15 October 2010

Reasons for testing blood glucose

Recently on one of the diabetes forums that I read, but seldom post on anymore, someone was questioning why type 2 people not on insulin were even testing. To their mind it was simply a waste of money.

Rather than answer, I wanted to think about why type 2 people not on insulin should be testing. Contrary to what the insurance industry is trying to prove with their studies that we don't need to test or test that often and the doctors that don't want their patients testing as it will be too discouraging and depressing for them to know, I believe there are valid reasons for testing regularly, and often.

Let's start with the people that are able to manage their diabetes with exercise and nutrition. While it is possible for them to purchase the home A1c kits and test monthly, many of them will tell you that being able to test several times daily is still good knowledge and tells them if there are potential problems. It tells them if they are eating too much, not exercising enough and if they need to reduce the serving size of what they ate.

Like one of them explained to me, he wanted to test regularly to know that he was on track with his diabetes management. In addition, he wanted to stay off oral medications or insulin for as long as possible. Without testing, he would have no knowledge of how he was managing the diabetes and it would be like flying blind. By regularly, he meant being able to test four to six times per day, although he admitted that three times per day was more common now that his blood sugar levels have been stable. More testing was reserved for days of new types of food or when eating out.

The same would apply or should apply to those on metformin to check that the dosage was proper to tightly manage diabetes. This would apply to all oral medications that do not create hypoglycemia by themselves.

Since most oral diabetes medications are capable of producing hypoglycemia by themselves or in combination with other medications, testing on a regular basis would seem very prudent for people on these medications and should not be limited by the insurance industry, medicare, or medicaid. With the danger of hypoglycemia present, frequent testing needs to be available and desirable.

Of course, there are no questions about the need for testing for those type 2 people that are on insulin and the poster went out of his way to exclude these people from the discussion.

I realize that I am stepping away from the position of many insurance companies on testing; however, some discussion with the insurance company and consulting with your doctor for extra testing supplies may help get them. Just be prepared, have your points well laid out and believable and that your doctor is on board.

Even the ADA has made the testing more individually manageable and they have allowed for hypoglycemia and hyperglycemia. Read at C. Glycemic control Assessment of glycemic control (below Table 8). Testing as part of (SMBG) self monitoring of blood glucose is checked and testing supplies seemingly under the control of the doctor with some allowances for patient preferences.

So to the person that believes this is a waste of money, I have to ask if he intends to control his diabetes, or is it going to control him. I am thinking the latter.

Just remember that the insurance companies are looking to cut costs and are funding studies to prove themselves right in their decisions.

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