Is testing really necessary for non insulin dependable type II

I came across an interesting study by The Institute for Quality and Efficiency in Health Care (IQWiG) which published the report on 14 December 2009.

The study suggests that the blood glucose self-monitoring is not in any way beneficial to non-insulin-dependent type 2 diabetes patients.

here is a link to the full report
Diabetes self monitoring for type 2

My question to you guys is who here does not test and if you do, would you go without testing if you absolutely knew by that I mean if study after study came out against, now remember that testing is by far one of the most expensive Items for diabetes management.
thanks Ronald Gregory

Testing can be beneficial if you do it with purpose. I think anyone who claims testing is not necessary, ever, probably does not live with Diabetes, and is making some assumptions from the safety of their plush recliner office chair. As long as you test with a purpose, you can control how many times a day you need to test, and learn from those results. If you have meals that are tried and true, and do not affect your blood glucose, than by all means, reserve your testing for those new meals you may not have such a clue how badly they will go, or not. Also, when we are sick, we NEED to test. Illness, and infection can raise blood glucose levels, and ketone levels, and sometimes very dangerously. There is no other way around it.

Folks who are using meds (but no insulin) should also test as well, to learn what their meds are doing and if they are still working. There may come a time when meds do not work anymore – like for my dad. He reached a point when he had to be insulin dependent. Testing glucose levels should happen, both as a learning and prevention tool, as well as a monitor for times of illness.

Agreed! Well said Lizmari!!!

always thought of T2 and as an experiment I find out what foods/exercise/supplements are doing to my sugars. without my meter I’d be lost.

also I may not be on insulin but I do take meds and think it useful to know where my sugars are at before taking oral meds and/or exercising. I have had terrible low and terrible highs that were confirmed w/ my glucose meter and have been sure I was low when my sugars were normal or even high - my meter confirms where I am so I can act accordingly instead of guessing blindly (which can be a recipe for disaster)

While the study which was a blind test followed two groups of testers and non testers over a 6 month period. You do have valid points Liz most of the studies are always on fixed parameters and when you are at the point in your life where you have the diet and fitness down packed then you can manage how often you test based on circumstances. It kinda reminds me of those ads you see on the web about someone who through diet and fitness, lost weight and stopped taking their meds and this is hailed as a cure for diabetes and can be applied as a cookie cutter version for the rest of us in form of said cure.

In a controlled environment maybe testing becomes invalidated. On the top of my head, I am thinking if you eat the same meals everyday and do the same exercises but as liz said sometimes you might grow a resistance to your meds and you have to be aware of that.

For me testing is important after meals to ensure I dont spike too high. If I eat poorly or overeat I will have high BG and it will take my own insulin a very along time to get it back down.

Each of these high spikes and lingering high numbers do damage to you, after all a twenty year old with a perfect pancreas would spike no higher than 120-130 and produce massive amounts of insulin to cover the huge spike and cover it in a very short time. When the time comes and I cant cover spikes then I want insulin to give my beta cells a rest.

I test 4 times a day, usually checking one of my meals each day in the mix.

The article focused on A1C’s but didnt address this issue that I saw. Lizmari I agree with all of your points too. Thanks Poor Diabetic for the post.

Wow you eat pizza lol, I haven’t had a slice in over 12 years, that was the first No No food for me after diagnosis it would spike my sugars so after I gave that up, I just haven’t tried it again. The association with back to those dark days is just too real.

who lives in a controlled environment? I eat yogurt every day for breakfast but my mid morning #s can be anywhere - maybe it’s stress of the commute/work; too much coffee, maybe I’m getting sick, maybe my pancreas is being a lazy b1tch today who knows but testing can help me figure out generally what works and what doesnt (i.e. 1 slice of pepperoni pizza and 4mg prandin and my sugars will be ok)

also I did a duathlon (run/bike/run) a couple years back and was shy about using my meter in front of other folks that day so i went by how I felt (I’ve been a diabetic athlete for over ten years at that point) well I was totally off and ended up bonking horribly. worst low of my life and I ended up dropping out of the race. I still kick myself for not using my meter and knowing what was going on with me

Studies like this base testing success on one thing: A1C. And that is very important, because getting it down and keeping it down, especially early in diagnosis, is key for long-term good outcomes. But they usually cover a very short time frame.

