Availability of Blood Glucose Test Strips

Test strips are a vital component for self monitoringTest strips are a vital component for self monitoring

Availability of blood glucose testing strips is a particular issue for people with type 2 diabetes, but can also be an issue for people with other types of diabetes as well.

Self monitoring of blood glucose (SMBG) can be very beneficial for people with all types of diabetes and can help to reduce the risk of developing diabetic complications.

Research into cost effectiveness

A number of research studies have been conducted to assess whether self-monitoring for blood glucose is cost effective for the NHS.

The studies have found self-monitoring has not been effective at improving blood glucose control in cases where patients have either not known how to interpret their results or have not been themselves committed to self testing.

However, many people with type 2 diabetes see self monitoring of their blood glucose as an essential part of their diabetes management and their self-testing has lead to a vast improvement in their blood glucose control.

NICE recommendations

The National Institute for Health and Clinical Excellence (NICE) recommends that self-monitoring should be available for people on diabetes medication to help provide information to avoid hypoglycaemia, to assess fluctuations in blood glucose, to cope with periods of illness and to ensure against accidents during dangerous activities such as driving or operating certain machinery.

In line with this, those who are prescribed self-monitoring equipment should be assessed at least as often as annually on the appropriate frequency of their testing and whether self-monitoring is benefitting the patient.

Can PCTs declare blanket bans on prescribing test strips?

Each PCT should consider each case for self testing individually. The government has responded to issues by underlining that PCTs should not impose blanket bans on test strip availability.

What can I do if my test strips have been withdrawn or reduced?

If your availability to blood glucose testing strips has been restricted, you should arrange to discuss the decision with your health care team. Ask your GP or health team why they have withdrawn or reduced your test strips.

  • If they say that self testing has not had an impact on your results, you may ask for further education to help support your home testing.
  • If cost cutting is cited as the reason you may ask for a copy of the policy that sets out the cost cutting guidelines.

Making a claim against the restriction of testing supplies

Your healthcare team may not be aware of the importance of self monitoring to you. Outline how self testing benefits you.

The following examples may help to improve your chances of being prescribed more test strips:

  • I experience hypoglycemia
  • Testing has improved my post meal blood sugar levels -cite examples
  • Since testing my HbA1c has improved by X%
  • I regularly drive
  • I regularly need to operate dangerous machinery

Making a complaint

If you have discussed your case with your healthcare team and have been unhappy with the reasons for restricting your access to testing supplies, you may wish to complain. A formal complaint may be sent to the following organisations:

  • England: Patient Advice and Liason Service (PALS)
  • Scotland: Your Local health Board
  • Wales: Your Community Health Council
  • Northern Ireland: The Patient and Client Council

It is generally advised to make the complaint in writing, either by letter or email or both.
Should your complaint not be resolved to your liking, you may take your case to the Public Service Ombudsman.

