Lancet review calls for access to diabetes tools


Published in The Lancet Diabetes & Endocrinology, the review recommends policy and practical changes to improve access to blood glucose meters and test strips, particularly in low resource settings. 

Dr Graham Ogle and Ms Emma Klatman, from the International Diabetes Federation Life For A Child Programme, together with Dr Yakoob Ahmedani from Pakistan's Baqai Institute of Diabetology and Endocrinology, and the CTC's Professor Alicia Jenkins authored the review.

Blood glucose meters and test strips for self-monitoring of blood glucose (SMBG) are vital tools in diabetes care, particularly for people with Type 1 diabetes and insulin-treated Type 2 diabetes. However, they are often inaccessible to, and infrequently used by, those with diabetes in countries where healthcare resources are limited.

As technology advances for people who can afford the new interstitial fluid glucose monitoring systems, the review said, blood glucose meters and test strips must remain available and become more affordable in low-resource settings.

These findings are particularly important in the light of the rapidly increasing prevalence of diabetes, particularly in middle and low-income countries, where healthcare systems are often limited.

The review assessed global access to these tools, collating published information on cost, availability, system accuracy, competitive bidding, technological trends, and non-financial barriers to their use. Their review also provides new information on global market share data and prices, taxes and tariffs, and product availability.

The authors conclude that blood glucose meters and test strips should be considered essential medicines, with issues of access prioritised by relevant international agencies, such as the World Health Organisation. Tariffs and taxes on these items should be reduced, and unified global system accuracy requirements agreed, with accountable post-marketing evaluations put in place. Preferential pricing arrangements, pooled procurement, and best-purchasing practices were also suggested as a means to lower direct costs. SMBG supplies should also be included in national health insurance schemes.