Several studies have shown that in a test group of type 2 subjects not using insulin, A1Cs don’t seem to improve much with self-monitoring of blood glucose–during the limited time of the study, which is often just 6 months or so.

But what about years after? Did these test subjects learn more about food choices, exercise choices, and blood sugar levels that they may have learned to apply more precisely later?

It’s not always easy to juggle and adjust all the parts of diabetes care in a short amount of time. I think 6 months is a short amount of time in a clinical setting–think about all the things that get in the way in real life that may disrupt or slow down diabetes learning and care!

I do firmly agree that testing with a purpose is key. I can test 18 times a day and not get useful data–or apply it well–if I’m not sure what or why I’m testing.

Sigh. Again, education and access to information and support and follow-up are needed so badly when it comes to diabetes.

I agree with you. If I want pizza it comes along with an hour work out. I had pizza last night and a 2 mile run. If I am going to eat that many carbs I run to pay for the carbs

U R right Kelly… I can test 20 times a day or just 4-5, if I do not know what to do with the information, then I am just as LOST as if i had not tested at all. I use my CGMS about 3 days out of the week, usually on weekends, or on times with unusual activity. I did not have it on yesterday, did not test upon arisal from bed, and missed preventing a 47 pre-breakfast low : I had done a lot of movement and exercise the previous day that I did not adjust the overnight basal rate for… so DOWN I went. I was not shaky nor nervous; just surprised that I had burned my oatmeal and put my boots on the wrong feet.The glucometer told me Why:
Both Type 2’s and Type ones need to Know what to do with information and data, not “feelings”. I used to think I could alweays “feel” my highs and lows…that is not true; Education and information are the key.

God Bless,

Well, there is a great deal of controversy on this issue, with much of it fallout focused on type 2s coverage for testing. As a new type 2, you certainly can learn a lot by testing, figuring out what foods do to your blood sugar. But over time, if you are diligent, there is going to be less and less that you learn about the food that you eat. So what purpose does the blood sugar testing have in a T2 that is not insulin dependent? I mean, they can’t correct if they are high. Perhaps they can go for a walk. I am sure that will correct the highs. What we can be clear about is

Blood sugar testing (and HbA1c) for a non-compliant diabetic is useless - Duh. I could have figured that out.

Blood sugar testing as a direct guide for immediate treatment changes for experienced and compliant diabetics has diminishing returns - You just don’t learn much more from the additional tests.

What is clearly more subtle and what really galls any long-term t2 is that daily testing keeps you focused. It is very easy over time to just become more and more lax with your diet. Your doctor will yell at you about your creeping HbA1c, but on a daily basis you see nothing different. Seeing those numbers every day makes it painfully clear how you are doing and should those numbers start to change, you will see it and can make changes.

This is a European study and as some of our UK members can attest, there has been a firestorm as the NHS has acted on these findings. Unfortunately, current diabetic treatment practice still does not teach “eat to the meter” and hence historical studies of whether a meter can help treatments methods that don’t utilize meters is a self-fulfilling prophecy. For the diligent type 2 diabetic who has learned to eat their meter, it makes a difference. For a longer term type 2, I have to believe that daily awareness of blood sugar control leads to better long-term control. But none of the studies look at these questions, instead, they focus on whether non-compliant diabetics eating an ADA style low fat diet give a cr*p about their meter readings. Jeez, I could have told them the answer.

I apologize to any non-compliant diabetics on an ADA diet out there.

I just cant take the risk, its actually more of a bad association for me, when I was diagnosed and early on when I was trying to get things managed, pizza used to give me the worst high’s so I essentially gave up on it…

I was thinking when it comes to studies that what they do and like Paul said the study followed a1c levels for about 6 months, my playing the devils advocate is simply my trying to understand how they would come up to that conclusion and what the parameters were

I am doing this for the diabetes management solutions project. so I will withhold comment maybe until then.
I am trying to figure out what foods in my diet causes my sugars to spike and how high, while I am not talking about carbs per se I am interested in finding those hidden carbs in foods like beans and peas.

