Frequency of Diabetes Data Review

I wrote a response to a story I just read at MedPage Today about how infrequently (you should read that as 'never') most people with diabetes review their diabetes data.

http://www.medpagetoday.com/MeetingCoverage/ENDO/46445

My thoughts on this article and the research behind it:

  1. CGM and SMBG are two completely different animals and should always be studied separately,

  2. There is no need for additional diabetes data beyond blood sugar values and an accurate time stamp in order to facilitate clinically significant improvements, Point 2b - there is no research showing that additional data collection beyond blood sugar contributes to any meaningful improvements,

  3. The authors arrived at 'frequently' as meaning 4 times per year and presumes that this somehow results in superior outcomes vs. those who never download data for review.

A few years ago I wrote a follow on paper to further explain observations from one of the few diabetes data oriented type 1 diabetes studies. In the original research, my team identified frequency of SMBG (checking blood sugar with a portable handheld meter, a disposable test strip, and a small drop of blood) review of at least one time per week as resulting in clinically significant improved blood sugar vs. those people who performed retrospective review LESS than one time per week. This contrasts with today's article in which the researcher defines frequency as once every 3 months.

Image Attribution: Stephen W. Ponder, MD showing the vetted 'Day over Day' blood sugar trend report used in the study entitled, "Integrating an Automated Diabetes Management System into the family management of children with type 1 diabetes: results from a 12-month randomized controlled technology trial". Dr. Ponder was the Principal Investigator of this study. The Day over Day report is part of the GlucoMON®-ADMS by Diabetech, LP, a company I founded in 2001.

In my study, those who did review their blood sugar data occassionally (e.g. every other week or so) experienced NO DIFFERENCE in mean blood sugar, A1c or other behavioral assessments vs. those who never reviewed their data.

The key to all of this for those who only use a meter (not using cgm) is AT LEAST WEEKLY review of just blood sugar data.

So, if you're waiting for a lot more data and some snazzy mobile app to bring it all together for you in a patient-centered visually compelling way (blood sugar, carb counts, insulin doses, etc...) you're wasting your time, at least based on what we know to be true today.

You can read my paper entitled 'Frequent Pattern Management' as a downloadable paper from my dropbox account here: http://j.mp/FrequentPatternManagement

The original research paper from Diabetes Care is published here: http://j.mp/t1pedsStudyPubMed.


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