Are Blood Glucose Test Strips For Diabetic Patients Overused?

People with diabetes can benefit from regularly checking their blood glucose. Using meters which comprise test strips is the most accurate way to do this, because it allows patients to keep a log of their results, a vital tool in keeping their condition under control.

Typically, after inserting a strip into the meter, the diabetic person uses the lancing device on the side of his/her fingertip to get a drop of blood and then squeezes the finger until a drop of blood forms. He/she then touches and holds the edge of the test strip to the drop of blood, and the blood glucose level appears on the meter's display. The test strips are recommended for people who have diabetes and are taking insulin or diabetes pills, on intensive insulin therapy, pregnant, having a hard time controlling their blood glucose levels, having severe low blood glucose levels from high blood glucose levels, or having low blood glucose levels without the usual warning signs.

However, a new Canadian study suggests that many diabetics who use the strips, especially those that are not taking insulin, may not need to. The study tracked test strip utilization between 1997 and 2008. It found that the use of test strips over this time period among older patients has increased by more than 250%, with use increasing among all diabetes patient groups, including those at low risk of drug-induced hypoglycemia. It reported that “30% of patients who did not use drug therapy to control their diabetes and 60% of patients taking oral glucose-lowering drugs not known to cause hypoglycemia were dispensed blood glucose test strips, despite evidence of no clear clinical benefit and some suggestion of harm.” For diabetics who are not taking insulin, some evidence suggests that regular self-monitoring can lead to increased discomfort, inconvenience, and worsening of depression, while it does not lead to improvement in the patients’ condition.

The study concludes that “in light of the overall costs and questionable benefits for many patients, […] we estimate that test strip use among older patients could have been reduced by between 9.5 million and 74.5 million in 2008.” Since each strip costs almost $1 and patients use multiple strips per day, it is suggested that these cost savings can be used to improve diabetes care in ways that are better supported by evidence. Instead of over-reliance on the test strips, experts suggest that patients should focus on their diet, exercise, weight and blood pressure.

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