A home diabetes test can be a waste of time and money

However, not everyone is on board. Critics of this latest study stated that it did not prove that monitoring blood glucose could not help: it is possible that with better training or greater attention to detail, there are ways to make it work.

The purpose of pragmatic comparative efficiency tests like this one however is to test the functioning of practices in the real world. In these high quality primary care practices, even with personalized help for interpretation of measurements (more than most patients), the blood glucose test did not make any difference.

Choosing carefully, an educational campaign to reduce the number of tests and unnecessary medical procedures, discourages routine control of home blood glucose for patients with type 2 diabetes who do not take insulin. He says that there is no benefit and that there is potential damage. This argument is supported by the American Academy of Family Physicians, the Society of General Internal Medicine and the Endocrine Society.

Of course, there are exceptions. When patients are seriously ill, change their regimen or find that their blood sugar is not well controlled, tests may be helpful. Such decisions should be made in consultation with a physician.

But for most type 2 diabetics who do not take insulin, the tests are inappropriate most of the time. This message does not pass. At the end of last year, another study had been published in JAMA Internal Medicine that quantified the prevalence of blood glucose testing in adults. The researchers examined a database containing data on more than 370,000 beneficiaries of commercial health insurance and Medicare Advantage suffering from type 2 diabetes.

Of more than 23% of patients who used test strips, more than half probably did so despite widespread recommendations that they should not do so. They used a median of two test strips per day at a cost of over $ 325 per year per patient.

In another sequence of ideas, The New York Times reported that "a surprisingly large number of people" who use insulin use less, because they can not afford it, this which puts them in danger.

With a health system as complex as ours, it's hard to take money from one pot to another and transfer it easily. The efficiency in each system is crucial. The fact that a necessary facet of diabetes care is increasingly out of reach – while unnecessary and potentially harmful care is easily overused – illustrates the magnitude of the work that remains to be done.