Assessment of self-monitoring of blood glucose in individuals with type 2 diabetes not using insulin

In light of the ongoing national conversation over wasteful and inappropriate health care, University of Michigan researchers looked at whether blood glucose monitoring among non-insulin-dependent type 2 diabetics might be an area for improvement.

In light of the ongoing national conversation over wasteful and inappropriate health care, University of Michigan researchers looked at whether blood glucose monitoring among non-insulin-dependent type 2 diabetics might be an area for improvement. Previous study has suggested that these patients, if prescribed metformin or other medication that is unlikely to cause hypoglycemia, do not have better disease control or other outcomes if they check their blood glucose levels daily. Yet, according to the Michigan team, tens of thousands of people pay out of their pocket for medical supplies to regularly check. Their retrospective analysis used deidentified claims data from a commercial database from January 2013 to June 2015, specifically from adults with type 2 diabetes who filled at least three claims for test strips during a calendar year and from their counterparts who did not file any. Among 86,747 in the first category, more than one-half were suspected of using the supplies inappropriately. Patients not taking drugs likely to trigger hypoglycemia (32,773) and those not taking any anti-diabetes agent (19,047) used a median of two test strips per day. The median claims cost for the supplies was $325.54 per person per year. Interventions are needed to improve engagement among caregivers and educate patients about low-value care, including alerts when ordering test strips for patients on nonhypoglycemic medications, physician communication training, and pharmacist review, to name a few possibilities.