May 9, 2013

Frequency of bG Checks for Non-insulin treated T2D


cheap-dateAn evidence-based study published in the British Medical Journal brings attention to the umbrella coverage for all people with diabetes, regardless of the medicine they use to control blood glucose. Should the same guidelines be applied to non-insulin using diabetics?

When using insulin to monitor you blood glucose, it is nonnegotiable that you need to check your blood sugar. Without a glucose number, you cannot determine what dosing of insulin you need to take.

Some people with T2D do not use insulin to control diabetes, and blood glucose monitoring is more for the smile of satisfaction on you healthcare provider’s face. The finger sticks are a pain in your fingers and elsewhere.

At the going rate, every test strip costs about $1. People with T1D check their blood sugar. They check it often (eat, sleep, gym, driving, etc.). People with T2D check their blood sugar, too. Depending on the treatments people with T2D use, it may be substantially less needed than T1D glucose checks.

This study found that the cost implications for glucose testing should be reflective upon the type of treatments used to maintain normal glucose levels. Insulin users should be expected to check quite frequently, whereas non-insulin users can be guided on a looser rein.

As it stands, glucose testing in non-insulin users will be driven by patient motivation and cost. Diabetes isn’t a thrifty disease to manage, by any stretch of the imagination. Having T1D mandates insulin as a nonnegotiable part of diabetes control. Checking blood glucose, once a day or once an hour, doesn’t make you a cheap date.

Although most continuous glucose monitors regulate glucose every 5 minutes, they really require calibration every 12 hours. In a perfect world we wouldn’t have diabetes. But the closet thing to a perfect world with diabetes is the assurance of a CGM following trends of bG values. I’m a believer in the Dexcom!!

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