Can People With Type 2 Forgo the Finger Stick?



Can People With Type 2 Forgo the Finger Stick?


One diabetes expert agreed that routine blood sugar checks may not be necessary for these patients.

“The value of self-monitoring of blood sugar levels in patients not treated with insulin is minimal,” said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

“In my practice, I advocate that every patient with diabetes needs to have a monitor, needs to know how to check blood sugars, and needs to check blood sugars from time to time, when they are sick and when treatment is changed,” he said.

Zonszein agreed that the main reason to check blood sugar is not to see if it’s too high, but to check if it’s too low.

This is especially true for patients taking sulfonylureas, such as chlorpropamide (Diabinese), he said.

“These agents can cause hypoglycemia, and low blood sugar is something we want to diagnose and treat. Those patients on hypoglycemic agents such as sulfonylureas need to monitor more often, as they can have a low blood sugar and not even know about it,” Zonszein said.

The majority of his type 2 diabetes patients are treated with metformin and one of the newer medications, such as a liraglutide (Victoza) or canagliflozin (Invokana) or combinations of those drugs.

“These patients tend to have a normal A1c and they rarely need to check their blood sugars, as these agents don’t cause significant hypoglycemia,” he said.

In other studies, frequent blood sugar monitoring has been found to not be beneficial, and might also lead to depression, Zonszein said.

“The authors proved what I have been telling my patients,” he said. “Monitoring blood sugar is somewhat painful and very costly, and when it is done, it has to have a reason.”

The findings were published online June 10 in the journal JAMA Internal Medicine, to coincide with a presentation of the study at the American Diabetes Association’s annual meeting, in San Diego.


SOURCES: Laura Young, M.D., Ph.D., assistant professor, medicine, University of North Carolina, Chapel Hill; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; June 10, 2017, JAMA Internal Medicine, June 10, 2017, presentation, American Diabetes Association meeting, San Diego, Calif.

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