We thank Stuart Whellans for his comments on our study on reduction of self-monitoring of blood glucose.1 We can reassure him that the study was entirely concerned with people with type 2 diabetes who were not on insulin and who are at low risk of hypoglycaemia. Our study does not deal with people on insulin who require self-testing.
All people with type 2 diabetes are recommended to have regular blood checks using HbA1c. For many of these people not on insulin with low risk of hypoglycaemia, this is a sufficient measure of glycaemic control and self-testing offers no added benefit. Self-testing in this group of people does not reduce hypoglycaemia nor does it improve diet or outcomes. Many patients regard self-monitoring as a task that reduces their quality of life; disposal of sharps can be hazardous, and self-monitoring has been associated with infection. As well as patient wellbeing and safety, cost is a further consideration.
People with type 2 diabetes not on insulin at low risk of hypoglycaemia should be reviewed on an individual case-by-case basis. Most patients are pleased and relieved to have a twice-yearly HbA1c check rather than frequent self-tests that result in reduced quality of life without tangible benefit.
- © British Journal of General Practice 2015
REFERENCE
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