As for studies showing that monitoring doesn’t benefit type 2s, it was just a matter of collecting data. If you just collect data and do nothing with it, it won’t help. The monitoring is NOT the problem, but failure to act on the the data.

I have consistently kept my A1C under 6% with minimal meds. By monitoring how different foods affect my blood sugar, I’ve discovered what I can eat and how much. One day I hope to get off my meds. In my interaction with other diabetics, I’ve discovered that foods affect people differently. What jacks up my blood sugar, may not jack up someone elses. The only way to know is to test and then act on what the data shows.

Of course, I’ve ditched the ADA diet since I’ve discovered it’s a guarentee of high blood sugar. The ADA just wants type 2s to blindly follow its diet and take their meds. With no monitoring, no one will know that the ADA approach isn’t working until they end up with nasty complications. The ADA lost all credibility with me a long time ago.

What does ADA rank and file members for – they got him?

Page 70

http://www.diabetes.org/uedocuments/2006_990.pdf

I’m not sure you said the speech was not about Type 1 with regard to technology, but if you did, I encourage you to write to him and say that. He will assure you that it was about Type 1.

T2 diabetics (in general) should be on low carb, low glycemic, low bad fats, and high fibre diets, which will automatically go a long way to keep their blood sugars stable. They should avoid all junk, processed, high fat, high glycemic, and high carb foods. I personally have never met a T2 not on insulin with severe swings in blood sugar. Most of the time, they stay fairly close to slightly above normal range, unless they eat something they shouldn’t, are stressed, or are ill. For the last two categories at least, it is true that testing is very important.

The fact is, the *vast majority* of T2’s gain very little from testing overall once they have made the proper lifestyle choices. I’ve read an article stating that one T2 knew to cut out his favorite candy snack after testing his blood sugar only to find it made his blood sugar shoot up. DOH! I mean if some people really ARE that dumb, OK. Give them a tester. But perhaps we should educate people to avoid those high glycemic foods 100% to both prevent and treat T2 diabetes in the first place.

It’s not that I think T2’s not on insulin should never test (of course not), but it is true that studies have shown that for most T2’s not on insulin, testing makes little difference on a daily basis. The exception to this would be adjusting meds for weight loss, exercise, illness, etc.

Sure maybe 20% of Type 2’s (including misdiagnosed LADA’s, MODY’s, thin and very active people with genetic insulin resistance, people who take steroids and other meds, those with other medical conditions, etc.)*should* test daily. But the point is that for the T2 diabetes epidemic as a whole, technology is NOT the answer.

It seems that Doctors, Diabetic Educators, et al, are ONLY “educated” by pharmaceutical companies and insurance companies. AND they seem to eat it up, thinking that “now” they know how to treat their patients better. Bah! Humbug!
Solution: Let’s develop a 5 or 7 point laminated list to distribute to EVERY medical person everywhere. The list would teach them how to question the “reps” that come to visit them on a daily basis. It would teach them to be cynical. It might go something like this:

To ALL medical personnel:

QUESTIONS TO ASK YOUR PHARMA REP WHEN THEY VISIT YOU:
1. How much does this cost the patient (assuming there is no insurance) per day / per month / per year?
2. Never let the rep. talk like every patient has good insurance, or any insurance at all.
3. Write their answers down on paper. Make a simple chart so they can see that you understand the real cost.
4. How many patients (T1? T2?) will WANT this product? Translation: How many patients feel this product will help control their diabetes. No, the pharma cos aren’t the best people to ask but believe me, they’ve done their research and the numbers will astound you (any maybe the rep).
5. If they don’t have the answers, show them the door and tell them to find the answers and don’t return until they have the answers. Also, tell them you will not be prescribing ANY of their products until they give you answers!
6. Verify their answers with real Diabetic patients. Use your own patients.

KEEP THIS LIST TAPED TO YOUR WALL WHERE YOU CAN SEE IT AT ALL TIMES, AND USE IT. DON’T BE INTIMIDATED BY PHARMACEUTICAL COMPANIES.

The cost to do this, though great, is minimal compared to the potential benefit. And don’t cope out by making it sound ‘nicer’, or sending it out in some throw-away mailing, or worse, a non-read email. It has to be a ‘keeper’. Hard plastic. Colorful. Small enough to fit on a desktop but big enough to see from 6 feet.

AND the insurance companies ALWAYS lag in accepting new technology so they don’t have to pay for it. I’ve been waiting for a continuous glucose monitor for 20 years (and I’m sure the technology was out there) but it’s only been available for a year or two. Now, the 7-day Dexcom is available but still considered (by my insurance) as experimental. Why? Because, obviously, the 3-day require twice as many replaceable parts (at $125 a shot) as the 7-day. And, is $125 even remotely related to reality? Yes, I want the pharmaceutical companies to make some profit but this is GOUGING and Greed. GREED. GREED!

Question: Surly, there must be some department in government (paid to protect citizen rights) that looks out for us. And fights for us. If the insurance syndicate and the pharmaceutical syndicate are the sole influence on capital hill, then where are the consumer advocate group?

For the record, this are my list of things that piss me off about the diabetic industry (read: suppliers and insurance; an unholy alliance if there ever was one):
1. cost of test strips
2. non-availability of generic insulin
3. lag in development/availability of CMG
4. influence of pharma cos on law/policy
5. influence of insurance cos on law/policy
6. lack of influence by T1 diabetic citizens on law/policy

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Individuals react differently to the same foods r.e. blood sugar levels.

Exactly what “meal plan” would you recommend for an older T2 woman who exercises very little and a younger woman training to run a marathon? Or a business professional who works 8-10 hours per day and exercises 45 min, 3 times per week? Or a mail delivery person who walks all day every day for her job?

Hopefully you don’t mean the useless plans put out by the ADA, do you?

Sorry, Sarah, there is no way a T2 can “know” what his/her blood sugar is unless they test, and test often.

Tight control is the ONLY approach a T2 can reasonably rely upon to avoid the complications that come with diabetes.

That’s just the reality of it.