"Psychologically Dependent" Type 2s Use Too Many Test Strips?

| Oct 2, 2007

According to Pulse, the UK's leading medical weekly, a review of the evidence has concluded that for type 2s on oral medication whose A1c's are below 7.5%, blood glucose monitoring offers "little advantage and may increase the likelihood of hypoglycemia."

According to Pulse, the review "could give GPs the confidence to resist pressure from well-controlled but psychologically dependent patients to allow them to continue self-monitoring."

Speaking to Pulse, Dr. Stephen Lawrence said, "GPs who are not diabetes specialists can feel under pressure to allow patients to self-test because the patients feel it is part and parcel of their diabetes care…There should be better education that while self-monitoring gives you a snapshot of your diabetes control, the A1c gives more of a camcorder approach over several months."

Dr. Ike Iheanacho, editor of the Drug and Therapeutics Bulletin (which published the study), added, "I don't think we can assume GPs know that the case for self-monitoring of reasonable control has yet to be made. It will come as a surprise to lots of people…Self-monitoring depends on proper medication because it is not a treatment in itself."

According to Pulse, a publication read by eighty percent of Britain's physicians, many GPs continue to encourage routine monitoring of blood glucose despite a lack of evidence of benefit for many patients. This reckless habit forced the National Health Service to spend over $65 million on monitoring agents in the last quarter of 2006 alone.

Source: Pulse, September 2007

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Categories: A1c Test, Blood Glucose, Diabetes, Diabetes, Low Blood Sugar, Meters, Type 2 Issues

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Posted by Anonymous on 27 October 2007

I've been recently diagnosed as well with an A1c of 9.3. I'm told I'm type 2 but I'm on 2 oral meds and 2 types of insulin injecting up to 5 times a day. I was previously uninsured and now that I've purchased the ONLY insurance available to me, they only allow type 2 diabetics to test 4 times a day.. or rather only pay for 4 test strips per day. I hate that the insurance company is dictating to me how often I should self monitor. Being newly diagnosed I need to test frequently to learn how what I eat, when I eat and how I exercise effects my blood sugar. Going from healthy to insulin dependant so quickly and now having to spend literally hundreds of dollars more per month to maintain my health, and being told the insurance company won't cover the cost for me to test more than 4 times a day really infuriates me! Especially since the doctor tells me the cause of my diabetes is genetic and not life-style.

Posted by jolo on 1 November 2007

This is insanity.
This article is almost like a satire from the old Monty Python show. Dark satire.

What a horrible situation this shows on how Diabetes is spreading faster than a wildfire all over the world. Yes, Diabetes is a 10 billion money maker for Big Pharm, but it is also crippling governments budgets who have any programs to pay for Diabetic care.
Big Pharm DOESN'T MAKE MONEY ON METERS !!Any Diabetic could call ANY meter manufacturer/distributer and get a free meter. Even their most expensive brand.
Why, because of the "organized crime" activity created by the collusion of Big Pharm, The FDA, U.S. Congress and the ADA.
Test strips are price fixed among the industry with the game "rigged" so that there is no competition and an item vital to Diabetes Management cost a company 1 to 2 (at most) cents per strip to make and distribute.
The retail cost of Test Strips ranges from $1 to $1.50.
This is because of the collusion between these entities that ensure that THERE IS NO GENERIC TYPE OF TEST STRIP. There are standards in force for EVERY SINGLE TYPE OF MEDICAL TEST FOR ALL BLOOD WORK, URINALYSIS, ETC, EXCEPT FOR THE STRIP TO TEST FOR BLOOD SUGAR. Every single brand of meter is made to only work with the test strip THAT IS MANUFACTURED/DISTRIBUTED by the company that makes the meter !! That is why any meter company will give overjoyed to give their meters away to any Diabetic who calls them !!
Call your Congressman, the FDA and let them know that the FDA HAS TO ALLOW FOR A GENERIC STANDARD FOR ALL METERS. Then they will be sold for what they are worth and this will allow competition in the marketplace.
Jon T.

