6.3.3.2 Blood glucose testing strips

Please see the Kent and Medway guidelines for full information on self-monitoring of blood glucose (SMBG) and ketones, and preferred formulary choices of blood glucose and ketone meters, test strips and lancets in adults, young people and children who have diabetes. This includes which patient groups/cohorts the preferred formulary meters/test strips are suitable/should be used for.

Guidelines for self-monitoring of blood glucose (SMBG) & ketones, & preferred formulary choices of blood glucose & ketone meters, test strips & lancets

The preferred formulary meters are recommended for use in Kent and Medway and are expected to be suitable for most patients, but it is down to patient/healthcare professional decision/choice if a different non-preferred meter needs to be considered, which should be based on the NHS England commissioning guideline. Occasionally, diabetes specialist services will initiate an alternative meter to meet specific patient needs and will need to inform the GP of this, to support ongoing prescribing of consumables.
When a non-preferred meter is used the choice should, wherever possible, take into consideration the cost of test strips in relation to similar meters.

Example situations where a non-preferred meter may be required (list not exhaustive):
•    Where a voice meter is required, e.g., visual impairments, a voice meter from the NHS England list is recommended e.g. On Call Extra Voice. Talking meters have audio cues to assist patients with visual impairments to use the meter. These currently only measure blood glucose
•    For a patient who needs support in another language then an appropriate meter can be prescribed from the NHS England document
•    Patients on insulin pumps have a blood glucose testing meter integrated with the insulin pump so the appropriate test strip needs to be prescribed from the preferred meters list (they are therefore automatically excluded). If a patient is using an insulin pump, their meter should not be switched in primary care. Please refer to the specialist if any review is required. Meters synchronised to insulin pumps should only be as per specialist advice. If a patient is on an insulin pump that requires a specific meter, that is not listed as a Kent and Medway preferred formulary choice and is not listed in the NHS England document, then this meter should be continued. Meters compatible with insulin pumps will normally be provided by specialist centres, but the test strips can be prescribed in primary care. Please note these meters do not usually have ketone testing functionality so a category 1 meter may also be needed 
•    If a patient is on dialysis, the Contour Plus Blue meter can be used which has a large easy to read display and allows patients to retest after 30 seconds (second chance sampling) 
•    Paediatric patients should aim to use meters on the preferred formulary, but there may be exceptions where other meters and lancets may be needed, such as Accu-Chek Instant or FastClix lancets to aid their engagement with blood glucose monitoring.