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Insulin
Dependent
Diabetes
Trust
Limiting availability
of blood glucose test strips
June 2004
IDDT continues to receive reports about
restrictions on the numbers, or total refusal, to prescribe blood
glucose test strips. These reports are usually from people with Type 2
diabetes whether or not they are on insulin but we are also receiving
similar reports from people with Type 1 diabetes.
The attitude to prescribing of strips varies from area to area but when
this is limited or denied altogether, it is a cost-based decision
resulting in post-code prescribing of blood glucose test strips.
IDDT Action
IDDT has written to Ms Rosie Winterton MP, Minister of Health with
responsibility for diabetes, and she confirmed that they are still
available on the NHS. Subsequently, IDDT raised this issue with Mr Tim
Loughton MP who asked the following Parliamentary Questions of the
Secretary of State for Health:
(1) what diagnostic methods are available on the NHS to allow diabetics to monitor their blood sugar levels?
(2) whether he intends that the provision of blood glucose test strips will remain available on the NHS in the long term.
Ms Winterton replied:
There are two types of diagnostic methods available on the
National Health Service that allow people to self-monitor their blood
glucose levels. These are blood glucose testing strips and urine testing
strips. Blood glucose testing strips are available on the NHS for the
foreseeable future and I am not aware of any plans to remove them from
NHS prescriptions.
Ms Winterton is being somewhat badly advised as urine testing strips do
NOT measure blood glucose levels, only glucose in the urine - different
and not sufficiently accurate to achieve the target blood glucose
levels. However, her reply confirms that blood glucose test strips are
available on the NHS and therefore refusal to prescribe them is a local
Primary Care Trust [PCT] policy.
Answers to Questions in the House of Lords confirm that recommendations
to prescribe them are advisory and not mandatory.
Opposing views from the medical profession!
- "People with type 2 diabetes
should have as many test strips as they like."
This is the view of Dr Richard Greenwood, consultant at the Norfolk and Norwich University Hospital, reported in The Eastern Daily Express [13.4.04] who says:
"My view is that people with Type 2 diabetes should be offered as many tests as they would like. A lot of patients feel more comfortable if their blood test is normal. There is a reassuring element with these strips which is very important with a condition like diabetes. This is where evidence based medicine and what patients want is at odds. I think PCTs are taking the health economics approach and trying to reduce expenditure whereas they should take a more humanitarian approach."
• But in Coventry there is a campaign to reduce testing!
The cost of blood glucose test strips to Coventry PCT was £700,000 in 2003. The Warwickshire Evening Telegraph [5.12.03] gives headlines to a new campaign:
"Local health bosses are concerned that people are blood glucose testing too often for no good reason and have launched a campaign highlighting "sensible" use."
Coventry GP, Dr Rodney Swallow says:
" Some patients are testing themselves at home more often than they need to and perhaps it is becoming an automatic thing. We are not saying that people should not test themselves, it definitely has its uses and it is a basic part of monitoring and treatment, if it is done correctly. Some people may be testing four or more times a day, everyday which is unnecessary. Too much testing can be scary, especially for older people who may become more anxious about their condition. Too much testing can lead to a lot of soreness of the fingers."
IDDT's advice:
If you are denied the glucose test strips you need, you should take
this up first with your GP and if this fails, with the Primary Care
Trust.
The following information may be useful in your discussions:
- The Minister has confirmed that blood glucose test strips are available on the NHS and there are no plans to discontinue this arrangement.
- It was on the recommendation of diabetes specialist that blood glucose testing was advised in the first place and not a mere whim of patients.
- The National Service Framework for Diabetes aims to increase patient empowerment and make them more responsible for their own treatment and care, restrictions on strips is not in line with these principles.
- There is no evidence that blood glucose testing actually improves diabetes control but Dr Greenwood highlights the needs of patients to have the assurance and comfort of knowing what their blood glucose levels so that they can take the necessary action.