients that are educated in testing and have learned the value of managing diabetes for better health will in the long-term be able to do this without physician assistance. With physician assistance, they will do even better.

1 comment:

Ila East said...

As you know, I have said time and time again that T2s need to test before meals so they can decide how many carbs they an eat.. And they need to test after to see how the carbs they ate affected them.

It shouldn't matter whether you are using insulin or not.