Bad Science

[bunbury]

Today's New York Times reports that The Canadian Agency for Drugs and Technology in Health has issued a non-binding recommendation against self-monitoring (with strips and meters) for many Type 2 diabetics who do not use insulin.

Apparently there's no benefit. It seems a Canadian study, presumably read by the Agency, says that more than 1,000 people would need to use strips regularly to prevent a single case of kidney failure.

Instead of relying on test strips, say these experts, patients need to be vigilant about diet, exercise, weight and ... wait for it ... blood pressure. My experience has been that my BP came down after I got the diabetes under control - not the other way round.

"The message we'd like to impart to those living with T2 diabetes, is that it takes more than testing your blood to look after your health," said Barb Shea, vice president of the health agency.

Well, to work off my irritation I'm going out for brisk drive through town now. I will control my speed with pedals and gears but have covered up the speedometer so that I can't read it. Varooooom....

[Evermont]

It's here: Vital Signs - Blood Sugar Monitoring Not So Beneficial, Canadian Study Finds - NYTimes.com

[Granny Shanny]

Very good analogy, bunbury.

[sumi]

I wonder who the h3ll they are! I have never heard of them. I'm going out for a drive, I feel like going for a walk, but could injure myself in the process thereby reducing my exercise capability. I, will not cover my speedmeter, but I WILL try not to look at it.

[Evermont]

Yeah, I don't know if this is bad or good science, but it smell like bad application of science either way.

... more than 1,000 people would need to use strips regularly to prevent a single case of kidney failure.

I suppose this is really helpful if you're trying to be profitable and insuring 1,000+ T2's - decidedly less helpful if your the single case of kidney failure.

Instead of relying on test strips, say these experts, patients need to be vigilant about diet, exercise, weight and ... wait for it ... blood pressure. My experience has been that my BP came down after I got the diabetes under control - not the other way round.

I think I agree with those experts. Turn all these knobs up to 11.0! There may be other knobs too - floss much? Avoiding #7 plastics? There are things that we can do to bring our BP into range - and we should do those things, diabetic or not. It may also be the case that the things that lower BP also help BG, I wish I knew.

The information provided by a meter dims in value unless one is actively making good decisions based on that information. Headlights on a car with a blown engine would likewise dim in value. I know of a T2 who likes to test non D people to "be helpful to them" - but secretly he's just fudging the average on his meter to fool doc. I'm not excited about helping to pay for that guy's strips.

"The message we'd like to impart to those living with T2 diabetes, is that it takes more than testing your blood to look after your health," said Barb Shea, vice president of the health agency.

Just like it takes more than staring at your speedo (meter) to manage D.

Well, to work off my irritation I'm going out for brisk drive through town now. I will control my speed with pedals and gears but have covered up the speedometer so that I can't read it. Varooooom....

More apt would be a car which never had a speedometer. Covering up a speedometer doesn't save money.

Not just being contrary bunbury - just provoking thought, which activates the brain, which burns 40% of our glucose when not exercising, which I'm not at the moment.

[bunbury]

Not just being contrary bunbury - just provoking thought, which activates the brain, which burns 40% of our glucose when not exercising, which I'm not at the moment.

Of course not! I eat to my meter. Without it I have no control other than that based on previous experience of eating to my meter, which if I'd followed this advice, I wouldn't have.

[raffi]

Instead of relying on test strips, say these experts, patients need to be vigilant about diet, exercise, weight and ... wait for it ... blood pressure. My experience has been that my BP came down after I got the diabetes under control - not the other way round.

I know others have already made this point, but how in the name of bureaucratic nonsense are we supposed to be "vigilant" about diet WITHOUT any feedback?

[CALynn]

That's one of the most asinine things I've ever heard. Sooner or later it'll backfire. Let's face it, it's the Canadian government's way of curbing government healthcare costs.

Out of curiosity, I wonder how frequently you can get an A1C test in Canada.

Pay attention, United States, if obamacare is passed this will be the shape of things to come! Meters will become extinct except for those who use insulin.

[Thank goodness Brown won!]

[ShottleBop]

Entirely contra the IDF Guidelines, too.

[Josselyn]

Today's New York Times reports that The Canadian Agency for Drugs and Technology in Health has issued a non-binding recommendation against self-monitoring (with strips and meters) for many Type 2 diabetics who do not use insulin.

Apparently there's no benefit. It seems a Canadian study, presumably read by the Agency, says that more than 1,000 people would need to use strips regularly to prevent a single case of kidney failure....

...Well, to work off my irritation I'm going out for brisk drive through town now. I will control my speed with pedals and gears but have covered up the speedometer so that I can't read it. Varooooom....

Of course not! I eat to my meter. Without it I have no control other than that based on previous experience of eating to my meter, which if I'd followed this advice, I wouldn't have.

LOL...I think I love you, Bunbury.
I do so enjoy a dark sense of humor...

[ramon]

I can see it now, shady doctors selling insulin scrips. You better get one now if even if you don't need the insulin.

[Tribbles]

Pay attention, United States, if obamacare is passed this will be the shape of things to come! Meters will become extinct except for those who use insulin.

I wouldn't be too smug. This is nothing to do with politics and everything to do with containing costs of T2 diabetes. The insurance companies would like to move from using blood strips for non-insulin using diabetics and I can see that happening. There are enough papers stating that SMBG meters make little difference to HbA1c for the companies to move away from strips with only the current ADA advice is stopping them. This is quite an interesting paper explaining why these studies aren't entirely what they seem (http://cme.medscape.com/viewarticle/710117) although it is sponsored by a company who sells meters.

[davef]

Ok, job done, meter and strips are now in the garbage. Now waiting for my psychic abilities to kick in. I've called the Doctor told him that I won't need anymore blood tests. At this rate I'll be off my meds within a week and just for good measure I have ripped the speedometer out of my car and will be "using the force" when driving home tonight.

The bonus is I won't be testing before driving either ....

[raffi]

There is not much of a distance between cost containment and politics. While I agree that the insurance companies are trying to contain costs, that will not change if the government becomes the insurance company. The biggest difference then will be no other company to compete with them. That does not give me much hope that it would be better.

[foxl]

What the ... FECK.

Maybe it is brinksmanship, threatening Big Pharma, so they will bring strip costs down???

I'm dreamin' -- only CHINA would try that, not Canada!