Posted on 12/21/2009 9:55:22 AM PST by decimon
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 http://www.cmaj.ca/embargo/cmaj091017.pdf and http://www.cmaj.ca/embargo/cmaj090765.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca .
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.
thanks, bfl
My doctor is a military doctor at a military hospital. She always wants to make sure that I track my blood sugar at a minimum twice a day. She and the other doctors I have had there have been great and leave nothing to chance. I’ve had more poking and prodding since retiring from the military than I ever had on active duty. After a military career and 16 years of retirement from the military I have received nothing but top rate care; same for my family. My hope is that it will continue but that hope is dimming. My wife has her primary provider through our workplace and her secondary is Tricare standard. Her coverage is as much in jeopardy as mine. If it comes to a confrontation I am fully ready to take part because I still hold to my oath to defend the Constitution against the Nazi democrat party.
Guess you’ll need to deteriorate to Type 1 Diabetes in order to get strips.
But the kicker now will be that insulin won’t be covered!
Is it just me, or are others noticing the pattern? Most of the medical news since the Democrats went over the cliff on medical care is about how preventative medicine is a poor use of resources, and we'd be better off without self monitoring of glucose, without mammograms, without pap smears, and without so many other tests that used to be considered essential back in the days when doctors who cared about patient outcomes made medical decisions. Today, with government bean counters in charge of medicine, we're going to get the "change" that Obama promised.
Blood glucose test strips: options to reduce usage
Here's the conclusion of the second abstract:
Interpretation: Many people who self-monitor their blood glucose are at relatively low risk for drug-induced hypoglycemia. The economic benefits associated with more selective testing could be redirected to more effective interventions for patients with diabetes.
IMHO, it's probably a reasonable conclusion, but in this atmosphere poisoned by rat duplicity, you can't have a rational discussion.
FReepmail me if you want on or off the diabetes ping list.
Thanks.
Diabetes ping list? I’ll try to keep you in mind if anything interesting comes up.
I’ve been doing this for a long time although I am not a diagnosed diabetic. I can find some good deals on ebay of unused strips. Just be sure to find some that are not expired or close to expiration. Another tip: The brand sold by Wal-Mart at a fraction of the price of others also gives very good and accurate results and they are also available on ebay.
I think it is just good insurance to keep from tipping into Type II diabetes as it is so common with obesity. And keeping weight off as we age is no easy task.
As the parent of a type 1 diabetic, pictures like those are very difficult to view.
So non-diabetics are using these strips to assess their condition. At their own expense. And competition is indeed keeping down the price. Sounds just right.
Most of the Test Strips are $50.00 for 50
“I take it that's good but I don't know”
My doctor didn't seem to have a problem with that variance
The test strips are an OTC item. It looks like Moe is attempting to shift costs.
Your doctor didn't have to pay for the strips. I think it would be good for medicine to be more consumer driven.
I can buy the strips without a prescription, but with a prescription my insurance picks up half the cost.
Unfortunately they are controlled use items so you have to have a prescription. That means seeing a doctor and the doctor is probably going to enforce the "standards of care".
I've heard many doctors are quite susceptible to intimidation so if your doc won't give you a prescription you know what to do.
With 5% of the population having the genes for Type II odds are excellent for you to get a jury with a diabetic on it, so you'll walk.
Folks using glipizide and glucophage are at considerable risk of hypoglycemia ~ which makes me think the guy who wrote this article is an idiot and didn’t correctly report what he was told.
I don’t believe it is accurate to say that glucophage increases the chance for hypoglycemia. I don’t know about the other med you mention.
The strips are an OTC item and do not require a prescription nor are they required for the lancets. The kits to measure the glucose levels are available most anywhere OTC or on the internet. I’m not sure about the insulin, however as it might be a prescription item.
To get some idea of the savings available, 50 strips of the Ascencia Contour strip which I use retail for about $57 at Wal-Mart. However, I regularly buy them from ebay for perhaps $15-$20. Alternatively, the house brand at Wal-Mart is considerably less retail but highly accurate as I have compared the result alongside one another. It might vary a point or two. The best test result is with the A1C test but that is more expensive and typically done with the blood work-up at the doctor’s office. For the average patient it is much easier to do the test at home.
Oddly enough, the highest readings are often in the morning and are known as the “Dawn phenomenon” and readings taken two hours later after meals will show perfectly normal. There has been much literature on this subject by many sources. One can read up on this and become educated on the actual facts.
Regardless, diabetes is a serious problem and could lead to early death from cardio problems; strokes and heart attacks and possibly blindness as the retina is affected as it also is with high blood pressure. I keep a VERY close watch on both at my age, 66, to ensure I don’t prematurely wear a toe tag or have to get about with a white cane.
I don’t believe it is accurate to say that glucophage increases the chance for hypoglycemia. I don’t know about the other med you mention.
The strips are an OTC item and do not require a prescription nor are they required for the lancets. The kits to measure the glucose levels are available most anywhere OTC or on the internet. I’m not sure about the insulin, however as it might be a prescription item.
To get some idea of the savings available, 50 strips of the Ascencia Contour strip which I use retail for about $57 at Wal-Mart. However, I regularly buy them from ebay for perhaps $15-$20. Alternatively, the house brand at Wal-Mart is considerably less retail but highly accurate as I have compared the result alongside one another. It might vary a point or two. The best test result is with the A1C test but that is more expensive and typically done with the blood work-up at the doctor’s office. For the average patient it is much easier to do the test at home.
Oddly enough, the highest readings are often in the morning and are known as the “Dawn phenomenon” and readings taken two hours later after meals will show perfectly normal. There has been much literature on this subject by many sources. One can read up on this and become educated on the actual facts.
Regardless, diabetes is a serious problem and could lead to early death from cardio problems; strokes and heart attacks and possibly blindness as the retina is affected as it also is with high blood pressure. I keep a VERY close watch on both at my age, 66, to ensure I don’t prematurely wear a toe tag or have to get about with a white cane.
The danger with insulin is that with the chance of accidentally injecting into a blood vessel, the first symptom you can have is a loss of consciousness.
Oral agents are much more likely to have prior symptoms like breaking into a cold sweat and feeling light headed before that happened. That can happen with insulin too, but those symptoms are warning signs that can be remedied with adding concentrated sugar in orange juice or soda pop.
How recent is that Meta? I used to get A1c kits (First Choice?) at WalMart then they disappeared about two years ago. I think they ran about $22 for the monthly test.
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