Type 2 more restrictions on self testing coming soon ?

Reduction in self-monitoring of blood glucose in type 2 diabetes: an observational controlled study in east London

Abstract
 
Background Self-monitoring of blood glucose (SMBG) confers no benefit for many people with type 2 diabetes not being treated with insulin. It accounts for 21% of diabetes prescribing costs.

Aim To improve care quality at reduced cost for type 2 diabetes by reducing unnecessary SMBG.

Design and setting Non-randomised, observational controlled study in two intervention clinical commissioning groups (CCGs) and one control CCG in east London.

Method In total, 19 602 people with type 2 diabetes not being treated with insulin were recruited from two intervention CCGs; 16 033 were recruited from a control CCG. The intervention (from 2010 to 2013) comprised implementation of a locally developed guideline, including IT support and peer feedback of performance. Data on practice prescribing SMBG testing strips were gathered using GP electronic health records. Information on costs were obtained via the ePACT electronic database.

Results Over 4 years, in all non-insulin type 2 diabetes treatment groups, use of SMBG was reduced in the two intervention CCGs from 42.8% to 16.5%, and in the control CCG from 56.4% to 47.2%. In people on metformin alone or no treatment, intervention CCGs reduced SMBG use from 29.6% to 6.0%, and in the control CCG use dropped from 47.1% to 38.7% (P<0.001). From 2009 to 2012 the total cost of all SMBG prescribing (type 1 and type 2 diabetes, including users of insulin) was reduced by 4.9% (£62 476) in the two intervention CCGs and increased in the control CCG by 5.0% (£42 607); in England, the total cost increased by 13.5% (£19.4 million). In total, 20% (3865 of 19 602) fewer patients used SMBG in the intervention CCGs.

Conclusion This low-cost programme demonstrated a major reduction in unnecessary prescribing of SMBG, along with cost savings. If replicated nationally, this would avoid unnecessary testing in 340 000 people and prescribing costs that total £21.8 million.


Full text: http://bjgp.org/content/65/633/e256

Such shortsightedness. £21.8million is a drop in the ocean for the NHS. Penny pinching to the extreme.

For the many T2's who use the strips constructively to adjust the carbs to their meter-especially in the early days-pulling the plug could remove this most valuable tool for many who cannot self fund which in the long run will cost the NHS far more in diabetic complications...BIG mistake and very counterproductive!

We already have restrictions in the US. I only got a cheap meter with 100 test strips when I was first diagnosed from Medicare. And when I ask for a refill after a month (I did not know they were suppose to last 3 months) the pharmacist said that I was trying to refill too soon. After that I did not qualify for any more refills. That was sort of OK since I did not like the cheap meter. I don't think that it even met the +- 20% guidelines.

Still from TV ads (from back when I had a TV) I expected that my medicare diabetic supplies would be delivered to my door. Now if you want to eat to your meter in the US and are on medicare you need to be able to afford your own supplies. I use the Freedom FreeStyle Lite meter and the best price I could find was $40 per 50 test strips. That adds up quickly especially when I was testing 6+ times a day.

I live in fear that someone will tell the Australian Government that it's a great way to save money

And when all the complications have to be paid for, we can always blame the other side - the blame game and passing the buck has become the only trick the politicians know these days. And they wonder why nobody listens to them any more

A few people at the flog are saying that this article is an elaborate April Fool's Day "Joke"

The sad reality is testing for many type two diabetics is very often a complete waste of time and money.

1. If they follow the usual dietary advice from the NHS and DUK they are never going to see safe numbers.

2. So many diabetics refuse to change their ways and stop eating junk.

3. Even those that can get to the NICE guidelines (as promoted endlessly at the flog) re. BG numbers are a high risk of complications.

Etc. etc. etc.

Indy51 wrote:A few people at the flog are saying that this article is an elaborate April Fool's Day "Joke"

I saw that too Jill!

This got me tapping my head against the wall earlier.

This is what I posted on the Low-Carb Blog:

This is absolute bonkers. The study is essentially saying; this costs money, we are investigating whether doing less of it costs less money. The conclusion? It does! Wow! Money well spent study people.

FFS!

This will get waved in the face of Type 2's as proof of something else entirely.

Note how that it does not appear to address at all the core assertion that "(SMBG) confers no benefit for many people with type 2 diabetes". What bollocks that is; it's patently untrue. If and here's the million dollar 'if' if you know what to do about the results and can free yourself from the things causing the high blood sugar.

From reading the link there is no suggestion at all that HbA1c was even measured. So how can they test that?

