May 26, 2015
Access to Test Strips Linked to Mortality Rates
This is a shock, but makes common sense. The title used is, “Access to Glucose Monitoring Supplies Linked to Mortality Rates.” Yes, those that can obtain sufficient test strips live longer. This is another reason for taking every advantage possible even if the Centers for Medicare and Medicaid Services (CMS) and the Veterans Administration (VA) don't like it as shown in my blog here.
Even the American Diabetes Association and the American Association of Clinical Endocrinologists (AACE) don't think people with type 2 diabetes need to test and want us to rely on the A1C two or four times a year. That is why this was such a shock to have this come out during the AACE meeting in Nashville, TN during the 24th Annual Scientific & Clinical Congress.
The researchers conducted an analysis of the importance of Medicare patients with diabetes having the proper supply of blood glucose monitoring tools (test strips). They found higher death rates among patients who received fewer supplies than the prior year. Then found lower death rates among patients who received more supplies than the year prior.
Study author Jaime Davidson, MD, who is the President of Endocrine and Diabetes Associates of Texas and is also a clinical professor of medicine at the University of Texas Southwestern Medical School in Dallas stated that safeguards must be put in place to monitor changes in the acquisition and to ensure patient lives are not being put at risk.
Davidson and his colleagues investigated the potential disruption of patent access to blood glucose monitoring supplies and its impact on health outcome after the recent implementation of the CMS competitive bidding program. Then the researchers assessed to impact of full acquisition of blood glucose testing supplies compared with partial acquisition on death among insulin-treated Medicare patients. The researchers defined full self-monitoring blood glucose (SMBG) acquisition as greater than 80 test strips covered, based on three test strips used per day.
The researchers found that 71.1% of the beneficiaries were treated with rapid-acting insulin, including analog pre-mix, and 20.4% with rapid-acting and long-acting insulin, including analog, recombinant human pre-mix. They reported that 4-year survival was negatively associated with partial or no SMBG acquisition in both groups.
The mortality rates were higher among beneficiaries with full SMBG acquisition in
2010 who migrated to partial SMBG acquisition or no SMBG record the next year compared with maintaining full SMBG acquisition.
However, the mortality rates were lower among beneficiaries with partial SMBG acquisition or no SMBG record in 2010 but migrated to full SMBG acquisition the next year, according to the researchers.
Davidson stated, “As a physician, I'm concerned that CMS did not report any changes in acquisition of SMBG supplies in their initial report of the competitive bidding program. We're continuing to look at the data to understand more about the full impact, but at this stage, given that acquisition of blood glucose monitoring supplies is indicative of actual blood glucose monitoring, anything that disrupts acquisition has a very strong potential to impact patient safety.”