2012-07-10

Frequent Testing Is Key To Blood Glucose Control

Under the headline "Patients Prefer New Diabetes Technology," Susan D. Hall of FierceHealthIT covers new research on the impact of insulin pumps and continuous glucose monitoring (CGM) technology on type 1 diabetes patients.

Ms. Hall reports that "patients say they're happier" with pump + CGM technology, as compared to multiple daily injection (MDI) therapy.

Considering my own experience with insulin pumps, faithful Stationary Waves readers would expect me to read this kind of article with a critical eye. I readily concede that many patients prefer pumps over MDI therapy, and that it is the right decision for patients who have this preference. But, I must reiterate, that at this point I do not prefer pump therapy. MDIs work for me, at least at this point in my life.

It is therefore interesting to note the following excerpt of the story:
The study found little difference in blood sugar control between those who give themselves multiple insulin shots a day and those who used insulin pumps. However, those who used the pumps along with continuous glucose monitoring devices, were able to better control their blood sugar.
Pumps were found to offer no significant improvement in BG control. This is consistent with my experience.

More importantly, CGM technology actually had a good impact on blood glucose control. This is consistent with my largely anecdotal experience, too. It seems to me that my BG is better controlled when I test more often.

But why just leave it at a gut feeling? In the below graph, I have actually graphed my average daily BG (blue) alongside the total number of tests taken (red), by day:

As you can see, there is a visual indication that when my number of daily BG tests decreases, my blood glucose itself seems to increase.

Not satisfied, I did a simple linear regression of one variable against the other. This confirmed the observation: I found that (setting aside all other factors), the number of times per day I tested my blood sugar was inversely related to my average BG by about 0.105 mmol/L (at the two-sigma confidence level).

That is, each test decreased my blood sugar on average by about 0.1 mmol/L. Not bad, considering I ignored all other factors.

Now, there are some problems with this. For example, I am more likely to test more often when I am experiencing hypoglycemia, as per maintenance recommendations. So that may explain a significant part of the impact.

Still, the results, combined with the graph and the findings of this new study seem to indicate that the better we diabetics can monitor our blood glucose, the more control we have.