Canadian diabetes experts are revisiting the idea that people with Type 2 diabetes need to monitor their blood-sugar levels daily.

Such frequent testing is valuable for people with Type 1 who take insulin many times a day. But for people with Type 2, who aren't on insulin, the benefits are less clear and are contentious.

Dr. Jeff Johnson's study suggests money would be better spent on prevention than on daily test strips.
(CBC)

At a three-day conference by the Institute of Health Economics that ends Thursday,  experts meeting in Edmonton will release a consensus statement on the value of daily checks of blood-sugar levels.

A six-month study by institute fellow Dr. Jeff Johnson concluded the test strips don't offer much benefit to Type 2 diabetics in the long run, and the money governments pay out may be better spent.

"There's a number of research studies conducted in the last few years since the time that our guidelines were written that suggest that the long-term benefit of doing more frequent tests for people with Type 2 diabetes has very little impact on their blood-sugar control," Johnson told CBC Newsworld on Tuesday.

The cost of the daily test strips adds up to $365 per person a year, or more than $700 million for the two million people with diabetes in Canada, said Johnson, a researcher at the University of Alberta.

"For people with diabetes, there's clear evidence that suggests that we can have a greater impact on their health by doing things like lowering their blood pressure, helping people with diabetes to lose weight, have healthier eating habits or being more physically active," Johnson said.

"Those things are probably a much better investment."

Costs add up

Like many practices in health care, self-monitoring is based on intuition that daily testing is a good idea.

But the research suggests the benefits are not as great as has been believed, and Type 2 diabetics may be better served by getting a checkup once every three months, Johnson said.

People with Type 2 sometimes feel powerlessness while trying to manage the condition, said Peter McDougall, who was diagnosed with the condition nearly four years ago.

"Ironically, those with the lowest incomes are also the least likely to have test-strip coverage benefits and yet they probably have the greatest need to test themselves simply because of lifestyle and nutrition," said McDougall, who will speak at the conference on Wednesday.

At a debate organized by the Canadian Diabetes Association in Toronto last month, Dr. Ehud Ur, an endocrinologist at Queen Elizabeth II Health Sciences Centre in Halifax, defended frequent daily testing.

Type 2s need access to education and resources to learn how to interpret the test results and make lifestyle changes accordingly, Ur said.