People with type 2 diabetes can lower their blood sugar and benefit from following a structured, personalized self-monitoring blood glucose (SMBG) schedule even if they don't require insulin, suggest data being presented at AADE15, the American Association of Diabetes Educators Annual Meeting & Exhibition.
The new research suggests working with a diabetes educator to create an individualized, structured schedule for blood glucose testing helps motivate people with type 2 diabetes who don't require insulin to eat healthier, be active and take their medications -- and as a result, lower their blood sugar levels. Some researchers, insurers and health care providers have questioned whether there is value in SMBG in those with type 2 diabetes who are not taking insulin; and in fact, many healthcare providers (including Medicare) limit the reimbursement of SMBG testing strips to one a day for people with type 2 diabetes.
"Participants in this study said that sticking to a regular SMBG schedule really helped them to know where their blood levels were and take appropriate action, such as adding physical activity or choosing a healthy snack," said diabetes educator Dana Brackney, PhD, RN, CDE, assistant professor of nursing at Appalachian State University, Boone, N.C. "They said it helped them accept that they had diabetes, but also feel confident that they could control it rather than letting it control them."
Brackney and her colleagues worked with the 11 participants in the study to design personalized, structured SMBG schedules that would provide the most helpful information to patients and their medical teams. The majority found self-monitoring twice a day to be most helpful in providing meaningful information regarding their blood sugar levels relevant to meals and activity; but there was room for individualization based on the individual's lifestyle and needs. For example, a patient might check twice a day three days a week instead of checking once a day seven days a week.
"Diabetes educators can help patients work around barriers to find a personalized testing plan that makes sense for them," Brackney said. "They help patients learn when and why blood glucose levels were most problematic and to confront those situations head on by developing a plan to be healthier."
Although it was not the focus of the study, the 11 participants lowered their A1C (blood glucose) levels from an average of 7.3 percent to an average of 6.2 percent. In patients with diabetes, the goal is to keep A1C levels below 7 percent.
Researchers found that patients in the study would react to their SMBG readings by eating a little less, or going for a walk. The study confirmed that patients do react to their test results and make positive changes, which many health care providers didn't think would happen, Brackney said. Testing helped patients see that they were benefitting by taking charge of their diabetes, including by taking their medication, eating right and being active, she noted.
"Most of the participants in the study were self-described 'country folk' who found that they were able to control their diabetes," Brackney said. "This study helps doctors and nurses to understand how people with type 2 diabetes can benefit from SMBG."
More than 29 million Americans -- nearly one in 10 -- have diabetes, 90 percent of whom have type 2 diabetes. Diabetes is a disorder in which the body doesn't effectively process glucose, which provides the body fuel for energy and growth. While diabetes can't be cured, it can be managed with medication and lifestyle changes.
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