Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .
Lack of insurance coverage for testing supplies is associated with poorer glycemic control in patients with type 2 diabetes
Background : Public insurance for testing supplies for self-monitoring of blood glucose is highly variable across Canada . We sought to determine if insured patients were more likely than uninsured patients to use self-monitoring and whether they had better glycemic control . Methods : We used baseline survey and laboratory data from patients enrolled in a r and omized controlled trial examining the effect of paying for testing supplies on glycemic control . We recruited patients through community pharmacies in Alberta and Saskatchewan from Nov. 2001 to June 2003 . To avoid concerns regarding differences in provincial coverage of self-monitoring and medications , we report the analysis of Alberta patients only . Results : Among our sample of 405 patients , 41 % had private or public insurance coverage for self-monitoring testing supplies . Patients with insurance had significantly lower hemoglobin A1c concentrations than those without insurance coverage ( 7.1 % v. 7.4 % , p = 0.03 ) . Patients with insurance were younger , had a higher income , were less likely to have a high school education and were less likely to be married or living with a partner . In multivariate analyses that controlled for these and other potential confounders , lack of insurance coverage for self-monitoring testing supplies was still significantly associated with higher hemoglobin A1c concentrations ( adjusted difference 0.5 % , p = 0.006 ) . Interpretation : Patients without insurance for self-monitoring test strips had poorer glycemic control
Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .