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).
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.
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.
To learn how often a patient needs to test:
- Diabetes Canada: Clinical Practice Guidelines and Resources for General Diabetes Management
- Diabetes Canada: 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
Further resources for patients:
- BC/CADTH Alternate Rx Pad: Available at PharmaCare Patient Information 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
- Diabetes Canada: Clinical Practice Guidelines and Resources for General Diabetes Management
- Diabetes Canada: Diabetes and You - Offers links to various resources on diabetes in general and on diabetes management
- Other health care providers: In person (or on phone)—Good resources include diabetes educators, nurse practitioners, pharmacists and HealthLinkBC at 8-1-1