title: Differences in self-monitored, blood glucose test strip utilization by therapy for type 2 diabetes mellitus.
abstract: OBJECTIVE
  To determine whether blood glucose test strip (BGTS) utilization in patients with type 2 diabetes (T2D) is associated with the type of diabetes therapy, classified according to hypoglycemic risk.
  
  
  METHODS
  A retrospective, longitudinal (2006-2012) study of Canadian private drug plans (PDP) and Ontario Public Drug Programs (OPDP) prescription claims was conducted. Analyses were restricted to patients with T2D with or without a claim for BGTS. Daily BGTS utilization (TS/patient/day) was evaluated by diabetes therapy classified by hypoglycemic risk. Multivariate analyses were conducted to identify determinants of BGTS utilization.
  
  
  RESULTS
  The T2D cohort comprised 5,759,591 observations from 1,949,129 claimants. Mean BGTS utilization was 0.84 TS/patient/day and differed between PDP and OPDP (0.66 vs. 1.00). Daily utilization was greatest in patients receiving therapy associated with a pre-defined high risk of hypoglycemia [insulin: basal + bolus (2.16), premixed (1.65), basal (1.16), other insulin regimens (2.13), and sulfonylureas (0.74)] versus non-sulfonylurea non-insulin-based regimens (0.52). For non-insulin therapy, BGTS utilization was greater for patients on multiple non-insulin therapies versus monotherapy (0.74 vs. 0.53 TS/patient/day). In multivariate analyses, drivers for BGTS utilization included insulin use, previous BGTS use, and female gender. Previous diabetes therapy and duration of therapy were negatively correlated with BGTS utilization.
  
  
  CONCLUSIONS
  BGTS utilization varies depending on the type of therapy used to treat T2D according to hypoglycemic risk. Decision making regarding BGTS needs to account for robust analyses of current utilization and its value in those settings, including in patients not receiving diabetes therapy and the prevalence of circumstances conducive to more intensive monitoring.
authors.affiliation: GlaxoSmithKline, 7333 Mississauga Road North, Mississauga, ON, L5N 6L4, Canada. ruben.v.tavares@gsk.com.
authors.forename: Ruben
authors.initials: R
authors.lastname: Tavares
authors.affiliation: IMS Brogan, a unit of IMS Health, Kirkland, QC, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Duclos
authors.affiliation: IMS Brogan, a unit of IMS Health, Kirkland, QC, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Brabant
authors.affiliation: GlaxoSmithKline, 7333 Mississauga Road North, Mississauga, ON, L5N 6L4, Canada.
authors.forename: Daniella
authors.initials: D
authors.lastname: Checchin
authors.affiliation: IMS Brogan, a unit of IMS Health, Ottawa, ON, Canada.
authors.forename: Nevzeta
authors.initials: N
authors.lastname: Bosnic
authors.affiliation: IMS Brogan, a unit of IMS Health, Mississauga, ON, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Turvey
authors.affiliation: GlaxoSmithKline, King of Prussia, Philadelphia, PA, USA.
authors.forename: Jorge Alfonso Ross
authors.initials: JA
authors.lastname: Terres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data*; D002170:Canada; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Blood glucose self-monitoring; Type 2 diabetes mellitus; Utilization