The happy balance between blood sugar control and diabetes cost saving

blood sugar control

An article by Deborah Mitchell published in diabetes care, summarizes a study that suggests that many people with Type II Diabetes mellitus can stop home glucose monitoring and can eliminate the pain and stress for millions in both type I and type II as well as the costs (Finger stick several times a day).


This conclusion comes from a team of researchers from Queen Mary University of London. The study conclusion is very interesting and purely monetary. It does not take into consideration the potential cardiac complications that can result from long term poorly controlled blood sugars.

Diabetes is no longer consider just a risk factor for cardiac disease it is considered "cardiac equivalent ", meaning that diabetic patients are to be treated as if they already have heart disease.

Regardless of all the education that patients are given there has to be an alternative way to test the patient in order to document diabetic control . The test is called Hemoglobin A1C(HGB A1C ) . It is usually checked every three months and correlates well with pre meal blood sugar testing.


Blood Sugar HGBA!C
125 6
154 7
212 9
240 10
269 11
298 12

If blood sugar is consistently in the 300 range and the HMG A1c is 12 or above then intervention is needed, to find out the reason for blood sugar elevation, be it infection poor dietary habits obesity lack of exercise, poor compliance or a combination of the above.

Cost savings in one area. (Decrease cost of testing & equipment) may end up being offset by increased admission for diabetic complications such as diabetic ketoacidosis, myocardial infarction and other diabetic complications.

There are other ways to test home blood sugars by using less painful methods such as using alternative sites, rotating sites, or even perhaps testing once a day.
Home glucose monitoring along with diabetic education allows for a partnership between the patient and his doctor and consequently better diabetic control in my opinion . I encourage all my diabetic patient to test their sugars at home , at least once a day at different times of the day sometimes pre-meal or after meal . You

In conclusion, we find ourselves at a crossroad, having to find a happy balance between cost savings and diabetic control and patient compliance and risk factor reduction.



I test my patients for dairy allergy and/or lactose intolerance! Milk sugar is called lactose, and lactose gives milk its sweet taste. An enzyme called lactase splits it up into glucose and galactose. Many people, in particular native Americans, Inuit, and many Southern Europeans normally stop the production of lactase at sometime in their lives. People who don’t have sufficient lactase to digest lactose will be “lactose intolerant,” and may suffer diarrhea, intestinal gas, cramps, and bloating from drinking milk. It is estimated that 30 to 50 million Americans are lactose intolerant, including up to 75% of Native Americans and African-Americans, and 90% of Asian Americans. A lack of lactase causes the inability of the sugar lactose to be split into glucose and galactose. The presence of sugar stimulates the production of insulin, but insulin is not effective on lactose, only on glucose and galactose. This leads to diabetes 2. In Type-1 diabetes, the immune system appears to attack and destroy insulin-producing cells in the pancreas. It usually begins in childhood, requires insulin injections, and afflicts about 800,000 people in the U.S. alone. In an allergic response to dairy protein, the pancreatic glands called islets of Langerhans are NOT TRIGGERED BY THE BRAIN TO PRODUCE INSULIN. In a 'fight or flight' scenario the digestive system is turned off and the immune system turned on, and no digestive responses ensue until the brain recognizes the danger has passed, until dairy is consumed again. Avoidance of dairy and a strict adherence to that avoidance will help controlling diabetes.