BMJ  2007;335:271 (11 August), doi:10.1136/bmj.39297.451250.1F

Letters

Self monitoring in diabetes

Education seems to work better

The article by Farmer et al reinforces our experiences in practice.¹ We have not prescribed testing strips routinely to patients with stable type 2 diabetes for the past three years. Aggressive diabetic management based on principles of patient education, development of trust between trained diabetes nurses and the patient, and early use of oral agents to achieve target HbA_1c levels have led to gratifyingly good outcome measures in our 3000 patient urban practice.

We discourage the use of self monitoring for several reasons: expense of testing strips and equipment, the anxiety generated by small variations in results and the subsequent medical time pressures in dealing with these, equipment failure, and the lack of evidence of any benefit. We have had pressure from hospital consultants, patients themselves, and pressure groups to provide testing strips, but we have firmly stuck to our guns. In the current state of knowledge, nothing would persuade us to go back to encouraging or supporting routine self monitoring in stable type 2 diabetes:our results are too good to justify the change.

Old Palace Medical Practice, Norwich NR2 4JA

---

Competing interests: None declared.

References

1. Farmer A, Wade A, Goyder E, Yudkin P, French D, Craven A, et al, on behalf of the Diabetes Glycaemic Education and Monitoring Trial Group. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. BMJ 2007;335:132-6. (21 July.)[Abstract/Free Full Text]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial

Andrew Farmer, Alisha Wade, Elizabeth Goyder, Patricia Yudkin, David French, Anthea Craven, Rury Holman, Ann-Louise Kinmonth, and Andrew Neil
BMJ 2007 335: 132. [Abstract] [Full Text] [PDF]