On Monday, March 31, A.J. called and
asked if he could come over as he had several things he wanted to
discuss. I told him to come on and I would try to answer some of his
questions. We talked briefly about some of the activities recently
and then he asked me to pull up this article. His comment was that
he had not seen me do any blogs from this source and I showed him two
that I had already posted and several others that I have been working
with.
When I went to open this blog, he asked
me to wait. He said that does not have many readers. I said this is
one of the things to expect when blogging. He asked me to scroll
down the list of previous blogs and he said a lot of them don't have
great readership. He said I have read every one, except for today's
post, which I will when I am on the computer. I then brought up the
statistics page and he said, “oh goodness.”
I said this is expected when people are
not interested in something I blog about. Then I went to the
audience page and he looked again and commented if it was not for
other countries and the readership by them where would you be.
I said this is expected at different
times when I write about topics that people are not looking for and
have no interest. He said they are of interest to me and I generally
find something that may apply in the future. He continued that he had
a doctor's appointment earlier that afternoon and he remembered to
silence his cell phone after reading that blog.
A.J. then stated the purpose of his
visit and that he was very concerned about what the author had stated
about there being no benefit for Self-Monitoring of Blood Glucose
(SMBG) for non-insulin using people with diabetes. He continued that
if he had not been on insulin and learned from the rest of our
support group how to use his test results, he might have believed the
article. He said that his insurance had limited him to one test
strip per day, but he felt fortunate to be able to afford the extra
test strips and felt that the investment was well worth the money.
A.J. continued that it was better than
operating in the blind and not knowing where his blood glucose levels
were at for different times of the day. I stated, let's take the
three points and analyze them.
#1. In patients with
diabetes who don’t require insulin, self-monitoring of blood
glucose had a modest effect on HbA1c levels at six-months, which
subsided after 12 months.
I asked him what he thought and he
stated he did not understand. I said that the studies used only
supplies meters and test strips with no education or minimal
education. Once the study ended, no more test strips were provided.
Okay, A.J.'s face lit up and he said now that I can understand. They
would not have understood what they were looking at and have even
less knowledge about how to interpret their readings. I then asked
A.J. to read this blog. After he finished, he stated your last
thought about why diabetes is then considered progressive really
highlights their lack of education.
#2. Self-monitoring of blood
glucose in non-insulin treated diabetics had no effect on
satisfaction, general well-being or general health-related quality of
life.
I brought this blog up and after A.J.
read it, he commented that now he had a better understanding of why
they could make stupid statements like this. Education is everything
and the key to understanding SMBG.
#3. Supplies required for
self-monitoring of blood glucose (BG) are more expensive than for
urine testing, a common alternative for non-insulin treated
diabetics.
Now A.J. was laughing. Peeing on a
test strip is not very accurate and almost worthless. He said he had
a friend that used them for another purpose, but had the guide for
blood glucose as well and he had tested a couple. The color of the
test strip was higher after the meal, but he had no true meaning for
the result. If it had not been for his meter and test strips, he
would still not know the true meaning of the results.
Then when A.J. read the paragraph after
the three points, he stated how idiotic the studies sounded. This is
the paragraph, “For type 2 diabetics who are not on insulin,
monitoring their blood sugar does little to control blood sugar
levels over time and may not be worth the effort or expense,
according to a new evidence review.”
I asked A.J. if he had not curtailed
the number of times he was testing now that he was off medications.
He admitted that he had, but did test at least after the evening meal
to know what his BG level was. He said he still keeps his food log
and stress log and this helps him when his AM fasting test is high
and the postprandial test was higher than he wanted.
Then A.J. asked why he did not remember
my blogs and others that would help keep him from being so concerned
when he read articles like this. I said because he is only reading
and not writing blogs.
We talked for another 30 minutes and he
asked to read several of the other blogs the search on my site had
collected. When he came to this blog and then read a link in it, he
said this even gives more of a reason the discredit the Cochrane
Review. I said they still like to trot this out every few years and
make their pronouncements. I said there are just too many pieces of
information that they leave out.
A.J. said it was time to get for home
and eat, but he thanked me for giving him something to think over.
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