Why patients who self monitor glucose might be more depressed

doi:10.1136/bmj.a246

BMJ 2008;336:1263-1264 (7 June), doi:10.1136/bmj.a246

Letters

Screening for type 2 diabetes

Why patients who self monitor glucose might be more depressed

The first 150 words of the full text of this article appear below.

O’Kane et al suggest that the negative effect of selfmonitoring of blood glucose might relate to "the enforced disciplineof regular monitoring without any tangible gain."¹ I suggestan alternative explanation based on personal experience. Inthe first few years after diagnosis, many people do not reallybelieve that they "have" diabetes because they feel well, especiallythose with easily controlled disease who are unlikely to havepolyuria and polydipsia. The diagnosis only emerges from bloodtests. They just take the pills and slip back into believingthat "I don’t really have it, I could get over it, itwill go away if I exercise and eat better." Self monitoringof blood glucose throws it in your face. You can’t denythat two pieces of pie did unmentionable things to your postprandialvalue. You must admit again and again that you have diabetes.Unmonitored patients do not have this . . . [Full text of this article]

Lucy M Candib, family doctor and trainer

¹ Family Health Centre of Worcester, 26 Queen Street, Worcester, MA 01610, USA

lcandib@massmed.org

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Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial: Maurice J O’Kane, Brendan Bunting, Margaret Copeland, Vivien E Coates on behalf of the ESMON study group
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