It is a very interesting article and clearly shows the dilemma regarding cost. Clearly there will be many such instances of cost cutting in the near future and one can only hope that the baby does not get thrown out with the bath water!
I am grateful to my current hospital care team, who have enabled me to do Self Monitoring of Blood Glucose and encouraged me to take control of my own condition.
The majority of us would agree with Catherine that those who are newly diagnosed, as well as those who have fallen by the wayside, need SMBG the most and really need educating.
I could wish that the education side of things was aligned to getting people, both HCPs AND Patients, to understand the effect of carbohydrates on BG levels. I believe that this is key to control in T2 diabetes, and in my own experience this is something that has never, ever been mentioned by anyone involved in my own care. When I mentioned to my GP and DN at the local surgery what I had discovered on this forum regarding testing and restricting/cutting carbohydrates, there was very inconsistent reaction, some of it very negative and even hostile.
Amongst HCPs there is clearly little personal experience of the effect that certain foods have on an impaired pancreas and the subsequent BG levels, in comparison to those of us who actually have diabetes and have been enabled to SMBG. It is sad that some HCPs are reluctant to accept the evidence of their patients, but perhaps understandably they feel it necessary for there to be an element of care to only put forward the established view of the authorities, or what they have been instructed or taught, in case they should face disciplinary action.
If you are a patient who has done SMBG tests consistently which clearly show that a particular food spikes your BG levels, and then you are told by an HCP that you must eat that food and it will not harm you in any way, then there is little wonder that distrust and an element of despair sets in.
Patients/people are nowadays educated to a level where it is not difficult for the majority to understand the principles of testing and analysing results, and subsequently changing behaviour or drugs or whatever is most appropriate. To be treated as if you are not intelligent enough to do so alienates the patient and makes a working relationship difficult, if not impossible. How we get over this situation is difficult to know, unless there is a willingness to re-evaluate the whole ethos of diabetes care for T2s.