Nice and valid point Kelly, these tests tend to be in controlled environments as well and the findings are skewered towards that, Kinda reminds me of a point I read recently about the whole nutrisystem for diabetes management where they provide you with the meals but do not really show you how to eat healthier so you are obligated to their programs because when you stop, you have no idea how to prepare said meals on your own.

Point still remains that regardless of diet and exercise management routines, Life does happen and factors like stress, sickness and someone also said resistance to medications affect your glucose levels.
For the purpose of looking at the a1c numbers, the premise was that these factors a fore mentioned are just short term adjustments to your levels and have little long term effects if you have control however.
I do tend to agree with you on the fact that if you are not diligent on a daily basis which is what daily testing gives you, it is much easier to fall unto the complacency trap.

If anyone has ever read any of my other posts on this topic, you would know where I stand on the notion.

I am infuriated whenever I read that T2 and testing doesn’t do any good for controlling BG levels. That is true if you don’t use the testing to gain an understanding and to learn what is good for you and what is not. The simple act of just testing, does no more good than the act of buying a gym membership.

If you don’t go to the gym, and do the workouts, the membership is useless. If you test and don’t use the data, its a waste.

Anyone who says testing is of no value to a T2, is, well, I won’t say it. Just fill in any derogatory term you like, because how the heck else would I have gotten my initial A1c number down from 6.8, to 5.5, to 5.0 if I didn’t know what I could eat, and when I could eat it??? Am I supposed to find twelve things I can eat, by testing, and then give up testing, and spend the rest of my life eating those twelve things? Am I not entitled to try new foods, and see how the affect me? You cannot test a new food without three strips, and one day of testing, doesn’t give you information that it will be okay every time you eat it. You need to verify it more than once.

There are days when I don’t test at all. Those days, I eat what I already know is okay for me, on a schedule I have an understanding of. There are days when things come unraveled, and any hope of a standard schedule or a regular set of meals, is out the window. What do I do then? Just eat, and spike, and not care?

I get up in the AM, and if things are okay, I am in the mid 80’s, so I know what I can eat for breakfast. I am very sensitive to carbs in the AM, but an 85 allows me to eat a good meal. Bad night’s sleep and a morning number of 107 precludes any real carbs in my breakfast, or I will go over the magic 140 mark.

Long day on a project and I don’t eat a whole lot, so by dinnertime, I test and I see as low as 75. That means I can eat a pretty good meal and satisfy my hunger.

As I, and many others have pointed out, the backwards, ignorant, money grubbing medical professionals think the only use of a strip is for a T1 to determine insulin amounts. They are stupid. Over paid, and underedictated. I went to a podiatrist with overwhelming pain and agony in both feet that put me on my back for most of the last month. I asked him if he had ever had any foot problems, and he said no. I won’t go back there for his advice, since he has no frame of reference for what I am feeling. I am stuck with the regular doctor I have, who threatens my strip supply every time I see him. When I do have a choice, he will be history.

I don’t seem to have a lot of high numbers, so far. Based on what I read from a lot of the good folks here, I am doing really well. Time will tell if that will continue, but I want to keep things as low as possible, to postpone any increases and issues that are sure to come along sooner or later.

Far as I am concerned, I could not care less about my A1c number. It doesn’t mean anything, and I say that because if I am not testing regularly, and I go find that my A1c number is rising, how in the world do I know what it is that is causing it, if I am not monitoring myself on a fairly regular schedule???

A1c is not relevant if you are testing enough to be confident that you do not exceed 140, and if so, for more than an hour or so, max. If I had to choose, I would want strips, and iforget the A1c test.

The question I always ask is, what is the downside to testing responsibly, for a T2? There is none. Doctors don’t seem to have any qualms about passing out the anti-depressants and mood altering drugs to anyone with a hang nail, and they are quick to diagnose high blood pressure and force pills upon you for that, rather than weight lose and exercise, and tell you to monitor at home, so what is the big deal about T2’s testing when they feel the need to know what is going on?

Its all about the money, and nothing else. Finally, a tool we can use to help maintain our health, and they don’t want us to use it.

Nuff said.