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Study suggests millions could be saved by reducing unneeded diabetes testing

TORONTO - Ontario could save tens and even hundreds of millions of dollars by cutting back on the number of unnecessary glucose tests conducted weekly by people 65 and older who have Type 2 diabetes, Toronto researchers suggest.

TORONTO - Ontario could save tens and even hundreds of millions of dollars by cutting back on the number of unnecessary glucose tests conducted weekly by people 65 and older who have Type 2 diabetes, Toronto researchers suggest.

Their work, published in the Canadian Medical Association Journal, looked only at data from Ontario. But the lead author, Tara Gomes, said the same may be true of other provinces as well.

A more rational policy on glucose self-testing by seniors with Type 2 diabetes could improve the quality of life for the people themselves and ease the strain on provincial coffers, said Gomes and colleagues from the Institute for Clinical Evaluative Sciences and St. Michael's Hospital.

"This could kind of allow redirection of resources to more effective interventions without actually putting at risk the health of any of the people who are currently living with (Type 2) diabetes and testing," she said in an interview.

Any changes would not apply to people with Type 1 diabetes or people who control Type 2 diabetes with insulin. They need to regularly monitor their blood sugar levels and adjust their therapy accordingly.

But clinical trials have found that performing multiple daily tests of blood sugar levels does not help people with Type 2 diabetes who aren't on insulin to control their condition. And there is some evidence it actually provokes anxiety and even depression.

In addition, it costs the province plenty. The researchers found that over the past 12 years, the amount the Ontario government spent on glucose test strips rose by 250 per cent.

They estimate that over the next five years, the province's tab for the test strips used by people 65 and over - picked up by the province - will be $500 million. But in 2008 alone, over 60 per cent of strips dispensed went to people who aren't using insulin.

To look at what might happen to expenditures if policies were changed to reduce the frequency of testing, the researchers ran mathematical models based on several different scenarios. In the most restrictive scenario, people with Type 2 diabetes who aren't on insulin only checked their blood sugar twice a week.

Potential savings ranged from $26 million to $300 million over the next five years, the modelling suggested.

"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," Muhammad Mamdani, director of the Applied Health Research Centre at St. Michael's Hospital and a senior author of the paper, said in a release.

 
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