Re: Meal-Related Structured Self-Monitoring of Blood Glucose
- From: Alan S <loralweightandcarbs@xxxxxxxxxxxxxxx>
- Date: Thu, 01 Sep 2005 01:12:28 +1000
On Wed, 31 Aug 2005 10:38:20 -0400, Jefferson
<croom1935@xxxxxxxxxxxx> wrote:
>This approach is much the same as suggested by Jennifer.
Well, close, but not quite. I had memories of us talking
about it a while ago, and found some of the discussion here:
http://tinyurl.com/bxrjy
At first glance it looks like, as you said, Jennifer's
"test, test, test" advice. And, to be fair, it's the only
study I've seen anywhere that even goes close to it.
But this is their version of "test, test, test":
"During a 2-week run-in period, patients in the SMBG group
were instructed in the use of a blood glucose device with
sensor disc (Glucometer Dex) and requested to measure blood
glucose six times (before and 1 h after main meals) on 2
days per week (one weekday and on Sunday) and to record the
values obtained in a combined diary for blood glucose data
and documentation of eating habits and their state of
well-being (all entries were counted and checked for
plausibility). It was explained to the patients that SMBG
plus their diary would provide them with information about
their day-to-day glycemic control, allowing them to make
appropriate adjustments to their diet and lifestyle (if
applicable), eventually resulting in improved diabetes
control."
I would suspect that most stuck to the 2 days per week
schedule (there's no mention of whether strips were
limited).
However, the interesting thing is that, despite all sorts of
other limitations, including both the test group and the
control group having similar weight loss, the control group
lost over a half-percent more HbA1c. On that basis, Wendy's
comment at the end of the previous thread is worth
repeating:
"This report is fascinating. What appeals to me, from a
public health point of view is that it might be a plan that
is possible for a wide range of people who would be put off
by the kind of daily testing most of us now take for
granted, like all those that the ADA (and the DA) seem to
aim its advice at. Asking for a weekday and weekend day
would be much more agreeable to so many and would improve
food awareness and control for vast numbers of people. It
has the same effect as the advice to just increase your
walking and even add up all your walks in a day rather than
advice that only heavy exercise or jogging 3 miles means
anything. It looks doable for many people who will find
themselves surprised at what their blood sugars do with
certain foods."
Incidentally, if Bastian is reading this, this may be a
useful paper to show to that difficult doctor. Try to hide
the "two days a week" bit:-)
One wonders why there has never been a follow-up study, or
even a continuation of that initial one. I wasn't able to
access the articles listed at the foot which cited this, but
maybe the answer is in the title of the first one 9although
I think I've seen the detail in a different source):
Diabetes CareHome page
M. B. Davidson
Counterpoint: Self-Monitoring of Blood Glucose in Type 2
Diabetic Patients not Receiving Insulin: A waste of money
Diabetes Care, June 1, 2005; 28(6): 1531 - 1533.
Cheers Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
.
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