Posted by Ladybird on 19 January 2008

I had read the article mentioned above in the BMJ and had infact written a letter to them that how outrageous it was that doctors could even do such a study and how Type 2's used the glucose monitor to see which foods were suitable/unsuitable to keep their glucose levels as "normal" as possible.

The ADA, I was surprised, actually finally wrote a letter also saying that they recommended testing for Type 2's, it was a good way to keep control. Most physicians, who had written to comment on the above research, had also written that they were surprised that anybody could even suggest that frequent testing at home, was not a good thing for Type 2's.

As all the above posters have said, there's just no way a 3/4 monthly A1c reading is ever going to help any diabetic to keep control. The A1c is only an average "idea", of where our glucose levels are; they certainly help us but not in the way that frequent testing at home in the long run is going to help us and does help us to keep control.

It is definitely the very high cost of tests strips which hamper the uninsured to able to control their diabetics. At a time of a diabetic epidemic across the US and most of the world, we need to emphasize to the Presidential candidates how important a better Health Care system is for all of us. An important part of it is being able to have better/free, if need be, access to diabetic supplies for those uninsured diabetics.

Posted by Anonymous on 26 January 2008

I completely agree with the comments that think this Pulse piece is rubbish. I use my meter as a learning tool and have discovered that some of the dietary guidelines are not precise. Whole grain cereals and breads as sold in stores give me a huge post meal spike for instance. Without self testing I would be merrily eating sandwiches made of whole wheat bread and getting much higher A1C scores.
Thanks to my meter, my A1C is 5.6, which means that I'm more likely to avoid complications. Since blood sugar has some correlation to cholesterol levels, that has gone down as well, (122 down from 143).
The article says that A1C of 7.5 is acceptable. Acceptable to who, some insensitive egghead with a stethoscope around his/her neck?

Posted by Anonymous on 2 April 2008

i just got a generic letter from my doc today stating diabetics not taken insulin will not be getting testing strips from them now .. i have an goood a1c (that my doc hasnt even talked to me about yet .. i had to bed the receptionist to tell me it.. doc wouldnt see me!) but this is due to me testing , can my doc now refuse me, it was on my repeat prescription and i wish to keep my a1c at a good level, i would change docs but it looks like everyone will follow suit, i praise uk health care alot but it seems to be letting me down :(

Posted by Anonymous on 7 August 2008

Well, I have health insurance (a captiated HMO plan) and a 'primary care' doctor, I'm type 2 for the last 10 years. I couldn't get a prescription for test strips - even though insurance would cover 150 of them for $10 a month, I haven't had an eye exam or an A1C for nearly 2 years. I get to see the doctor later this month, but it will probably be another 10 minute cattle call, full of empty promises. I can't even get the 'well woman' screening tests normal for a woman of 55. The insurance company is no help. They say that they cannot tell him how to practice medicine. I can't find another doctor, but I continue to try. I got so much better care on a PPO plan, but my employer picks the insurance. I am afraid of developing 'complications' but trying to do this all by myself is very confusing. Thanks for the newsletter. I rely on it for all of the diabetes info I get. Those of you who actually have a diabetes team - be very grateful. Wish I had something like that. Thanks!

Posted by volleyball on 20 January 2009

I liked the reference the pulse gave to cut out strips, that it costs so much money. Typical bean counter looking at one piece of the pie.
I would like the insurance company to give everyone tons of strips. The problem is that our premiums would go up so much. I cannot blame them for having limits. So for those that chose to use a lot of strips, then they can chose to pay for them. You will be paying directly or through your premium payments.
But back to the article. A1c is a great tool. But it gives an average. So it is useless to see how a food will affect you. Or if you are in a hypo. A1c and meter testing go hand in hand to guide you towards good control.
To the docs that do not want to give out strips. I suggest that all their patients wait until one hour before closing to arrive. Their work day totals will average out to a few patients an hour so what's their complaint?

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