Q&A: Necessity of Blood Sugar Testing

I have diabetes and take a drug. My doctor has me test my blood sugar twice a day. I have insurance, but it still gets expensive and tiresome. I thought I remembered reading in your newsletter that testing is not necessary. Can you write about this sometime?

For individuals with type 1 diabetes, regular testing of blood sugar is reasonable because it may lead to adjustments in insulin dosing. For those with type 2 diabetes, which I presume you have because you’re taking an oral drug, I feel that incessant testing is not only unnecessary, it’s debilitating.

When you test your blood sugar, do you make any alterations in your treatment program? Do you use testing to identify foods that drive up blood sugar—and eliminate them from your diet? Does testing alter your medication dosage? If not, what’s the sense of it?

Two studies published in the British Medical Journal came to similar conclusions. They found that self-monitoring of blood sugar levels did not improve glucose control but was associated with higher costs, lower quality of life, and more depression.

We’ve treated several thousand patients with type 2 diabetes at the Whitaker Wellness Institute over the years, and rather than requiring regular self-testing, we periodically measure their hemoglobin A1C levels. Whereas a finger stick is a snapshot of your blood sugar at a given time, this test gives a broader picture of average blood sugars over two or three months. This allows us to evaluate how well a patient’s treatment program is working and to make adjustments, if necessary.

Adjustments do not include drugs—we take virtually all patients off their oral diabetic meds. Our changes consist of dietary modifications (fewer carbohydrates and more protein), increased exercise (including a 10-minute brisk walk after meals), weight loss, and a sophisticated nutritional supplement program. In addition to improving blood sugar control, this approach also gives patients a fighting chance against the ulcers, neuropathy, vision loss, heart disease, and kidney problems that afflict so many patients with this condition.

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