Berikut merupakan kutipan ilmiah kedokteran yang bermanfaat sehingga disusun dan digunakan sebagai referensi pribadi.
The DiGEM study
The most authoritative study on the subject of self-testing for people with type 2 diabetes is the DiGEM study.
The report here concludes that:
“This trial does not provide convincing evidence to support the routine use of SMBG for non-insulin-treated patients with reasonably well controlled type 2 diabetes.”
What did the DiGEM study involve?
The study involved three approximately equally-sized groups, of around 150 participants with type 2 diabetes and not using insulin. One group was a control group who were not encouraged to self test. A second performed self-testing with training from a clinician. The third performed self-testing and were given additional training to interpret results, apply changes and to aid motivation.
What were the results of the study?
The results were sadly disappointing. The group with less intensive education scored an average improvement in A1c results of 0.14% and the more intensively trained group achieved an average improvement of 0.17%.
Who were excluded from taking part in the study?
The first clue is offered in the exclusion criteria –ie which people were excluded from taking part in the trial:
Average participant was aged 66 years old
It’s worth noting that the average participant’s age was 66 years old. Therefore, if I were say a 50 year old type 2 diabetic and I’d had my test strips withdrawn by my GP as a consequence (indirectly or otherwise) of this study, I’d feel disgruntled on this basis as well.
Was the intensive training any good?
The report of the study provides a wealth of anecdotal evidence about the study itself, featuring a number of interesting comments from the participants.
As an example, one participant from the intensively trained group noted:
“my readings very, very rarely alter, they’re all between 7 and 10, depending which time of day I take them.”
Unwilling to learn
When you look at some of the attitudes of some of the patients, it just goes to show how significant a bearing the exclusion of pro-active testers may have been on the study outcomes:
“… a sort of reminder of the fact that you know that I’ve got something wrong with me…I don’t like to be reminded particularly.”
So what does the study show?
The study indicates that encouraging people with type 2 diabetes to self test as a matter of course may not be viewed as cost effective.
And what does the study not show?
The study excluded any testers who had recently shown a concerted commitment to self test. Therefore, the study cannot draw any conclusions about people with type 2 who are actively keen to self-test their blood sugar levels.