We can all rest easy & save our money...or maybe not?

Interesting article on self-monitoring for T2s not on insulin. I think it’s bunk. I haven’t had time to research the study’s funding. I also haven’t read the actual study. I don’t think I’m alone in thinking this proves the idea of once per day testing is a waste of time.

“Of course, patients and providers have to consider each unique situation as they determine whether home blood glucose monitoring is appropriate,” Donahue said. “But the study’s null results suggest that self-monitoring of blood glucose in non-insulin treated type 2 diabetes has limited utility. For the majority, the costs may outweigh the benefits.”

Limited utility, if all they’re doing is telling PWD to test, without actually teaching anything like how to use diet & exercise, or testing in pairs etc.

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I think it might be true of an uninvolved (or “non-compliant”) Type 2, but if they’re non-compliant, why would they be testing?

Forgive me for the use of the phrase “non-compliant.”

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I know zip about the study population or methodology, but that being said, the only way this can possibly be true is if testing is being done but the results are not being used for anything, i.e., making adjustments in lifestyle habits or treatment… Which I didn’t need a study to tell me. Did someone get paid to produce this earth-shaking conclusion? (Rhetorical question, never mind.)

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Ironically, I saw another article (for which I don’t have a link, unfortunately, however, it references ‘SMBG’ - Structured self-monitoring of blood glucose), that came to the exact OPPOSITE conclusion – that self-monitoring of BG was VERY helpful in reducing HbA1c in a very significant way (as we already know). If you find and read that article, you will see the difference is that in that case, decision-making was involved – in other words, the patients, assisted by medical professional, made changes to their care based on the results of those BG tests.

Yes, testing without action is pointless. But action without data is impossible.

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Not at all impossible. Just very very risky. (Not to mention dumb.)

Dumb, risky action to me is the equivalent of impossible, but you’re right, I should change that to something like “positive, directed action without data is impossible.”

Well, this is just semantics and therefore purely intellectual, but . . . if it were impossible, it wouldn’t be dangerous.

Except most of the studies supposedly proving SMBG to have little effect (that I’ve read anyway) require testing 1 x per day or less. One study required 4 x per week.

This is real sore spot with me. It’s as though these people can’t figure out that teaching eat-to-your-meter or testing in pairs can actually improve results, yet they’re stumped by why outcomes are so poor. And don’t even get me started on how money spent on these useless studies could be better spent.

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4 times a week? Either I am living in an alternate reality, or else the people who funded that study are.

Median of 4x per week.

Unfortunately the majority of studies of whether SMBG is useful involve a question “Is SMBG useful to cliniciians?” And the answer is surprisingly “NO.” And we say “DUH?” Who in their right mind would even ask such a stupid question.

The real question is “Does SMBG help a patient make better actionable decisions?” I posted back in 2015 a study by a researcher who looked at this question

The answer is obviously yes and leads to a second question. Why aren’t patients being taught to eat to their meter?

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Without structured and proper education nothing works, the same here. I shared this news with some CDE friends, and they were not happy at all. For years they have been trying to teach t2’s the importance of checking blood sugars and understanding what they mean. The sad part is that health insurance companies will use this information as an excuse for not covering more strips.

This is not the first “research” about it, but it is sad things like this get funded.

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My wife is actually in the category for whom testing is probably not cost effective. She was diagnosed with “pre-diabetes” shortly after my diagnosis for T1 about 10 years ago. She spoke to a CDE and a dietitian, lost some weight, increased her exercise and has kept her A1c from going up for a decade. She tests a few times a week but the numbers rarely vary much and she doesn’t use them to modify her self-management.

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I actually have a theory that CDEs have systematically ignored the obvious. The standard dietary advice has been to eat a high carb low fat calorie restricted diet. If you tell PWD to “eat to their meter” then they will reduce the carbs in their diet and inherently they will increase their dietary fat. In order to avoid advising PWD to restrict carbs the standard advice was to tell PWD to just report their blood sugars to their doctor and have them increase their medication if need. I dearly hope we are beyond this medieval view of the world but I have to admit there are still Luddites out there.

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How’d this thread get bumped? For a moment I assumed BSC had popped in said hello? Doesn’t appear so though

This was bumped by a spammer. It happens occasionally when a spammer posts on an old thread. Its a trick they sometimes try, they post on an old thread hoping no one will notice. Unfortunately for them it does not work.

There is a deleted post on this thread that you are not seeing.

This post was flagged by the community and is temporarily hidden.