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Research on bg monitoring

Alexandra100

Alexandra100

Well-Known Member
Messages
3,796
Location
West Yorkshire
Type of diabetes
Prediabetes
Treatment type
Tablets (oral)
Medscape
"Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin
Allen F. Shaughnessy, PharmD, MMedEd
Clinical Question
Does home monitoring of blood glucose levels improve glycemic control or quality of life in patients with type 2 diabetes mellitus who are not using insulin?

Bottom Line
Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin. Patients did not feel more empowered or satisfied as a result of home monitoring, nor did they have fewer hypoglycemic episodes, and their physicians did not seem to respond to the home glucose levels to any beneficial effect. (Level of Evidence = 1b)

Synopsis
These researchers identified adults (average age = 61 years) with type 2 diabetes not treated with insulin and who had A1C levels between 6.5% and 9.5%. Most of the patients (75%) monitored their blood glucose levels at home before the study but had not been treated by an endocrinologist. The 450 patients (who had type 2 diabetes for an average of eight years) were randomly assigned, using concealed allocation, to one of three arms: (1) no home glucose monitoring; (2) standard once-daily monitoring; and (3) enhanced once-daily monitoring, consisting of glucose values immediately reported to the patient plus automated, tailored messaging delivered via the meter. The patients' physicians were given the home glucose monitoring results but were not asked to follow a specific protocol to respond to them. After both six months and one year, there were no differences, on average, among the groups in A1C levels, hospitalizations, episodes of severe hypoglycemia, or quality-of-life scores. Similarly, there was no difference among groups in treatment satisfaction or feelings of empowerment."

I was infuriated to read this. Of curse the patients were not empowered or helped by monitoring their bg but having no instructions on linking their readings to their food intake. Why are so many professionals in the area of diabetes SO STUPID??? NB the patients, who were all non-insulin-using T2s, did not have less hypos while monitoring - but why would they have any? By contrast, we are not told if they had fewer "hypers".
 
I find that honesty promotes trust. In this case the HCPs should come right out and say 'The NHS does not provide monitors or strips because to do so would see it bankrupt within a couple of years'. They should then tell patients that monitoring does no harm and give guidance as to best use.

This 'study' was a complete waste of time and is tantamount to propaganda.
 
If people arent taught how to use BG readings and motivated enough to do so, then all the home testing in the world will make no difference.
All the study seeems to have shown is that home testing without proactive use of the results by patients and clinicians makes no positive impact.
No s*** Sherlock! Another bull**** study wasting time and money that could be bettter utilised
 
Alexandra100 said:
Medscape
"Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin
Allen F. Shaughnessy, PharmD, MMedEd
Clinical Question
Does home monitoring of blood glucose levels improve glycemic control or quality of life in patients with type 2 diabetes mellitus who are not using insulin?

Bottom Line
Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin. Patients did not feel more empowered or satisfied as a result of home monitoring, nor did they have fewer hypoglycemic episodes, and their physicians did not seem to respond to the home glucose levels to any beneficial effect. (Level of Evidence = 1b)

Synopsis
These researchers identified adults (average age = 61 years) with type 2 diabetes not treated with insulin and who had A1C levels between 6.5% and 9.5%. Most of the patients (75%) monitored their blood glucose levels at home before the study but had not been treated by an endocrinologist. The 450 patients (who had type 2 diabetes for an average of eight years) were randomly assigned, using concealed allocation, to one of three arms: (1) no home glucose monitoring; (2) standard once-daily monitoring; and (3) enhanced once-daily monitoring, consisting of glucose values immediately reported to the patient plus automated, tailored messaging delivered via the meter. The patients' physicians were given the home glucose monitoring results but were not asked to follow a specific protocol to respond to them. After both six months and one year, there were no differences, on average, among the groups in A1C levels, hospitalizations, episodes of severe hypoglycemia, or quality-of-life scores. Similarly, there was no difference among groups in treatment satisfaction or feelings of empowerment."

I was infuriated to read this. Of curse the patients were not empowered or helped by monitoring their bg but having no instructions on linking their readings to their food intake. Why are so many professionals in the area of diabetes SO STUPID??? NB the patients, who were all non-insulin-using T2s, did not have less hypos while monitoring - but why would they have any? By contrast, we are not told if they had fewer "hypers".
Click to expand...
My question is where does this information come from?I can't read and evaluate stuff without knowing that.
 
From my experience, I find that to be a total load of nonsense. I am not diabetic (yet). I am likely not even quite pre-diabetic, but I got a little bit of a scare after a blood test (which I now know is likely from Dawn Syndrome and/or hormonal glucose changes which impact me a lot).

After that scare, I got a meter and have been testing quite a bit...I've learned so much about my body, how it reacts to foods/carbs etc. In my opinion, they should be teaching blood glucose monitoring in high school so everyone knows and understands from an early age as possible.
 
Nexus6 said:
From my experience, I find that to be a total load of nonsense. I am not diabetic (yet). I am likely not even quite pre-diabetic, but I got a little bit of a scare after a blood test (which I now know is likely from Dawn Syndrome and/or hormonal glucose changes which impact me a lot).

After that scare, I got a meter and have been testing quite a bit...I've learned so much about my body, how it reacts to foods/carbs etc. In my opinion, they should be teaching blood glucose monitoring in high school so everyone knows and understands from an early age as possible.
Click to expand...
I totally agree. It would save so many people from nasty surprises and from being saddled with complications that started developing before they even knew they might have a problem. It should be normal for everyone to have a meter and do some intensive testing eg once a year as a check.
 
Ok found it.. what a pointless study.. once daily testing was the most looked at.. complete waste of everyone involveds time
 
bulkbiker said:
Yep that was it but in the meantime I'd joined medscape and found it.. thanks though..Shame it just gives the synopsis and not the details.. still my views on the study are above.
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I believe it's standard practice to give just the synopsis for new studies, older ones are available free in toto after abut 2 years. I can't think why more people don't sign up to Medscape. I get email alerts from them for all the medical topics that interest me. So educational, and it only takes a moment to scan through the list of topics and delete if nothing strikes me.
 
That's how you fix a result, design it so it cannot give any other possible result, other then the one they wanted all along.
 
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