Limit on diabetes test strips coming Aug. 1 0
Upcoming changes to how the province will distribute blood glucose test strips isn’t concerning Orillia’s Adult Diabetes Education Centre.
“The allotment that they’ve outlined ... is adequate for the majority of people,” said Janet Cooper, co-ordinator of the centre.
Beginning Aug. 1, the Ministry of Health and Long-Term Care will limit strips based on patient needs, said ministry spokesperson David Jensen.
“... We’re following research that’s indicated that blood glucose test strips have limited benefits for patients who do not take insulin to manage their diabetes,” Jensen said.
A July 2009 report from the Canadian Agency for Drugs and Technologies in Health stated blood glucose test strips, in practice, have limited clinical benefit for many patients who are not on insulin, states the ministry’s website.
Currently, diabetes patients are given unlimited strips through the Ontario Drug Benefit Program.
“The amounts were going up every year,” Jensen said. “It was something we took a look at.”
The strips cost the government 68 cents each. The changes are expected to save the province $15 million to $25 million each year.
The local diabetes centre, which operates out of Orillia Soldiers’ Memorial Hospital, offers education for the prevention and management of diabetes.
Cooper, a dietitian and diabetes educator, said the government’s distribution changes are financially responsible.
“... Lots of people do test more often than they actually need for their clinical care,” she said. “I think it’s a good, financially responsible and appropriate plan.”
Cooper said it could encourage diabetic patients to improve the quality of their testing.
“If they don’t have free access to as many strips as they can get, then maybe they’ll make better testing-time choices,” she said.
Patients should test more often before they see health-care providers and should ensure they are testing throughout the day, she added.
“Some test every day, only in the morning,” Cooper said. “All that person ever knows is what their blood-sugar is first thing in the morning. It’s not the same quality of information.”
Patients should vary their testing each day so they have results before each meal and before bed.
Patients managing diabetes with anti-diabetes medication with a high risk of causing hypoglycemia will be allotted 400 blood glucose test strips per year.
Cooper is concerned the changes could negatively impact that particular group.
It’s recommended patients in that category test their blood-sugar before they drive to ensure it’s not low, Cooper said.
Those patients can apply for an extra 100 strips with their health-care providers, but will still have fewer than two per day.
“That person probably is not going to be able to test every time before they drive,” Cooper said. “That would be probably my only concern.”
Patients managing diabetes using anti-diabetes medication with low risk of causing hypoglycemia will be given 200 each year and patients managing diabetes through diet/lifestyle therapy only (no insulin or anti-diabetes medications) will be allotted 200 each year.
Patients managing diabetes with insulin will have access to 3,000 strips each year.
“The amount is right in the range of what people were getting already,” Jensen said.
The changes are supported by the Canadian Diabetes Association (CDA), said Janet Hux, chief scientific adviser with the CDA.
The distribution thresholds align well with the CDA’s most recent clinical-practice guidelines, she said.
“We feel ... the overall guidelines, in terms of the number of strips in the different categories (and) the ability of pharmacists to create special exceptions, does meet the needs of people with diabetes,” she said.
The CDA guidelines recommend purposeful testing, Hux said.
Testing is important when patients are learning about the disease, if there is a change in their treatment (like missing a meal and testing to see if they need to adjust their next insulin dose) and for safety reasons.
“For someone who is not adjusting their medication, is already well informed about their condition, testing three or four times a day may not be helping them,” Hux said.
Testing — when the results are not being used — can also cause anxiety, she said.