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Question:

From Idaho, USA:

In this era of cost containment, what would be optimal for a stable diabetes, Type 2, person to self monitor his blood sugar? Should we spend money on strips to monitor blood sugars to test 2 or 3 times daily? Once/week? or only when the patient feels strange?

Answer:

The decision as to how often to test is dependent on several obvious factors:

  1. The cost of the strips (which is prohibitively expensive for many people of limited means)
  2. The convenience (or rather, the inconvenience) of testing (especially on the job for working adults)
  3. The complexity of the medical regimen: if the patient is on multiple doses of varying insulins, the risks of hypoglycemia are higher, compared to if the patient is only on a small dose of diabetes pills.

I sometimes advise my patients to test much less than I'd ideally want, based on the first two of these factors. Overall, my advice to stable Type 2 patients, is to test:

  • When ill (the stresses related to any acute illness will probably raise the blood sugar level)
  • When curious (to see what's going on with their body when in an unusual situation, like eating out, or doing strenuous exercise, or when feeling "strange" or "different" than usual)
  • A minimum of (fill in the number of tests) per day (or per week).

Whatever numbers we decide on is very individualized, and is negotiated jointly by the patient and myself to be realistic for their individual circumstances.

WWQ

Original posting 4 Jan 97

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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