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From: Alan S on 26 Nov 2006 17:04
Hi All

Lately we've seen two studies, one from West Australia and
one from Canada, claiming that testing by type 2's is a
waste. I think it's no accident that the studies appeared in
countries which have governments which subsidise diabetes
consumables.

I came across some interesting statistics yesterday on the
Diabetes Australia web-site.
http://www.diabetesaustralia.com.au/ndss/doc_pdf/NDSS-Fact-Sheet.pdf

"Diabetes Classification Number of Registrants % Total Reg.
Type 1 130,172 18%
Type 2 (Insulin Requiring) 78,025 10.8%
Type 2 (Non Insulin Requiring) 464,596 64.7%
GDM (Insulin Requiring) 9,547 1.3%
GDM (Non Insulin Requiring) 32,874 4.6%
Other Diabetes 2,764 0.6%
Total Diabetes
<snip> 717,978 100%
Over 3.67 million NDSS product units were supplied by the
NDSS during FY2004/05 at a total cost of about $103 million.
This unit growth was approximately 11% growth over the
previous year. During the financial year to June 2005, the
following were provided to Registrants:
• Blood Glucose Testing Strips - 3 million boxes
• Sharps – 565k boxes (Needles & Syringes 165k, Pen Needles
400k)
• Minimal Urine testing strips & older style Pump
Consumables
• New Insulin Pump Consumables (listed Sept 04) - 13k units"

Playing around with those numbers, some interesting things
appear.

First, some assumptions. I've assumed that:
All insulin users test at least once daily.
The numbers are reasonably accurate for insulin users, but
understate non-insulin users.
A "box" of strips averages 60 strips, on the basis that 20%
are Optium (boxes of 100) and the rest are boxes of 50.

If you work out the numbers, that means that the insulin
users would need 1,324,609 boxes per year, leaving 1,675,391
for the rest. That works out at 0.55 tests per day for them.
About four tests per week. More like thrice weekly allowing
for the unregistered type 2's.

If you increase the frequency of type 1 (but not the other
insulin users) testing to twice daily - the non-insulin
users drop to 0.29 daily, or about twice per week. And if
you increase the type 1's to 3 times daily, the others drop
to 0.03 per day or about once per month. Above three times
daily for the type 1's alone is more than the 3,000,000
available.

On the other hand, if every diabetic of all types tested
just once each day - it would consume 4,367,700 boxes per
year and increase the budget by about AU$40,000,000.

An increase in that vicinity has just been announced - but I
think that was negotiated on foreseen other cost increases,
not major increases in test costs.

Of course, my attitude is that properly educated diabetics
using systematic testing would save the government far more
in other health areas by reducing complications - but it's
not hard to see why the bean counters ignore that and love
"studies" such as the WA and Canadian ones that support
cost-cutting.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Pompeii, Amalfi, Bari
From: Jefferson on 26 Nov 2006 20:16
Alan S wrote:
> Hi All
>
> Lately we've seen two studies, one from West Australia and
> one from Canada, claiming that testing by type 2's is a
> waste. I think it's no accident that the studies appeared in
> countries which have governments which subsidise diabetes
> consumables.

Governments trying to reduce or at least control costs. The UK might do
the latter. A system like the US has which is largely insurance funded
also tries to minimize cost, but the issue is the profit motive rather
than revenue levels and taxes.
>
> I came across some interesting statistics yesterday on the
> Diabetes Australia web-site.
> http://www.diabetesaustralia.com.au/ndss/doc_pdf/NDSS-Fact-Sheet.pdf
>
> "Diabetes Classification Number of Registrants % Total Reg.

> Type 2 (Non Insulin Requiring) 464,596 64.7%

Do you have any idea what proportion to the non-insulin requiring T2s
are on diet and exercise only? These may be the ones least likely to be
monitoring using meters.

> following were provided to Registrants:
> � Blood Glucose Testing Strips - 3 million boxes

> Playing around with those numbers, some interesting things
> appear.
>
> First, some assumptions. I've assumed that:
> All insulin users test at least once daily.
> The numbers are reasonably accurate for insulin users, but
> understate non-insulin users.
> A "box" of strips averages 60 strips, on the basis that 20%
> are Optium (boxes of 100) and the rest are boxes of 50.
>
> If you work out the numbers, that means that the insulin
> users would need 1,324,609 boxes per year, leaving 1,675,391
> for the rest. That works out at 0.55 tests per day for them.
> About four tests per week. More like thrice weekly allowing
> for the unregistered type 2's.
>
> If you increase the frequency of type 1 (but not the other
> insulin users) testing to twice daily - the non-insulin
> users drop to 0.29 daily, or about twice per week. And if
> you increase the type 1's to 3 times daily, the others drop
> to 0.03 per day or about once per month. Above three times
> daily for the type 1's alone is more than the 3,000,000
> available.
>
> On the other hand, if every diabetic of all types tested
> just once each day - it would consume 4,367,700 boxes per
> year and increase the budget by about AU$40,000,000.
>
> An increase in that vicinity has just been announced - but I
> think that was negotiated on foreseen other cost increases,
> not major increases in test costs.
>
> Of course, my attitude is that properly educated diabetics
> using systematic testing would save the government far more
> in other health areas by reducing complications - but it's
> not hard to see why the bean counters ignore that and love
> "studies" such as the WA and Canadian ones that support
> cost-cutting.
>

