Tuesday, August 11, 2015

Is SMBG for Type 2 Useful?

Dana Brackney PhD, RN, CNS, CDE, BC-ADM
This is a report of a presentation at AADE 2015 by Dana Brackney PhD, RN, CNS, CDE, BC-ADM entitled "Use of SMBG in T2 DM Self-Management:‘Knowing Where I Am At.’"  There still remains a huge controversy on whether Self-Monitored Blood Glucose (SMBG) is effective and worth the cost in diabetes patients who are not insulin using.  This presentation was a breath of fresh air as it described purposeful SMGB and efforts to measure positive outcomes.  While this is a small and limited study, hopefully this will start to gather more interest in doing studies where SMBG is done in a way that is patient centered and purposeful.  There are many patients that learn to "Eat to Your Meter" with great success.  It is really too bad that studies of SMBG effectiveness have been so deeply flawed and although they claim to be "intervention" studies, if you don't use SMBG in a purposeful way then you don't really have an intervention.

AADE 2015 - Does the DOC Benefit or Harm Patients?

Michelle Litchman, PhD FNP-BC
Diabetes education is still navigating its way through the wave of change as patients turn to on line communities and resources for knowledge and support.  Educators have had fundamental questions about whether DOC really helps patients in measurable ways and whether there are serious risks of harm.  On on Aug 8th at AADE 2015, a presentation entitled The Diabetes Online Community: A SOCIAL MEDI(c)A(l) Approach to #DiabetesCare by a bright young researcher named Michelle Litchman, PhD FNP-BC finally spread some light on these questions.   The conclusions of her work suggest that involvement in the DOC is associated with better glycemic control, self-care behavior and quality of life.   Dr. Litchman further found very little reporting of harm, with no serious harm reported and only 2% of her respondents report minor harm.  This probably suggests the DOC is a safer environment than a hospital.  She further observed that the DOC seemed to fill a fundamental gap in the current healthcare system, providing information, emotional support and a sense of community and belonging that is simply not provided as part of the current system.  Dr. Litchman’s study does have some limitations being a survey and not an intervention study one cannot conclude that the DOC caused all these positive outcomes, it may simply be that motivated patients sought out the DOC.  And while there were few type 2 respondents it did provide a compelling picture of the future.  Dr. Litchman concluded that for those that participated in the DOC, they patients had significantly improved glycemic control, self-care, emotional health and quality of life.  She further concluded that participation in the DOC should be considered for all adults with diabetes.