Diabetes: do you need to check your blood glucose levels?
Publication Date:18/04/2008
If you have diabetes, you may have been advised to measure your blood glucose levels with regular finger-prick tests. But a new study shows that people with type 2 diabetes who don't use insulin, may not get any medical benefit, and that regular self-testing might even make you feel depressed.
What do we know already?
People with type 2 diabetes have too much glucose in their blood. Glucose is a kind of sugar that your body uses for energy. If it builds up in your blood, it can make you sick. Treatments include making changes to your diet, doing more exercise, taking medicines, and for some people, injecting insulin. Insulin is a hormone that controls the amount of glucose in your blood.
If you take insulin, you need to check regularly to make sure your blood glucose hasn't become dangerously low. You do this by pricking your finger and testing the drop of blood with a glucose-monitoring machine.
Most people with type 2 diabetes don't need to inject insulin. Some doctors think it's still a good idea to check your blood glucose levels regularly. That way, you can see if your treatment is working. It may help you feel more in control of your condition.
But others think that there's no point testing your blood glucose yourself, if you don't take insulin. You'll have your average blood glucose level (called your HbA1c level) checked regularly at your diabetes check-ups. So if your treatment isn't working, your doctor will be able to tell you.
There's a lot of disagreement about whether people who don't use insulin get any benefit from testing their blood glucose. So this new study tried to find out if it's worth the effort.
What does the new study say?
People who tested their blood glucose regularly didn't get any health benefits from doing so. Self testing didn't have any long term effect on blood sugar levels. And people who self tested were more likely to feel depressed than people who didn't test.
Tell me more about the study's findings
Half the patients in the study were taught to test their own blood glucose, eight times a week. The other half were not asked to test their blood glucose. Everyone had education about how to eat and exercise to improve their diabetes, and everyone was treated with medicines if needed. Researchers checked patients in the study every three months for a year. They looked at:
- Their average blood glucose readings (HbA1c levels)
- How much diabetes medicine people needed
- Whether anyone's blood glucose had got too low.
They didn't find any important differences in these measures between the two groups. Everyone's HbA1c levels were down to the recommended level by the end of the year.
The researchers also asked how people felt, based on a questionnaire about their mood at the end of the study. The people who tested their blood glucose felt more depressed than the people who hadn't tested themselves. On a scale of 1 to 100, they were, on average, 6 points more depressed.
Where does the study come from?
The study was carried out by doctors at the University of Ulster in Northern Ireland. It was published in the BMJ (British Medical Journal) which is owned by the British Medical Association.
How reliable are the findings?
The study was carried out very carefully. It was a randomised controlled trial (one of the best types of study) of 184 people, who had been recently diagnosed with diabetes. However, 184 people is not a very big study. So, although the findings are likely to be reliable, it's possible a bigger study might find that some people did get some benefit from testing.
The study can't tell us why people who tested their blood glucose were more depressed. It may be that people in the study just didn't like having to test themselves. Some people find it painful and a nuisance.
What does this mean for me?
If you've been newly diagnosed with type 2 diabetes, you may be taught about testing your own blood glucose. You'll have lots of other things to learn about as well, including changes to your lifestyle, and medicines. You may find it helpful to concentrate on the most important things first.
This study tells us that it may be more important to follow your doctor's recommendations about diet and exercise, and take any medicines you are prescribed, than to check your own blood glucose. That's what will make a difference to your blood glucose levels. See your doctor regularly for check-ups, and he or she can tell whether your treatment is working.
If you are using insulin, things are very different. You do need to check your blood glucose regularly, to make sure you don't get dangerously low blood glucose.
What should I do now?
It depends on how you feel about testing your blood glucose levels. If you are already doing it, or plan to start, and you're happy with that, there's no reason to change. But if you don't like the idea of it, and you don't use insulin, you could talk to your doctor about this study. There may be a particular reason why your doctor thinks you should test yourself. But if not, you may decide not to self-monitor.
From:
O'Kane M, Bunting B, Copeland M, et al. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. Published online 17 April 2008.
To find out more, read our information about type 2 diabetes.
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This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
