If you have diabetes, testing your blood sugar with a glucometer and disposable test strips may be as routine as brushing your teeth. This makes sense if you have type 1 diabetes or if you’re one of many with type 2 diabetes who are on insulin. Self-monitoring can help determine the amount and timing of insulin injections and reduce risk of hypoglycemia. But for patients with non-insulin-dependent diabetes, daily finger sticks are a waste of time and money. Here’s why.
Superfluous Test Results
Most of the diabetic patients I’ve treated over the years had been instructed to do daily self-testing and record their blood sugar levels. When I asked what they did if their blood sugar was too high or too low, the usual reply was “Nothing.” They didn’t increase or lower their oral drugs, change their diet, or modify their exercise. All they did was worry about their levels. In other words, these folks—and tens of millions of others—religiously stick their fingers every day to get readings that trigger zero activity on their part.
Truth be told, physicians don’t pay much attention to finger-stick readings either. They focus on hemoglobin A1C, a test that gives the average blood sugar over the previous couple of months. If the A1C is going up, they intensify therapy. If it’s going down, they’re happy. If it stays the same, it’s business as usual. Finger-stick measurements are superfluous. Nevertheless, it doesn’t seem to enter the minds of physicians or patients to question this expensive and inconvenient practice.
Studies Confirm Lack of Benefit in Blood Sugar Testing
Dozens of studies have found that regular self-monitoring has little to no effect on glucose control, nor does it enhance overall well-being or quality of life.
One of the more recent studies was a year-long clinical trial conducted at 15 medical clinics in North Carolina. Patients with non-insulin-dependent diabetes were instructed to either self-test their blood sugar once a day, self-test and receive feedback messages on their glucose levels, or do no testing. At the study’s conclusion, there were essentially no differences in the three groups. Self-monitoring did not improve A1C levels or health-related quality of life. It provided no benefits at all!
If You Do Blood Sugar Testing, Use Results Constructively
If you or your doctor insists on self-monitoring, then use the results in a constructive manner. For example, figure out what foods have the most dramatic effects on your blood sugar. Test one to two hours after eating various meals and compare the results to determine which foods are best to avoid.
Self-monitoring can also be a motivator to exercise. Exercise, like insulin, has the ability to lower the blood sugar level, and lower it fast. When you’re in a resting state, the large muscles of your body require insulin for glucose to enter the cells. If those muscles are exercising, however, glucose can enter the cells even in the absence of insulin. This is a well-known but little-used method of lowering blood sugar, and it is ideal for individuals with type 2 diabetes.
For instance, if your finger-stick test is high, take a walk for about a half hour, wait another hour, and repeat the test. More often than not, you will see a dramatic drop. That’s how powerful exercise can be.
Follow the Money
Used in these ways, self-monitoring becomes a tool for engendering therapeutic activity, not a bothersome and pricey waste of time and effort. Unfortunately, self-monitoring is rarely utilized in a productive manner. It’s easy to figure out why: just follow the money. Test strips, which cost pennies to make, cost up to $1 apiece, and many patients test several times a day. That’s a multibillion-dollar windfall for medical device companies.
The bulk of these test strips are used by people with type 2 non-insulin-dependent diabetes—precisely the kind of patients who benefit the least. If you are one of them, talk to your doctor about the necessity of daily blood sugar testing. If you aren’t using your readings to adjust your medication dosages, identify and eliminate problem foods from your diet, or lower your blood sugar by exercising, then what’s the point?
