Do I really have to check my blood glucose?

In Chapters 13 and 14 of The Diabetes Answer BookI talk a lot about testing your own blood glucose levels.  Pricking your finger one or more times every day can be a "real pain."  Some people get so frustrated about it that they wonder why they even bother testing at all if they feel fine.  In fact some recent research studies have challenged the idea that blood glucose testing is necessary at all.  O'Kane and colleagues published an interesting study in the British Medical Journal a couple of years ago (O'Kane, MJ, Bunting, B, Copeland, M, et al. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial.  BMJ 336:1174-1177, 2008).  They studies 184 people with newly diagnosed type 2 diabetes who were not requiring insulin but could manage their diabetes by improving their lifestyle and taking one or more pills.  They were all given educational advice about how to eat healthier and get more exercise but while half of the subjects were also taught to check their own blood glucose levels several times a day the other half did no self blood glucose monitoring.  The results of the study were surprising: after one year both groups had improved their overall blood glucose control to the same amount.  The average HbA1c level in both groups had fallen from 8.7% to 6.9%.  Both groups had lost about the same amount of weight and the number of episodes of hypoglycemia (low blood glucose levels) was the same in both groups.  In fact the only difference between the groups was that the subjects who had done no blood glucose testing were significantly less depressed than the group who did lots of blood glucose testing!

What are we to make of these results?  On one hand they shouldn't surprise us.  Thirty years ago, before the techniques for testing blood glucose levels at home had been invented, people with diabetes still managed to lower their overall blood glucose levels by eating healthier, getting more exercise and taking pills.  After all, testing your own blood glucose level isn't a treatment that improves your diabetes control.  It is simply a tool that allows you to know what your blood glucose level is an any particular time.  It is like being given a flashlight on a pitch dark night to help you get where you want to get to more safely.  You might be able to get where you want to go without the flashlight but you may trip or bump into more trees if you try to move forward in the darkness.  The key thing about the O'Kane study is that the people they enrolled in the study were not in much danger of having their blood glucose go too low.  They simply needed to lose some weight, eat healthier and exercise more.  Some people might be motivated to see their blood glucose levels dropping in response to their improved lifestyle but other people are just as happy to make the changes and not worry about what is happening to their blood glucose.

The key thing about testing your blood glucose is to learn from the information that you get.  So if you want to know what happens to your blood glucose after going for a thirty minute walk test your blood glucose before hand and then again when you are done with the walk.  If you want to know how much higher your blood glucose goes after eating a baked potato compared with a piece of grilled fish then test your blood glucose before and one hour after eating each type of food.  If you have had a really stressful day and are feeling "weird" or tired when you get home you might be interested to know what your blood glucose level is.

So do you really have to check your blood glucose?  If you won't use the information to change anything you are doing to manage your diabetes then it is probably a waste of time to check.  But if you learn something useful that gives you insight about how to manage your diabetes better then testing your blood glucose can be very helpful.  Maybe I'm just not very brave and not much of a risk-taker but if I was asked to run down the street on a pitch dark night when the power was out I would prefer to have a flashlight in my hand!

Comments

[Cholesterol Clinic Werribee]

There is no harm in having a timely checkup of glucose level of blood. This precaution not only helps you to get informed about metabolic changes in your body but also helps in fast recovery from diseases like diabetes.