B.C.'s Glucose Monitoring Health Technology Assessment ignores evolution in technology and evidence
April 1, 2021
Diabetes Canada is joined by JDRF Canada and Type 1 Together in expressing disappointment with the recommendations recently published by British Columbia’s Health Technology Assessment (HTA) Committee. The data used to inform the review are out-of-date and do not take into consideration all the evidence, patient voice, or the future health-care environment.
“Diabetes is a complex disease, with no ‘one size fits all’ approach to treatment and care,” says Seema Nagpal, Vice-President of Science & Policy with Diabetes Canada. “Diabetes management varies greatly between individuals and it is the role of the health-care provider and patient to determine individualized therapy and treatment plan based on best evidence. Unfortunately, advanced glucose monitoring devices such as Flash Glucose Monitors and Continuous Glucose Monitors are not accessible to many people living with diabetes who can benefit, which is why Diabetes Canada urges governments to publicly fund these proven technologies.”
“The health of people with diabetes relies heavily on self-management,” says Sarah Linklater, Chief Scientific Officer of JDRF Canada. “Advanced glucose monitoring devices provide both patients and healthcare providers with a more fulsome and accurate picture of blood sugar levels. This allows people with diabetes to stay on top of their disease management and make informed treatment decisions. This means fewer complications, better overall health outcomes and improved quality of life. Government support is urgently needed to ensure the gap in care between those who can access and afford these technologies versus those who cannot do not widen leading to inequity in our health care system.”
Diabetes Canada, JDRF Canada, and Type 1 Together caution the B.C. government on using the HTA recommendations to form healthy public policy. Much of the research cited within the report was published three or more years ago, and there’s been considerable advancement in technology since that time. These results are reported on outdated systems that are inconsistent with the pace of technological innovation in diabetes devices. Additionally, the recommendations do not take into consideration blood glucose ‘time in range,’ which can provide additional information that using A1C testing information alone. The narrow review criteria have resulted in ill-informed recommendations.
“The current pandemic climate has put a spotlight on the critical need for proven digital health resources to support those living with chronic illness such as diabetes,” says Nagpal. “We urge the B.C. government to listen to patients and use the latest scientific evidence to support better health outcomes for British Columbians living with diabetes.”
"I am disheartened by this report and its conclusions. How does PharmaCare expect people living with type 1 diabetes to continuously manage over a lifetime without proper tools?" Jen Alexander, Founder of Type 1 Together
“I cannot really express how heartsick and angry this makes me. These recommendations manage to be even worse than anything I had imagined.” Nadine Pedersen, mom of a child with type 1 diabetes and member of the Diabetes Coalition.
As recently as last fall, Diabetes Canada provided the B.C. government with an analysis of responses from 873 individuals regarding an assessment of advance glucose monitoring devices. This public submission noted patients frequently describe how unrelenting the disease can be and its heavy impact on daily life. A device that can help to lessen the burden as well as improve diabetes management has value and should not be ignored by the B.C. government.
About Advanced Glucose Monitoring Technology
Advanced glucose monitoring gives people living with diabetes an accurate picture of their blood sugar management, which can lead to better short- and long-term treatment decisions. The main purposes for checking glucose include:
- Ensuring the safety of people taking insulin and some oral medications by detecting or preventing low blood sugar (hypoglycemia).
- Helping people living with diabetes make dosing decisions regarding their medication, especially insulin.
- Judging how well changes to diet, activity, and medications are working to maintain healthy blood sugar levels.
Finger prick testing (using a test strip and meter) has been the standard for glucose monitoring but for some, this is not enough. There’s a wide range of circumstances where frequent or continuous monitoring is necessary, which is where other types of testing options and technology are available: Flash Glucose Monitors or Continuous Glucose Monitors. How regularly people must monitor their glucose levels depends on the type of diabetes they have, their current treatment regimen, and their risk of low blood sugar.
About Diabetes Canada
Diabetes Canada is the registered national charitable organization that is making the invisible epidemic of diabetes visible and urgent. Diabetes Canada partners with Canadians to End Diabetes through:
- Resources for health-care professionals on best practices to care for people with diabetes.
- Advocacy to governments, schools, and workplaces; and
- Funding world-leading Canadian research to improve treatments and find a cure.
For more information, visit diabetes.ca or call 1-800-BANTING (226-8464).
JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat T1D and its complications. To accomplish this, JDRF has invested more than $3 billion CAD in research funding since our inception. We are an organization built on a grassroots model of people connecting in their local communities, collaborating regionally for efficiency and broader fundraising impact, and uniting on a national stage to pool resources, passion, and energy. We collaborate with academic institutions, governments, and corporate and industry partners to develop and deliver a pipeline of innovative therapies to people living with T1D. Our staff and volunteers throughout Canada and six international affiliates are dedicated to advocacy, community engagement and our vision of a world without T1D. For more information, please visit jdrf.ca
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