Your Comments
I am a Type 2 diabetic on insulin and glucophage, my doctor has just written to me and said that they have a preferred meter they want me to use and will be prescribing the testing strips for that meter. I dont want to change my meter because I am happy with the convenience it provides, strips are in a self dispensing pre-loaded capsule and the finger pricker is attached to the side of the machine,s o very convenient. Do i have to agree to change to the new meter where the user has to insert the strips and the finger pricker is separate. My gut feeling is that they have gone for a cheaper option?
Posted by IZZY, Essex on Saturday, October 13, 2012
I am a 31 year old diabetic. I have been diabetic for 8 years now, and am truly very sick of it. Having constantly had mouth ulcers, yeast infections, it is so terrible. I associated diabetes with just keeping an eye on sugary foods. Little did i know that even having a flu can make me so ill. And now that my doctor has refused testing strips, stresses me out. When i was diagnosed diabetes, my blood sugars were all the time high, but years after my blood sugars fall below 4, its good I recognise the signs, but dissapointed with my gp. Would it be worthwhile to change surgery to be able to get test strips on the NHS?
Posted by Rashda on Wednesday, August 15, 2012
Hi everybody, I'm type 2 and I did not know we could get strips on the NHS. I have been testing myself for 18 months now and buy my strips from the auction sites. Seeing my GP on Wed for annual review, might try him and see what he thinks. I control by diet but it doesn't seem to work and when I see GP and nurse they don't to really care that my BG is between 7 and 9. Am I safe or should I go on insulin?
Posted by Mike Beaut, Brixham on Sunday, July 01, 2012
How much does it cost to medicate/care for patients with poorly controlled diabetes? I would be interested to know what metformin costs. Like other contibutors I am trying to avoid medication but find it hard without the support of testing. Doctor will not prescribe. Also had on occasions bought strips only to have them expire before use. Low turnover for bought strips perhaps? Why are they so expensive?
Posted by Sylvia, United Kingdom on Wednesday, June 27, 2012
My diabetic nurse has just informed me that as a type 2 diabetic I will be allowed only one box of 50 testing strips per annum. After having consistently high levels for many years I reduce them to within the normal range by regularly testing. Thinking I had cracked it, I tested less in the last year, and they crept up again. However, recently, my levels have been much higher levels following a long lasting infection, causing a leak at the back of my eye. I have had to fight to get increased medication to help restore things to normal. Testing has been vital at this stage. But here is my long term problem. If only 50 strips per annum is my ration, how can I carry out the medics recommendation test at least one day per week throughout the day? 50 strips will not facilitate even one single check per week, and will certainly not allow me test before driving if I have not eaten for some time? As a type 2 diabetic, I have experienced hypos. Mostly I recognise them, but 'test before driving' is a responsibility I take seriously. Presumably the medics will not do my time if I am imprisoned for driving dangerously with low blood sugars. It seems to me that we are now little more than an inconvenient expense, and the new strategy is ridiculous verging on criminal when the health and well being of diabetics are at risk. We will certainly be more costly in the long run when complications arise. I am appalled that type 2 diabetes is not taken seriously by the Government or those they appoint to advise on medication. Especially so when the condition is mushrooming among the population.
Posted by Margaret, Wisbech Cambridgeshire on Monday, April 02, 2012
I have been denied testing strips by my doctor I guess it is a case of money, I buy them myself now as I want to know how I am doing and what my blood sugar is. I managed to get my HBA1C down one point last time I had a blood test, but without the strips it would not have happened. I am told by my doctor I am doing well. I know I am lucky to be able to afford to buy the strips. How do other people manage if they cannot afford the strips? I cannot say that I am happy with the situation but there seems to be nothing I can do in this situation.
Posted by Betty Shenton on Friday, March 30, 2012
I am a type 1 diabetic, diagnosed last summer. When I went to collect my script yesterday, the pharmacy told me I was to be rationed to 3 boxes of strips a month. On this, I can't fulfill my legal obligation to the DVLA to test before I drive. I can't test when I take exercise, or if I'm ill (I'm asthmatic too), or in my very demanding work, or to correct my doses of insulin (I have attended no carb-counting course). This is not safe for me or anyone else, and it is untenable. My diabetic nurse was sympathetic, but said testing more than 4 times a day is a 'lifestyle choice'. How is that please and what am I supposed to do now? If I drive without testing and have an accident I will be legally liable. It is SCANDALOUS! What's more Diabetes UK say they are receiving hundreds of these cases from all over the country - some type 1's have been told to test just twice a day and in some cases just twice a week. This is wrong. It will cost the NHS buckets more in the long run with all the ensuing complications. We need to get very vocal about this, and refuse to take it.
Posted by sue shaw, Oxford on Friday, February 24, 2012
I've also been denied test strips and, guess what, my last HBa1C was up! I saw my Diabetic Doc, and his response was to increase my Metformin dose, but he flatly refushed me any strips. He also refushed to give me an HBA1C test until next year. We had a heated argument, with him saying that when I'd been to medical school for 7 years then I could disagree. I'm lucky, I can afford to buy my own strips. But this is a time bomb waiting to explode.
Posted by benniesmum on Thursday, October 13, 2011
I was even more incensed to read this morning that some people get free bread and cakes on prescription in Wales! This is obviously MUCH more important than free test strips for diabetics.
