Intended for healthcare professionals

Research

Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39534.571644.BE (Published 22 May 2008) Cite this as: BMJ 2008;336:1174

Ignoring the obvious

It is indeed obvious that testing, without the wherewithal to
influence the results of said tests, will cause depression. Although the
study states that participants were given "a structured education
programme", from anecdotal and personal experience of such "education"
programmes, little practical advice on how to influence blood sugars is
given. The dietary advice dispensed on such education programmes is, if
followed to the letter, almost guaranteed to result in high blood sugar
levels, since it advocates the "eatwell plate", and advises:-
"plenty of bread, rice, potatoes, pasta and other starchy foods – choose
wholegrain varieties whenever you can". It is a simple biological fact
that carbohydrates turn to sugars in the blood stream. Hence for
diabetics on oral medication or diet and exercise, even if the low GI
versions are eaten, the result will be high BGs post prandially.

However, members of diabetes-support.org.uk have significantly
improved their results (and hence their Hba1cs) by learning the affect of
carbohydrates on their own bodies and managing their intake to minimise
them. A structured regime of testing for a few weeks will quickly show
what foods can be tolerated on an individual basis, because oddly, each
person has a different tolerance level to different foods. The effect of
exercise in reducing any resulting spike in BG levels can also be
demonstrated in a practical way and this in itself can be a motivation to
improve both diet and exercise regimes.

These findings are repeated over and over in every single diabetic
forum on the internet. Yet Doctors are refusing to prescribe test strips
in what can only be regarded as a short-sighted and cost conscious
fashion. Whilst those who can afford it can purchase the test strips to
educate themselves, those who cannot are simply being denied a very simple
means of being in charge of their own health and preventing future
complications.

Competing interests:
Patients welfare

Competing interests: No competing interests

24 August 2008
Patti D Evans
Administrator
Penzance, TR18 3PE