Blood Glucose Monitoring — Oops!

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It wasn’t until about eight years after I was diagnosed with Type 2 diabetes that I was told to check my blood glucose. It would be another year before I was told how to check—when to check, what numbers to strive for, how to write them down so a pattern could be seen, how to adjust for highs and lows. Long before the next year had ended, my HbA1c had dropped from double digits into the 7th percentile. One of the biggest contributors to that was learning how to interpret my blood glucose readings.

Now comes word from British researchers that non-insulin-using people with Type 2 diabetes don’t necessarily need to check their blood glucose. It really doesn’t make a significant difference in control, they said in a research article published in the June 25 issue of the British Medical Journal. Besides, they added, it’s expensive and insurance companies don’t really want to pay for it. You can access the article here.

“It makes me very angry when [health care agencies and professionals] use this kind of research in order to restrict access to test strips,” wrote one British subject with Type 2 diabetes who has benefited from checking her blood glucose.

As one of the people who testified in favor of insurance coverage of diabetes-related supplies, drugs, and education in my state (it passed), I can tell you that insurance companies surely don’t want to pay for more than they absolutely have to: I sat through their testimonies, too.

I’ll disregard the fact that the researchers should have used subjects with average HbA1c levels higher than 7.5% so blood glucose values in the intensive intervention group could have had farther to go than -0.17% from the control group.

Instead, I’ll just say that instead of throwing obstacles in our paths and then complaining that many people with diabetes are out of control, the powers that be should be providing us with meters and an adequate amount of test strips to provide necessary information, as well as education to help us interpret that data.

There are many benefits to checking your blood glucose levels:

  • If they’re written down properly, it’s easy to detect patterns. When I was first told to check, I wasn’t told how. I merely had a jumbled mess of numbers until I was told how to list the results, with each meal in its own row. When I did that, patterns became clear at a glance and I knew immediately where my problem areas were.
  • Want to see how a particular food affects your blood glucose? Check both before you eat it and then two hours after you take that first bite.
  • How does exercise—or different forms of exercise—affect your blood glucose? You won’t know unless you check before, after, and maybe even during.
  • Do you need to make a change in your diabetes medicines? How will you know what to tell you doctor unless you check to see if you’re running too high or too low?
  • Planning to drive someplace? If you take a medicine that lowers blood glucose levels, checking before getting in the car can tell you if you have or are in danger of developing hypoglycemia. I have a friend who very proudly told me she didn’t have to check her blood glucose levels; her doctor had told her “it’s not for everyone.” So when she was out and began sweating and feeling dizzy, she got into her car and drove to the doc’s office to find out what her blood glucose was. I’m glad I wasn’t driving on the same road as she was.

The British researchers appear to believe that merely knowing your HbA1c is sufficient to assess your diabetes control. But it won’t help you with the above list. Only checking and acting on the results can do that.

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