Letter from the Editor #495

This week the International Diabetes Federation (IDF) came out with some new guidelines on the use of self-monitoring of blood glucose (SMBG) for non-insulin using patients. (See Item #2.) Their new guidelines talk about how SMBG should be considered at the time of diagnosis but only used when patients, their caregivers, and/or their healthcare providers have the knowledge and willingness to incorporate findings into the diabetes management plan.

I took the time to read through the 44 page document and, although this is a great improvement over what the American Diabetes Association (ADA) is currently saying, there seems to be a whole track of thinking that is missing.

Each and every week there are articles, studies and comments about the relationships between food choices and diabetes and obesity. We even have articles this week about low carb versus high carb, and in the past have focused on which works better. We know that, regardless of what foods our patients choose, there is a direct correlation between what they eat and glucose levels. So why not take advantage of this to improve diabetes care and give non-insulin using patients a definite reason to monitor?

According to various studies the average adult eats about 35 different foods a month, typically eating the same meals over and over again. What if our SMBG plan helped them evaluate their meals and make corrections to their choices? Could we let them know that foods with excessive carbohydrates raise glucose and, if their glucose goes up more than 40mg/dl, 2 hours after they eat, they should try eating less of the sugary high carb foods? Once they get that meal glucose increase down to 40mg/dl or less then they can eat the same thing over and over again.

This simple process works. Try it in your practice and see if your patients respond.

dLife: Nov. 22, 7PM ET on CNBC

Learn how diabetes can affect your memory and mental function, and how to reduce your risk. Plus, dLife goes back to school with a look at diabetes on the college campus; one woman's amazing weight loss story; and a healthy steak dinner that won't break the bank. Find more help with your diabetes life in this informative episode of dLifeTV: Sundays on CNBC at 6:30 PM ET, 5:30 PM CT, and 3:30 PM PT.

CGM, weight management, carb counting, insulin use in Type 2's, advanced pumping techniques, motivation, foot screening, health insurance, tai chi, Type 3 issues, grocery store pitfalls and gems, empowerment, keeping your kidneys kicking, cooking demos, zumba dancing, laughter, integrative medicine, Type 1 research update, cutting edge treatments for neuropathy, sexual health and diabetes, the list goes on and on and on....  Register today!  www.tcoyd.org

*****************************

We can make a difference!

***************************

Check out this week's "Test Your Diabetes Knowledge" question.

Dave Joffe, Editor-in-chief