GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #28: Don’t Routinely Recommend Daily Home Glucose Monitoring For Patients Who Have Type 2 Diabetes Mellitus And Are Not Using Insulin.

For the first time since I started this blog eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!

OK – this is sort of a weird research project for me…

I just got done wearing a CGM (Continuous Glucose Monitor) for two weeks, along with a heart monitor that was “glued over me heart”; part of a health study my father started in, my sister and brothers and I became part of, and then were invited to be part of a Generation 2 extension of the original study.

My wife has been wearing a CGM for a couple years now.

In prepping for my by-weekly post, I ran across this headline: “Don’t routinely recommend daily home glucose monitoring for patients who have type 2 diabetes mellitus and are not using insulin.”

WHAT?!?!?!?!?!?!?!

There’s no date on THIS particular article, but it appeared on the website of the AAFP Publications American Family Physician Collections Choosing Wisely 369

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So, let me see if I’m reading this right: THERE IS NO BENEFIT TO WEARING A CONSTANT GLUCOSE MONITOR if you’re not taking insulin? Pardon my French, but WTF are we wearing them for? It doesn’t lower your regular blood sugar levels, and as far as I can tell, the article is pretty clear when it writes:

“Self-monitoring of blood glucose is an integral part of patient self-management in maintaining safe and target-driven glucose control in type 1 diabetes mellitus. However, daily finger glucose testing has no benefit in patients with type 2 diabetes mellitus who are not on insulin or medications associated with hypoglycemia, and small, but significant, patient harms are associated with daily glucose testing. [THEY MENTION THIS AND THEN DON’T EXPLAIN IT?] Self-monitoring of blood glucose should be reserved for patients during the titration of their medication doses or during periods of changes in patients’ diet and exercise routines.”

There’s no link to where this study is published NOR does it mention who did the research or where it came from!

After a long search, I FINALLY came to this article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10954850/

“Its headline reads: Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis”

Diabetologia. 2024 Feb 16;67(5):798–810. doi: 10.1007/s00125-024-06107-6

Milena Jancev 1, Tessa A C M Vissers 1, Frank L J Visseren 1, Arianne C van Bon 2, Erik H Serné 3, J Hans DeVries 3, Harold W de Valk 1, Thomas T van Sloten

Copyright and License information; PMCID: PMC10954850 PMID: 38363342

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10954850/,
"Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis"

https://www.aafp.org/pubs/afp/collections/choosing-wisely/369.html#:~:text=Self%2Dmonitoring%20of%20blood%20glucose,patients'%20diet%20and%20exercise%20routines.; "Don’t routinely recommend daily home glucose monitoring for patients who have type 2 diabetes mellitus and are not using insulin."

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg