Restricting test strip access for people with type 2 diabetes sends the wrong message, study argues

Restricting access to test strips for people with non-insulin-dependent type 2 diabetes “sends the wrong message,” according to new research.
The study, conducted by researchers at the Australian Centre for Behavioural Research in Diabetes, Australia, urges the government to provide test strips for people with type 2 diabetes, even if those people are not dependent on insulin. Doing so would encourage and enable people with type 2 diabetes to take control of their blood glucose management.
Currently, people in Australia with non-insulin-dependent type 2 diabetes who have their blood glucose levels under control are limited to 100 strips per year. In the United Kingdom, access to test strips is similarly restricted. Under most circumstances, people with type 2 diabetes who are not dependent on insulin will not receive access to test strips on prescription, despite evidence that self-monitoring of blood glucose is beneficial.
The decision to restrict test strips in Australia is based on a three-year review, which described the clinical benefits of self-monitoring of blood glucose for people with non-insulin-dependent type 2 diabetes as “limited.” It echoes the recommendations of Choose Wisely Australia, an organisation that aims to eliminate unnecessary medical testing. The organisation said: “Don’t advocate routine self-monitoring of blood glucose for people with type 2 diabetes who are on oral medication only.”
To an extent, the researchers agree – random, infrequent blood glucose testing is ineffective because it does not allow patients and healthcare professionals to act on the blood glucose patterns they detect. But, when testing is “structured,” which means it is done regularly and frequently, testing leads to lower HbA1c levels, less fluctuation in blood glucose levels, and less time spent with high blood glucose.
“Restricting access to glucose monitoring strips conveys the wrong message philosophically,” the authors concluded. “At face value, it implies that some forms of diabetes require less monitoring and are, therefore, less serious than other. Yet all diabetes is serious and all diabetes lead to complications if not monitored and managed appropriately.”
The findings were published in the Medical Journal of Australia.
The Type 2 Testing Program provides a free blood glucose monitor, a structured support program and a monthly supply of test strips, for a quarterly or annual fee. After taking part in the program, users experience an average drop in HbA1c levels of 1.2 per cent.