Self-monitoring with blood glucose test strips inefficient use of health-care resources

Routine self-monitoring of blood glucose levels by people with type 2 diabetes who are not taking insulin is an ineffective use of health resources as the modest benefits are outweighed by the significant cost of test strips, suggest 2 studies in CMAJ (Canadian Medical Association Journal).

In Ontario, blood glucose test strips are the third largest cost for the Ontario Public Drug Programs in 2007/08, accounting for $100 million or 3.3% of drug expenditures. Usage of test strips increased by almost 250% from 76,320 people in 1997 to 263,513 people in 2008. Almost 53% of people aged 65 and over with diabetes received diabetes test strips by 2008. Sixty-three per cent of patients not receiving insulin used blood glucose test strips in 2008.

"In light of the overall costs and questionable benefits of blood glucose self-monitoring in many patients, more focused policy decisions regarding test strips have been proposed in several jurisdictions," write Muhammad Mamdani of St. Michael's Hospital in Toronto and coauthors in a study on options to reduce test strip usage. They project that expenditures associated with blood glucose self-monitoring will exceed $1 billion in Canada and suggest policy changes could lead to cost reductions.