August 7, 2013
Intensive BG Monitoring Is Useful
Granted, I have changed the title from a question to a positive statement. I firmly believe that if the study had been properly set up and too many variables not tracked that should have been accounted for, the results could have been much more positive. Patients were eligible if they were 35 to 75 years of age, had type 2 diabetes not treated with insulin, and HbA1c levels between 7% and 9%.
Yes, the “experts” said, “They were not convinced the extra cost of SMBG (self-monitoring of blood glucose) was worth the marginal added benefit. Also, this approach may not be generalizable outside of a clinical-trial setting, they said, noting that patients tend to tire of such self-monitoring in the long run.” None of the “experts” participated in the study. The problem with most studies of this type is that no education is given to the participants beyond a minimal amount.
Yes, some are taught more, but many are not given enough practice to have this become a habit. And this is a must to make the desire become important and make a person want to manage their diabetes. No, I do not think that intensive blood glucose monitoring needs to be done long-term, but at diagnosis, the first six months are critical to determine how the different foods or food combinations affect your blood glucose. This is one way to know which foods may need to be eliminated or reduced in the meal plan.
Then over time, you will need to up the testing intensity again when you add new to your meal plan foods, when you are ill, and when you are having problems for which you have no easy answers. What the “experts” do not realize is that by cutting to testing supplies over the years, people are less likely to maintain A1c's below 7.0% and this is the reason many people end up with progressive diabetes. People do need the education and encouragement to test more than twice per day, but testing for most people with type 2 diabetes should not require more than five times per day once a routine has been established.
Yes, there will be days when more testing may be required, and there may be days when less testing may suffice. With education and support, many people should be able to prevent their diabetes from becoming progressive. Yet, the “experts” don't care about the desires of patients and look at diabetes as progressive when it does not need to be. Because of the pronouncements of the “experts”, the insurance companies are happy to increase their profits by limiting the testing supplies for diabetes.
Please read about the study here and make your own analysis.