For people with Type 2 diabetes, the task of testing their blood sugar with a fingertip prick and a drop of blood on a special strip of paper becomes part of everyday life. But a new study suggests that some of them test more often than they need to.
In fact, the research shows, 14% of people with Type 2 diabetes who do not require insulin are buying enough test strips to test their blood sugar two or more times a day – when they do not need to test nearly that frequently according to medical guidelines.
That's costing them time and sometimes worry while their insurance plans pay hundreds of dollars a year for their supplies. Multiplied over the millions of Americans who have Type 2 diabetes, the findings could mean millions of unneeded blood sugar tests and millions of dollars spent for no good reason.
The study, published in JAMA Internal Medicine by a team from the University of Michigan, focuses on the subset of people with Type 2 diabetes who research has shown don't get a benefit from daily tracking of blood sugar levels. This includes both patients who don't take any medicines to reduce their blood sugar, and those who take oral medicines that don't require monitoring.
How the study was done
Platt and senior author A. Mark Fendrick, M.D., a professor in General Medicine, decided to look at information from a national insurance database made available through U-M's Institute for Healthcare Policy and Innovation, of which Fendrick is a member.
They focused on data from after the Endocrine Society and Society of General Internal Medicine issued their guidelines to reduce inappropriate home testing in 2013 – and looked at patterns of test-strip prescription fills over one year of each patient's records.
The study included patients with private insurance whether obtained through a job or through Medicare Advantage plans that cover about a third of people over age 65.
They only studied Type 2 diabetes patients who were not taking insulin, and who filled prescriptions for packets of 90 test strips three or more times a year, suggesting that they were testing their blood sugar regularly. They also looked at data from patients who didn't fill any test strip prescriptions.
In all, 23% of the study population 86,747 people filled test strip prescriptions three or more times. But more than 20% of this subset didn't fill any prescriptions for diabetes medications medicine at all and another 43% filled prescriptions only for metformin or other medicines that didn't carry a risk of hypoglycemia. After the patient has found the dose of these medications needed to keep their sugar levels stable, they don't need to do daily testing.