September 12, 2013
Urgent - Internists Blow It in Choosing Wisely Points
Dr. Robert Ratner, chief scientific and medical officer for the ADA that says, “Many people with type 2 diabetes who are on medications don't need to do home glucose monitoring at all," in talking about oral medications must be celebrating big time now. The Society of General Internal Medicine (SGIM) released their list of not always necessary, tests or procedures.
Topping their list is, "Don't recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.” This means that patients will not receive any education and will be operating in the dark to manage their diabetes. This also means that insurance will not pay for any testing supplies.
We think the diabetes epidemic is bad now, but wait until the full effect of this takes place. Diabetes complications will cost our healthcare system dearly. We complain about Medicare only covering one test strip per day now. Just wait until test strips become more expensive and patients on oral medications are operating in the blind and not able to know what their blood glucose levels are.
Think of the deaths caused by hypoglycemia, the trips to the emergency department because the patient cannot test or goes into a coma from hypoglycemia. Angry, HELL YES, I am angry. This is one of the most idiotic things to do to patients with type 2 diabetes. We don't need less, in this case no testing supplies, but should be receiving more test strips.
Now I wonder if doctors or endocrinologists will even go to bat for their patients to receive more test strips to learn what foods are doing to their blood glucose. This is a horrible blow to the diabetes epidemic and confirms that doctors don't care about diabetes. They just want patients to develop the complications so they have something to treat and don't want patients that become knowledgeable to stop the progression to the complications.
More on this when I have more time to think and get my anger under some semblance of control.