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Access to test strips – a postcode lottery?

Many people with diabetes need, or find it useful to, self-monitor their blood glucose levels. This is usually done with a finger prick blood test using a blood glucose meter that indicates the blood glucose level at the time of the test. For many people with diabetes self-monitoring is necessary to manage their diabetes well. Not everyone needs to self-monitor, but if they do they should have access to test strips and the meter they need.

Diabetes UK is concerned that people with diabetes are experiencing restrictions in their access to test strips and meters. We have conducted three surveys since 2013 to monitor the restrictions and assess the impact on people with diabetes.

Test Strip and Meters Survey 2016

The most recent survey conducted from March to May 2016 found that 27 per cent of the 1,000 respondents have, in the past 12 months, been refused a prescription for blood glucose test strips or have had the number of test strips on their prescription restricted. Of these, over half (52 per cent) have Type 1 diabetes. This is of particular concern as NICE recommends that all adults with Type 1 diabetes should routinely self-monitor their blood glucose levels, and test themselves at least four times a day, including before each meal and before bed. For people who are frequent drivers, taking regular exercise or who are at high risk of hypos this could increase to around ten times a day.

Budget constraints or “excessive testing” were the most frequent reasons given for the refusals and restrictions. People with diabetes found these restrictions stressful and had to make difficult decisions about when to test or not. As a result many had bought or considered buying test strips from pharmacies or online.

In addition, 66 per cent of respondents were given no choice of blood glucose meter. Of these, one in four (25 per cent) were not happy with the meter provided. For instance, the meter was too large to easily move around or didn’t upload the data to a computer.

Previous surveys have also found that the restrictions had a considerable impact on the ability of people with diabetes to manage their diabetes and people were concerned for their immediate safety and future health.

Rationing blood glucose test strips for these people is unsafe and puts the health of people with diabetes at risk. It is an unacceptable example of short-termism, storing up long-term costs for the NHS because diabetes complications are extremely expensive to treat.

Diabetes UK is calling for prescriptions for test strips and provision of meters to be agreed on a case-by-case basis and in a joint decision-making process between the person with diabetes and their doctor. Local policies should allow sufficient choice and flexibility for individual circumstances to be taken into account when prescribing test strips and meters for people with Type 1 or Type 2 diabetes.

The fullreport of the 2016 survey (PDF, 132KB) is now available to download and read. 

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