A very small study has produced some very thought-provoking results. In a report entitled "Self monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients' perspectives", researchers in the UK reported results of their interviews with 18 Scottish patients with type 2 diabetes. The full report is available on-line.
They commented that self monitoring decreased over time, and health professionals' behavior seemed crucial in this: participants interpreted doctors' focus on levels of hemoglobin A1c and lack of perceived interest in meter readings, as indicating that self monitoring was not worth continuing. Some participants saw readings as a proxy measure of good and bad behavior, chastising themselves when readings were high. Some participants continued to find readings difficult to interpret, with uncertainty about how to respond to high readings. Reassurance and habit were key reasons for continuing. There was little indication that participants were using self monitoring to effect and maintain behavior change.
The authors concluded that "Clinical uncertainty about the efficacy and role of blood glucose self monitoring in patients with type 2 diabetes is mirrored in patients' own accounts. Patients tended not to act on their self monitoring results, in part because of a lack of education about the appropriate response to readings. Health professionals should be explicit about whether and when such patients should self monitor and how they should interpret and act upon the results, especially high readings."