Additionally, of course, as it is NHS policy to keep to the low-fat high carb diet the diet these people would have been advised to stick to would be just that; the good old NHS diet of death and guess what? Even with blood testing if you are eating 100's of carbs a day things aren't going to get better.

What an outrageous piece of idiocy this is.

We are on our own here when this type of rubbish gets any attention.

Dillinger

Also note this bit of 'we're not very good at this job so let's fudge the results' type thinking;

"Patients report that use of SMBG can be associated with feelings of blame or failure, and disappointment when clinicians are disinterested in readings."

So, you've been given really bad nutritional advice and you do your best to follow it but your devilish SMBG is just showing that the nutritional advice is shit. Guess what? These are DOCTORS speaking to you and even more certain in their knowledge DIABETIC NURSES; so poor you - the reason your blood sugars are so appalling is you; you failure. You're not really following the diet we set are you? Do you like chocolate? Of course you do. Hobnob?

To compound all this when you ask me about your blood sugars I can't be bothered to look at your silly little jottings in your school book. I bet that makes your feel like no one gives a damn? Yes, yes. Well done. We'll see you in 12 months if you excuse me I have a meeting with that nice man from Merck; he's got a fantastic golf handicap.

So, the advice is terrible and no-one follows up on the data you have showing that. The best thing to do? Get rid of the data! Everyone's a winner. Except you. But you can't have everything eh? Or in your case 'anything'. Is that the time? I really have to go; we're teeing off in half an hour.

Best

A strangely annoyed Dillinger

I like the strangely annoyed Dillinger ! He talks a lot of sense !

mo1905 wrote:I like the strangely annoyed Dillinger ! He talks a lot of sense !

Dillinger is only a light weight, he hasn't been banned from the flog yet. When he gets banned I'll start taking him seriously.

Loose Cannon wrote:

mo1905 wrote:I like the strangely annoyed Dillinger ! He talks a lot of sense !

Dillinger is only a light weight, he hasn't been banned from the flog yet. When he gets banned I'll start taking him seriously.

Watch it you; at least I don't keep changing my name. I just had a post deleted by our friend Noblehead if that's any help?

Dillinger wrote:

Loose Cannon wrote:

mo1905 wrote:I like the strangely annoyed Dillinger ! He talks a lot of sense !

Dillinger is only a light weight, he hasn't been banned from the flog yet. When he gets banned I'll start taking him seriously.

Watch it you; at least I don't keep changing my name. I just had a post deleted by our friend Noblehead if that's any help?

LOL!! You didn't say anything negative about the British Heart Foundation did you? A sure fire way to get ol' Nige breathing fire!

Dillinger wrote:

Loose Cannon wrote:

mo1905 wrote:I like the strangely annoyed Dillinger ! He talks a lot of sense !

Dillinger is only a light weight, he hasn't been banned from the flog yet. When he gets banned I'll start taking him seriously.

Watch it you; at least I don't keep changing my name. I just had a post deleted by our friend Noblehead if that's any help?

Sorry Dillinger a post deletion by Noblehead doesn't count. That bloke would sell his Granny for a bag of Hobnobs, and a pat on the head from Anna.

OldTech wrote:We already have restrictions in the US. I only got a cheap meter with 100 test strips when I was first diagnosed from Medicare. And when I ask for a refill after a month (I did not know they were suppose to last 3 months) the pharmacist said that I was trying to refill too soon. After that I did not qualify for any more refills. That was sort of OK since I did not like the cheap meter. I don't think that it even met the +- 20% guidelines.

Still from TV ads (from back when I had a TV) I expected that my medicare diabetic supplies would be delivered to my door. Now if you want to eat to your meter in the US and are on medicare you need to be able to afford your own supplies. I use the Freedom FreeStyle Lite meter and the best price I could find was $40 per 50 test strips. That adds up quickly especially when I was testing 6+ times a day.

$40 per 50 test strips sound a lot to me !!

But you have done fantastically well with your numbers, as well as many Forum members have.

Thank goodness for the internet / home research / and like minded people.

All the best Jan

Indy51 wrote:A few people at the flog are saying that this article is an elaborate April Fool's Day "Joke"

The study was first published by the BMJ on Tuesday 31st  March so can't be an April Fools joke. 

Research News
Simple education reduces inappropriate blood glucose self monitoring in type 2 diabetes, study shows
BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h1715 (Published 31 March 2015)

http://www.bmj.com/content/350/bmj.h1715

You miss the point. If T2 get problems then drugs company's get more money treating them.
To be very blunt.... A whore needs a client to make money...guess which is which