Posted by benniesmum on Tuesday, July 19, 2011
I used my local hospital diabetic clinic and my nurse left the practice. The first I knew was 6 months later when I went for my next appointment. Since then I have had conflicting advice. I changed to secondary care held at my local chemist after being advised by the nurse at my local practice. I now have excellent service by my new adviser Tracy. This lady took time to explain everything to me and I have learned a lot. Thanx Trace. Now I get letters saying I have missed appointments what do I do?
Posted by oliverl smith, Burton-on-Trent on Tuesday, April 26, 2011
You don't need to test as you only have type 2 diabetes was the standard response from my local health practice, yet the government funded X-pert program for new diabetes patients advised differently, especially for those who were taking Gliclazide medication. Did the doctors agee? No. Unable to take metformin, I was eventually prescribed Gliclazide, which quickly reduced the effects of the diabetes, reduced sugar levels and is allowing me now to lead a normal life. Metformin made me tired, drowsy and at four tablets a day, effectively knocked me out for up to 16 hours a day! The trouble with Gliclazide is the Hypo effect, which was not explained by my health team, and even after suffering a hypo, did not believe it to be true. So I got a meter and next next time it happened, checked my sugars, which were 3.7! The standard answer seems to be you can't change things with tablets - but you can. You change the time at which you take them and it does effect the control as I now know. You know your own body and can read what it is telling you. You will know when to eat and when to increase your sugar levels and maintain a balance. I believe that testing should be available to everyone to enable them to know what affects the levels and what does not. It does not have to be every day, but there in case it is needed. Had I not had the test option available last time I had a hypo, I would not have known how low my sugars were (1.7), and what level of food and type was needed to make me feel better. I drive a lot and need to feel comfortable with myself in terms of being safe to drive. I was diagnosed after feeling very unwell while driving and going straight to the GP the following day. Like all medication it should not be abused, but I strongly believe that the patient should have the choice to be in control of their own condition.
Posted by Ken 53, Worcestershire on Tuesday, April 26, 2011
Hi. I've been a type 2 diabetic for 10 years. I only check my sugar levels from time to time. Perhaps, if you know you are eating sensibly, you would know what your sugar levels would be. But for your records and peace of mind, at least check your blood sugars 2-3 a week. Your HbA1c will tell you if your diet should be improved.
Posted by vicky260411, Isle of Man on Tuesday, April 26, 2011
I went in to my local chemist to reorder my medication and he imformed me that my testing strips had been stopped by the Doctor. BUT he has had a word with the doctor and people with type 2 could purchase testing strips at a reduced price if they needed them! If I needed them why were they stopped in the first place!! I have trouble maintaining my blood sugar levels. As already said on this forum, I don't want to be guessing and I cannot afford the £50-£60 per month needed for strips and lancets. My diabetic nurse does not want to discuss this issue further! I suppose we all have to make sacrifices so our goverment can raise more of our money to GIVE AWAY to Europe. It makes me feel a lot better knowing that Ireland, Greace and Portugal are getting our money through our taxes and our health???
Posted by Trevor Morris, Essex on Tuesday, April 26, 2011
I have Type 2 controlled fairly well by diet - unfortunately not diagnosed for a few years and treated as arthritis when it was really diabetic neuropathy. Have great trouble controlling pain - take Pregabalin and paracetemol and ibuprofen but some days are agony and I have to control tears. Also have plantar fasciitis. Readings are 7.4. Have been told to get below 7 to avoid medication. Any suggestions.
Posted by hermy456, Manchester on Tuesday, April 26, 2011
re strips. My GP told me it was the government who set the rule that type 2 diabetics do not require to test blood sugar as they should know by their symptoms??? Also as a retired RGN, I thought you had to fast for an accurate HbA1C. I really got angry as I diagnosed myself that she gave me a prescription.
Posted by anna timblin, Renfrew, Scotland on Thursday, April 21, 2011
It can never be a waste if a diabetic patient wants to check their blood sugars... After all a hypo will never get back to normal readings without some glucose or jam!!! Shall we wait 'til passing out?
Posted by probatelady, Hove, East Sussex on Wednesday, April 20, 2011
Diabetes can be cured by doing yoga. I have had type 2 diabetes for more than 12 years of my life now for the past 5 years No tablets or insulin. My recommendation for others is to become Vegetarian and practice yoga. You can watch AAstha channel at 5am every day to learn how to do it.
Posted by S. Sharma, UK on Tuesday, April 19, 2011
I am type 2 diabetic. When first diagnosed I was shocked, but did everything I could to bring my sugars under control. I was scared by the thought of complications and determined not to allow that. I was able to get strips prescribed by making a case that I wanted to proactively manage my condition. My HbA1cs came down satisfactorily. I gained some understanding of what I could and could not do. Since then the prescriptions have been stopped. I cannot afford to buy strips. I now feel I am working in the dark and just feel things have slipped. I am not optimistic about the next results. I do not feel I am managing the situation without being able to test. It's a basic principal for anything, if you can measure it you can manage it. How can we be expected to be positive and proactive about managing diabetes when control depends on your financial position?
Posted by Kim Yeomans, Cambs on Sunday, February 27, 2011
