Many diabetics unable to interpret glucose values

NEW YORK (Reuters Health) - A large number of patients with type 2 diabetes have difficulty interpreting the results of their blood sugar (glucose) levels and are unsure what to do if the readings are high, investigators report in BMJ Online First.

The British team, led by Dr. Elizabeth Peel from Aston University in Birmingham, tell doctors that "education about blood glucose self-monitoring should be explicit, goal oriented, tailored to individual needs, and on a continuous basis."

Peel and her associates conducted a study in which 18 patients with type 2 diabetes were interviewed three times during the first year after their diagnosis and once more 4 years later.

At the end of the first year, 16 were self-monitoring their blood glucose, but only 10 were still doing so at the final interview. And many patients who did continue to monitor their glucose had cut back on the frequency of testing.

One theme that emerged was that patients doubted their physicians were concerned about the self-monitoring results.

Another common issue was that patients did not know what to do if their reading were high. Reactions ranged from "puzzlement to great anxiety," with some patients thinking that high glucose levels meant they "should be dead."

Furthermore, it appeared that patients weren't using the results of self-monitoring to guide long-term lifestyle changes.

Peel and her associates tallied the reasons why patients stopped or continued self-monitoring. Patients, particularly women, often stopped because they blamed themselves when glucose levels were elevated. Some discontinued because they believed they could sense when their glucose levels were off, while others did so because their readings had stabilized.

Some of the patients who continued to monitor blood glucose levels said they did so because it had become part of their routine or because they felt comforted by keeping on top of their health status.

Peel and co-investigators emphasize that "the role of health professionals is crucial" in educating patients on "if, when, and how they should be self-monitoring."

SOURCE: BMJ Online First, August 30, 2007.