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This is indeed an important finding on several levels, yet it remains
translating this into clinical practice. I have found myself even more
ambivalent about suggesting SMBG to patients reasonably well-controlled on oral anti-diabetes medications.
In an effort to translate these findings, I propose the following
1. For patients struggling to comply with health care...
1. For patients struggling to comply with health care
now know that SMBG does not need to be as high a priority in our
2. For patients struggling to afford all the components necessary to
perform SMBG (e.g., glucometer, strips, lancets), this now becomes an area
potential cost savings. Freeing up their limited discretionary income
allow them to afford a nutrition consultation, important medications or
expensive interventions with better evidentiary support.
3. For patients fully complying with SMBG, this might be a time to
to check their BG less frequently (e.g., Tuesday and Friday, fasting and
post-prandial, and prn for signs and symptoms of hypoglycemia and/or
hyperglycemia) instead of at their current rate.
Finally, since there is potential to have a critical study in the
these recommendations, I am choosing to use caution both in how I explain
this study and in discontinuing anyone from SMBG.