Frank





From: Alan S on 26 Nov 2006 20:50
On Sun, 26 Nov 2006 20:16:44 -0500, Jefferson
<xyz(a)adelphia.netng> wrote:

>
>> Type 2 (Non Insulin Requiring) 464,596 64.7%
>
>Do you have any idea what proportion to the non-insulin requiring T2s
>are on diet and exercise only? These may be the ones least likely to be
>monitoring using meters.

No, I haven't. I doubt that it's high. When I was attending
the local support group meetings I found that, out of 15-20
regulars who were type 2 only two or three of us were d&e.
All the others were on meds, some (probably in the ratio of
those stats) were on insulin.

Of course, now I'm on metformin too.

When I gave a presentation on "test, test, test" it was
depressing to find about a third didn't own a meter. And
very few indicated they were likely to follow that advice.

Most, if they tested at all, did a few fasting tests each
week; a couple did an occasional 2hr PP.

I haven't been to a meeting for nearly a year. Too
frustrating and depressing.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Pompeii, Amalfi, Bari
From: Larry on 27 Nov 2006 01:02
Alan: I am resigned to eating EXACTLY the same thing for breakfast most
every day so have no need to do post meal readings more than every 10
days or so. I am almost doing the same for lunch so find it unnecessary
to test quite so often. I've cut back on fbg tests as they are the same
most days except for a gradual drifting upwards over the past 7 yrs
which is normal diabetes progression which we can't do much about
anyway except for changes in meds as diet/weight and exercise are
optimized already. :-)

Larry
Alan S wrote:
> On Sun, 26 Nov 2006 20:16:44 -0500, Jefferson
> <xyz(a)adelphia.netng> wrote:
>
> >
> >> Type 2 (Non Insulin Requiring) 464,596 64.7%
> >
> >Do you have any idea what proportion to the non-insulin requiring T2s
> >are on diet and exercise only? These may be the ones least likely to be
> >monitoring using meters.
>
> No, I haven't. I doubt that it's high. When I was attending
> the local support group meetings I found that, out of 15-20
> regulars who were type 2 only two or three of us were d&e.
> All the others were on meds, some (probably in the ratio of
> those stats) were on insulin.
>
> Of course, now I'm on metformin too.
>
> When I gave a presentation on "test, test, test" it was
> depressing to find about a third didn't own a meter. And
> very few indicated they were likely to follow that advice.
>
> Most, if they tested at all, did a few fasting tests each
> week; a couple did an occasional 2hr PP.
>
> I haven't been to a meeting for nearly a year. Too
> frustrating and depressing.
>
> Cheers, Alan, T2, Australia.
> d&e, metformin 1000mg, ezetrol 10mg
> Everything in Moderation - Except Laughter.
> --
> http://loraldiabetes.blogspot.com/
> http://loraltravel.blogspot.com/
> latest: Pompeii, Amalfi, Bari

From: Alan S on 27 Nov 2006 02:04
On 26 Nov 2006 22:02:10 -0800, "Larry" <boelkowj(a)aol.com>
wrote:

>Alan: I am resigned to eating EXACTLY the same thing for breakfast most
>every day so have no need to do post meal readings more than every 10
>days or so. I am almost doing the same for lunch so find it unnecessary
>to test quite so often. I've cut back on fbg tests as they are the same
>most days except for a gradual drifting upwards over the past 7 yrs
>which is normal diabetes progression which we can't do much about
>anyway except for changes in meds as diet/weight and exercise are
>optimized already. :-)
>
>Larry

There is a significant difference between you and the vast
majority out there testing rarely: you've done the work in
the past to know your own body. They haven't. So you can be
confident that your breakfast, or any other meal, isn't
putting you in dangerous territory - but they haven't the
faintest idea. It's the difference between a cartographer
following his own map and a sailor in the middle of the
Atlantic without a compass or a map.

I test a little more often because I believe in variety of
my menu as part of my "way of eating". I find it easier to
be a bit more disciplined if I can look forward to meals
rather than treat them simply as fuel. YMMV, but that means
I test a little more as I fiddle with recipes etc.

I also test to check that things are still as I expect them.


Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Pompeii, Amalfi, Bari
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