The Pharmaceutical Journal
Vol 279 No 7468 p250
8 September 2007

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Patients need clearer guidance on blood tests

Health professionals should be more explicit about whether patients with type 2 diabetes need to monitor their blood glucose levels themselves, and how often they should do this, researchers say.

There is still no firm agreement among professionals about the role and value of self-monitoring in patients with type 2 diabetes, say the researchers, and this appears to be reflected in patients’ attitudes to testing.

Detailed interviews with 18 patients were conducted when they were newly diagnosed and four years after diagnosis. The interviews revealed that self-monitoring decreased over time, and patients believed that doctors were not interested in their meter readings.

Some patients found the results difficult to interpret and tended not to act on them. Patients also said that low blood glucose readings provided reassurance but high readings created a sense of failure.

Mahesh Sodha, a community pharmacist in Chelmsford, Essex, who runs weekly diabetes clinics, commented that a tailored self-monitoring plan should be made for each patient. He said that prescribers are currently experiencing pressure from primary care trusts to limit their prescribing of testing strips for patients with type 2 diabetes.

He pointed out that newly-diagnosed patients might find it helpful to test their blood glucose frequently, for example, to gain an understanding of how their body reacts to a new type of meal. However, in general, a once- or twice-weekly check should be adequate for patients with type 2 diabetes. He added that specialist diabetes nurses and pharmacists can help promote a tailored plan for each patient, and ensure they understand how to interpret and act on the results.

The study was published in BMJ Online First on 30 August 2007.