Blood Glucose Testing

Research shows that most people with type 2 diabetes who are not using insulin do not need to test their blood sugar routinely, as there is little evidence that frequent self-monitoring of blood glucose without a medically valid reason improves diabetes care.

BC PharmaCare limits the number of blood glucose test strips it covers for a patient each calendar year. The amount 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  Limit
With insulin and without the use of a continuous glucose monitor (CGM) If a patient takes insulin and is not also using a CGM, this limit applies whether or not they are also taking other diabetes medications. 3,000
With insulin and with the use of a CGM If a patient uses a CGM, they may also occasionally need blood glucose test strips. For example, if they see an error code on their CGM or if their symptoms don’t match their CGM readings. 200
Anti-hyperglycemic 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
Anti-hyperglycemic 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 (DPP-4) inhibitors such as linagliptin
  • Incretin mimetics/glucagon-like peptide (GLP-1) agonists such as semaglutide
  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors such as empagliflozin
  • Thiazolidinediones (TZDs) such as pioglitazone
 200
Through diet/lifestyle No notes. 200

Important: If a patient belongs to more than one category, and is not using a CGM, the higher limit will apply. 

What if more frequent testing is warranted?

In certain circumstances, more testing is warranted, resulting in a need for more strips than a patient's annual limit.

If a patient meets one of the criteria below and is not on insulin or is a patient using a CGM, PharmaCare covers 100 extra strips per year with a Special Authority request from a prescriber or health professional at a diabetes education centre or authorized primary care network. 

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)
  • Gestational diabetes

Additional test strips for a pediatric patient under Nursing Support Services using a CGM may be requested at the time of initial CGM request or with a CGM renewal request (using the CGM Special Authority request form).

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 for your patients

  • Diabetes Canada
    • Blood sugar testing
    • Monitoring blood pressure and foot health
    • Developing an action plan