Free Test Strips and Blood Glucose Control

September 29, 2015 updated by: University of Wisconsin, Madison

The Impact of Increased Availability of Test Strips on Blood Glucose Control in Patients With Diabetes

This study is designed to determine if there is an impact on blood glucose control in patients who receive free test strips. Patients in the study have no insurance or insurance that does not cover the purchase of test strips. A comparison of weight, blood pressure, and Hemoglobin A1C from entry to the final visit will be used to compare patients' management of their diabetes. Recommended values for these parameters will be used as the standard for comparisons. The investigators anticipate that patients receiving free test strips will show an improvement in the listed parameters as well as in satisfaction with their care.

Study Overview

Detailed Description

According to the National Institutes of Diabetes and Digestive and Kidney Diseases, an estimated 16 million people in the United States have diabetes mellitus. About one third of these people don't know they have diabetes and are therefore, not receiving treatment. Another 798,000 people are diagnosed with diabetes each year.

Diabetes is the fourth leading cause of death in Wisconsin, as stated at the Wisconsin Department of Health and Family Services website. Diabetes costs an estimated annual $2.1 billion in health care costs and lost productivity. Each year, over 3,600 Wisconsin residents die from diabetes. Others experience disabling complications, including blindness, amputations, heart and kidney disease. In 1998, in Dane County alone, the direct costs of diabetes were estimated at $82.0 million and indirect costs at $100.4 million.

Two landmark studies in the United States and the United Kingdom proved that the level of blood sugar control predicts the onset and severity of diabetes-related complications for both Type 1 and Type 2 diabetes. Thus, people who are able to keep their blood sugars as close to normal as possible can reduce their risks of complications and live relatively "normal" lives. Moreover, the costs to the community will also be reduced.

In order to do this, persons with diabetes need to test blood sugar levels multiple times per day. There are a variety of meters available for testing. Many people have insurance that covers the cost of the meters and related test strips. For those who do not have this coverage, meters are often available free of charge. Unfortunately, this is not true of the test strips, which average $1 each. A person testing four times a day, seven days a week would need almost $1470 to purchase strips for a year.

In the past year, the investigators have seen 35 patients followed in either the East or West Diabetes Clinics who do not have insurance and thus, no way to pay for test strips. It can be assumed that without an adequate number of test strips, these patients are not getting the necessary information to achieve optimal blood sugar control. This puts them at risk for more complications of their diabetes with concurrent emotional and financial costs to them and their families. Further, the cost to the community in the long run is increased.

2. Describe the design of your study. Use care to distinguish experimental interventions from standard medical treatment. Specifically include the following information:

The investigators will enroll 35 subjects identified in either the East or West diabetes clinic who do not have insurance or who are underinsured. Underinsured indicates patients with insurance that does not cover the purchase of test strips. Certified Diabetes Educators (CDE) identified other patients after an initial visit when lack of adequate insurance coverage was noted. The list of identified patients was sent to the patient's physician and CDE. Two patients were eliminated who are self-pay by choice; they are self-employed and have adequate resources. Other subjects were eliminated for the following criteria: discharge from UWHC Diabetes Clinic to a primary care provider; patients whose diabetes is controlled by diet alone; patients who are incarcerated and currently have coverage through the penal system.

Subjects will be provided a voucher to obtain free test strips. Subjects routinely return to the clinic at 4-month intervals (study entry, months 4,8,12). During these visits subjects will undergo a Hemoglobin A1C, check height, weight, and blood pressure and complete satisfaction questionnaires at study entry and month 12. Only the questionnaires would not be considered standard of care.

3. What method(s) will you use to recruit subjects? Will these methods involve material inducements? Subjects who meet the eligibility criteria will be offered participation. Subjects will receive testing strips, clinic visits at entry and at months 4,8 and 12 and Hemoglobin A1C (HA1C) testing at the above intervals free of charge.

4. Does your study have a statistical justification for its sample size? For the analysis of its results? If you answer "yes" to these questions, briefly describe each justification.

No

C. Identify the potential risks to subjects of participation in your study. Describe the expected frequency, severity, and reversibility of the major risks you identify. Include possible late effects of participation (e.g., secondary cancers).

All subject records will be kept strictly confidential according to HIPPA privacy rules. Subject records will contain only a study number. The key to the study numbering will be kept in a locked filing cabinet. Subjects may experience slight pain and bruising from the blood draws of the HA1C.

D. Identify the expected benefits to subjects of participation in your study. Also identify any potential scientific benefits produced by your study.

Subjects will receive free testing strips and free HA1C testing for a year. Subjects may experience better control of their diabetes as a result of testing their blood sugar levels.

E. Describe the procedure for obtaining the consent of each subject or the subject's parent or representative. Confirm that you have attached a copy of each consent form. The form should include all the elements of consent listed in the HSC Guidelines.

Subjects will be given the informed consent and allowed ample time to read the informed consent or have it read to them. Once the consent form has been read subjects will have as much time as needed to ask any questions they may have. Once the subject has had all of their questions answered and agrees to participate the subject will sign the consent form in the presence of the PI or a delegate. Subjects will be given a copy of the signed consent form for their records.

Study Type

Interventional

Enrollment (Actual)

22

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Wisconsin
      • Madison, Wisconsin, United States, 53792
        • University Of Wisconsin

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with a diagnosis of diabetes who have no health insurance or insurance that does not pay for purchase of blood test strips

Exclusion Criteria:

  • Patients with a diagnosis of diabetes who have health insurance that pays for purchase of blood test strips

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: glucose monitoring
Each participant received a Bayer Breeze Monitor and glucose test strips for monitoring blood sugar.
All study participants received glucose meter and test strips.
Other Names:
  • Ascencia Breeze glucose meters made by Bayer and test strips
Each participant received a Breeze monitor and glucose test strips.
Other Names:
  • Ascencia Breeze Glucose Meter, Bayer

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Blood pressure
Time Frame: one year
one year
Weight
Time Frame: one year
one year
Hemoglobin A1C
Time Frame: one year
one year

Secondary Outcome Measures

Outcome Measure
Time Frame
Satisfaction with care
Time Frame: one year
one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Sherree Drezner, ACSW, LCSW, University of Wisconsin, Madison

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2004

Primary Completion (Actual)

November 1, 2007

Study Completion (Actual)

November 1, 2007

Study Registration Dates

First Submitted

September 13, 2005

First Submitted That Met QC Criteria

September 13, 2005

First Posted (Estimate)

September 20, 2005

Study Record Updates

Last Update Posted (Estimate)

October 1, 2015

Last Update Submitted That Met QC Criteria

September 29, 2015

Last Verified

September 1, 2015

More Information

Terms related to this study

Other Study ID Numbers

  • M-2004-1069

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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