There seems to be a misunderstanding within the medical community that only T1's really need to test, and that somehow guessing what you should eat and waiting 6 months to a year to find out if your current diet is controlling your HbA1c is a good method of avoiding complications. Personally, I don't like working on the basis of hope and luck, I'm generally in favour of doing things based on evidence. Surely the cost of the strips is outweighed ten times over by having to treat me for complications because I don't know what my blood sugar levels are?
Posted by The Governor, Hampshire on Saturday, January 22, 2011
My doctor has just informed me that self monitoring is not needed with type 2 diabetes. Is she right?
Posted by Ruth Jones, South East on Thursday, January 20, 2011
I could see how really annoyed was after they came out the surgery. I have asked lots of times for more strips but just have to keep getting them by prescription whenever I can. I order them then order them again & hope they don't notice. HA!HA!
Posted by Morag Walker, Scotland on Thursday, January 20, 2011
Hi, Thank you for this great article :) I live in Malta where they provide free testing strips at a rate of 1.5 per day (which is stupid, either give 1 or 2 but not 1.5) but this is far from being enough. I personally have to buy strips on a regular basis so I can perform more tests and this can be quite expensive each month considering a roll of 50 strips costs 25 Euros. This applies for all diabetics in Malta and after 35 years old, you are no longer eligible for free testing strips at all. What do you think can be done about this? The older you get, the more frequently you should test yourself to avoid complications. Anybody paying social security and contributing to the country should be eligible for more than this, at least 4 strips a day. If anybody has suggestions on what can be done to combat this, it would be highly appreciated.
Posted by Christine, Malta on Thursday, January 20, 2011
I have Type 1 diabetes and have impaired warning signs and have been told to stop testing as much. I drive regularly and with impaired warning signs I won't get behind a wheel of a car unless I know I am ok. Cost cutting strips can cause serious problems for the people involved. Most doctors don't have a clue what it's like to be a diabetic.
Posted by Rebecca Smith, Glasgow on Thursday, January 20, 2011
I have asked several times for strips for self monitoring. I feel it is of great benefit to see what foods make my diabetes worse. Also I feel it is my body, and I am the only person who really cares what goes on with it. The doctor said I could have one, the diabectic nurse said I couldn't as the strips were too expensive. I have type 2 and am on Glucophage sr but my Levels still run to 17. My morning one is 10.8 and I am trying to get this under control and down to accepted levels. I have CKD stage three so it is important for me to self test in my opinion as I cannot monitor with urine strips. I cannot afford to keep buying these strips as I am on a pension. I feel help should be given. I was told type 2 is equally as important as type 1 so I cannot really see what the problem is.
Posted by Angelheart262, Yorkshire on Thursday, January 20, 2011
So far, I have not experienced ANY restrictions on availability of test strips. I use in the region of 4 a day. 1 before breakfast, lunch and dinner and 1 at bedtime. I sometimes wake at night and sense that blood glucose is low and take another test and have a biscuit if it is. Additionally I test before going out to drive. I would be very unhappy if my usage was restricted as I believe that continuous testing controls what I eat and assists in keeping my HbA1c under control. Some people may not be aware that these test strips cost 50p EACH.
Posted by Brian Frankham, Washingborough, Lincoln on Thursday, January 20, 2011
I feel strongly that test strips MUST be made available. I use them to control my BG levels and find that readings help me to know when I have to modify my diet, exercise and stress levels to ensure that I manage my diabetes so that I put off or better still avoid the long term complications this disease can cause. I am fine with a limit being imposed of say 8 per day as that allows me to test before after meals and before bed with one spare in case the blood sample is too small. Restricing me below this would knock my ability to manage my diabetes. The testing is an integral part of my management process. It is ridiculous and odious to restrict test stips such that the patient self management regime is compromised. The longer term outcome being higher costs for the NHS due to amputations, kidney transplants etc.
Posted by Richard Page on Thursday, January 20, 2011
In 2006 I was told if I didn't get control of my bg, I would have to go onto insulin. With the help of close bg monitoring I dropped my HbA1c from 8.2 to 5.9 and reduced my daily medication. Since then my highest is 6.4. Fortunately my Dr recognises my success is in part due to having the bg test strips and has not restricted my prescription, although I do have to request it more frequently as I get 1 pot each time - previously it was 2. These bg test strips are vital to any type 2 diabetic who wants to gain AND keep control of their blood glucose.
Posted by Carol, Dorset on Thursday, January 20, 2011
I have just attended a DAFNE course. Prior to this I tested once a day. Now I test 4 times per day. I have discovered my HbA1c control is not as good as I thought it was and in less than a week have eliminated some high readings and made reductions in the insulin I take. A good case for more testing??
Posted by moyesy, Darlington on Thursday, January 20, 2011
A while ago my doctor reduced my supply to 100 strips annually. Although type 2 I felt that this was insufficient for my wellbeing. However about a year later, without any request from me, my prescription renewal list gained strips to be renewed for 12 issues. This leaves it up to me and, as I have been able to improve my sugar situation by regular testing, I use 150 to 200 annually depending upon my test results. I am constantly trying different foods etc striving to improve even further and the ability to use the strips as needed is essential. Over the last 5 years since being diagnosed, I have managed to bring my sugars down to 6.4 at my last annual check last september thanks to my doctor and diabetic nurse.
Posted by Ron Jones, Snodland , kent on Thursday, January 20, 2011
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