Do You Believe in Glucose Self-Monitoring?

JAMA Internal Medicine published information for a trial conducted between 2014 and 2015. The question, is self-monitoring blood glucose levels effective for people with non–insulin-treated type 2 diabetes in improving either A1c levels or health-related quality of life (HRQOL) in primary care practice?

Participants with A1c levels between 6.5% to 9.5%, were divided into the following groups: 1) no glucose self-monitoring, 2) once-daily self-monitoring, 3) one-daily glucose self-monitoring with enhanced patient feedback including automatic tailored messages delivered through the meter.

The conclusion of this trial revealed no clinical or statistical difference after one year in glycemic control or health-related quality of life.

I can hear type 2 diabetes patients across the country saying, “See, why should I test my glucose if it doesn’t help?”

Here’s why. The trial seems very flawed. Why only test glucose once per day? What do you do with the information? Assume you test your fasting glucose and it is below 100 mg/dL. You feel good and consume a higher than normal amount of carbs for breakfast. Without testing two hours after your meal, how do you know if you consumed an appropriate breakfast?

Without glucose testing before and after each meal, how do you determine the food you should consume? It’s like a runaway train. I question my clients as to what they did with the information when testing their glucose prior to coaching. The answer – they did nothing and when they shared the information with their doctor, he or she did nothing.

My clients commit to testing their glucose before and after each meal during the coaching period. They record food, beverages, activity level and glucose levels for me to review. This allows us to pinpoint issues and set a course for successfully reducing glucose levels for a lifetime.

My average client reduces their A1c by approximately two points. Through my Reverse My Diabetes program, my clients have learned how to keep themselves in check. Once your glucose is impaired, there can be some A1c fluctuations over time; however, based on lifestyle, it can be very well controlled.

If we can avoid progressing to insulin and additional medication, life is much easier. To avoid insulin, it helps understand how food consumption, activity, stress, and illness effect your glucose levels. If you are directed to check your glucose once a day and see increases in your A1c, that is proof once daily glucose monitoring is not enough.

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Reference:
http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2630691