Blood Glucose Testing and PharmaCare Annual Quantity Limits

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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.

A patient's annual limit is 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).

Annual limits
Treatment for Managing Diabetes Notes Annual Quantity Limit
With insulin If a patient takes insulin, this higher limit applies whether or not they are also taking other diabetes medications. 3,000
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
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
Through diet/lifestyle No notes. 200

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

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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 covers 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 are considered on a case-by-case basis. The letter should outline the need for the additional strips and the quantity required.

 

Resources

To learn how often a patient needs to test:

Further resources for patients: