Blood Glucose Testing and PharmaCare Annual Quantity Limits

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Understanding the PharmaCare Quantity Limits (effective January 1, 2015)

Recent research shows that most people with type 2 diabetes who are not using insulin do not need to test their blood sugar as often as they do now.

There is very little evidence that more frequent self-monitoring of blood glucose improves diabetes care.

As of Jan. 1, 2015, a patient's annual limit will be based on the diabetes treatment they are receiving.

The annual limits provide enough strips to account for normal variations in self-monitoring of blood glucose necessitated by common health changes (e.g., colds, influenza).

Treatment Category

Notes

Annual Quantity Limit

Managing diabetes with insulin

If a patient takes insulin, this higher limit applies whether or not they are also taking other diabetes medications.

3,000

Managing diabetes with anti-diabetes medications with a higher risk of causing hypoglycemia

Drugs with a higher risk of hypoglycemia include insulin secretagogues (e.g., sulfonylureas such as glyburide and meglitinides such as repaglinide).

400

Managing diabetes with anti-diabetes medications with a lower risk of causing hypoglycemia

Drugs with a lower risk of hypoglycemia include alpha-glucosidase inhibitors such as acarbose, biguanides such as metformin, dipeptidyl peptidase-4 inhibitors (DPP4I) such as linagliptin, incretin mimetics/glucagon-like peptide (GLP 1) agonists such as liraglutide, sodium-glucose cotransporter 2 (SGLT2) inhibitors such as canagliflozin, and thiazolidinediones (TZDs) such as pioglitazone.

200

Managing diabetes through diet/lifestyle

200

Important: If a patient is on more than one treatment for diabetes, the higher limit always applies.

What if More Frequent Testing is Warranted?

In certain circumstances, periodic increases in testing may be warranted, resulting in a need for more strips than a patient's annual limit allows.

If a patient meets one of the criteria below and is not on insulin, PharmaCare will cover 100 extra strips per year on receipt of a Special Authority Request from a physician or from a health professional at a Diabetes Education Centre recognized by the B.C. Ministry of Health.

Criteria for Additional Test Strips

Patient has:

  • not met glycemic targets, as determined by a physician, for three months or more;
  • an acute illness or co-morbidities, which may impact blood glucose control;
  • had changes in drug therapy that may impact blood glucose control (e.g., starting or stopping medications that induce hypo- or hyperglycemia, drug-to-drug or drug-disease interactions);
  • a job where hypoglycemia presents a significant safety risk (e.g., pilots, air traffic controllers, commercial drivers); or
  • gestational diabetes.

Note: In the rare case that a patient has a medical need for even more frequent testing, or when a patient on insulin needs to test more frequently, an endocrinologist may submit a written request to PharmaCare for additional strips. Requests will be considered on a case-by-case basis. The letter should outline the need for the additional strips and the quantity required.

Understanding Blood Glucose Testing for People with Type 2 Diabetes Not Taking Insulin

How Do I Find Out How Often a Patient Should Test?

CDA: Clinical Practice Guidelines and Resources for General Diabetes Management

www.diabetes.ca/clinical-practice-education

Canadian Diabetes Association website

www.diabetes.ca/takecharge - Created with leading health care experts, this site offers online tools to help you find the best blood sugar testing pattern, to learn about monitoring blood pressure and foot health, and to develop an action plan.

 Resources for Your Patients

BC/CADTH Alternate Rx Pad

Available on the PharmaCare Patient Information Web page in multiple languages—This information sheet offers tips for the circumstances under which a patient might want to test their blood sugar. It also offers general tips for managing type 2 diabetes.

Canadian Diabetes Association:
Clinical Practice Guidelines and Resources for General Diabetes Management

www.diabetes.ca/clinical-practice-education

Canadian Diabetes Association:

Diabetes and You

www.diabetes.ca/diabetes-and-you—Offers links to various resources on diabetes in general and on diabetes management.

Refer to other health care providers

In person (or on phone)—Good resources include diabetes educators, nurse practitioners, pharmacists and HealthLinkBC at 8-1-1.

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