Author: fgummett

Sugary drinks have been blamed for a surge in cases of the painful joint disease gout.

Men who consume two or more sugary soft drinks a day have an 85% higher risk of gout compared with those who drink less than one a month, a study suggests.

Cases in the US have doubled in recent decades and it seems fructose, a type of sugar, may be to blame, the British Medical Journal study reports.

UK experts said those with gout would be advised to cut out sugary drinks.

About 1.5% of the UK population currently suffers from gout and there has been an increase in numbers over the last 30 years – although the condition is more associated with Victorian times.

The symptoms of painful, swollen joints, mainly in the lower limbs, are caused when uric acid crystallises out of the blood into the joints.

US and Canadian researchers said the increase in cases had coincided with a substantial rise in the consumption of soft drinks.

Previous research had also shown that fructose increases levels of uric acid in the bloodstream.

To look in more detail, the team carried out a 12-year study of 46,000 men aged 40 years and over with no history of gout, asking them regular questionnaires about their diet.

Over the period, 755 newly diagnosed cases of gout were reported.

The risk of developing the condition was significantly increased with an intake level of five to six servings of sugary soft drink per week.

This link was independent of other risk factors for gout such as body mass index, age, high blood pressure and alcohol intake.

Diet soft drinks did not increase the risk of gout but fruit juice and fructose rich fruits (apples and oranges) were associated with a higher risk, the researchers said.

But this finding needs to be balanced against the benefit of fruit and vegetables in preventing other chronic disorders like heart disease and stroke.

Dr Hyon Choi, from the University of British Columbia, in Vancouver said dietary advice for gout had focused on restricting purine-rich foods, such as red meat and beer.

He said practitioners should advise patients with gout to reduce their fructose intake.

"I can think of some situations, for example in severe treatment failure gout, where reducing sweet fruits, such as oranges and apples could help," he added.

Dr Andrew Bamji, president of the British Society for Rheumatology, said anecdotally cases of gout appeared to be rising.

"When you think about it, it makes a lot of sense in that fructose inhibits the excretion of uric acid.

"I will certainly change my advice to patients and I suspect the number drinking fructose is quite large."

An appetite suppressant should be taken off the market, European regulators say.

The risks of sibutramine, marketed as Meridia in Canada, outweigh its benefits, the European Medicines Agency said Thursday, after reviewing the drug’s safety.

"Doctors should no longer prescribe, and pharmacists should no longer dispense, the medicine," the agency said in a release.

"Patients currently taking sibutramine should make an appointment with their doctor at the next convenient time to discuss alternatives measures to lose weight. Patients who wish to stop treatment before seeing their doctor can do so at any time."

A six-year trial of nearly 10,000 people comparing sibutramine to a placebo showed an increased risk of serious, non-fatal cardiovascular problems such as heart attacks and strokes among those taking the drug, the regulator said.

Most people in the trial were not taking the drug in accordance with the prescribing information, the agency noted, since sibutramine is contraindicated in patients with known cardiovascular disease.

But since obese and overweight patients are likely to have a higher risk for heart attacks and strokes, the agency considered the trial data relevant to its review.

The agency’s report said the suspension will remain until the company can provide data "that are sufficient to allow the identification of a group of patients for whom sibutramine’s benefits clearly outweigh its risks."

European Union nations are expected to adopt the agency’s recommendation.

"We believe there are many patients who benefit from sibutramine and respectfully disagree with the committee’s opinion and the recommendation to suspend the medicine," said Abbott spokesman Kurt Ebenhoch.

The U.S. Food and Drug Administration added new warning labels to Meridia warning the drugs should not be taken by patients with heart failure, hypertension, irregular heart beats and other problems.

Health Canada includes a similar list of contraindications.

TORONTO — A new study says genetic susceptibility is unlikely to be responsible for increased rates of severe H1N1 cases in aboriginal people.

It has been noted with H1N1 and with earlier pandemics that aboriginal people seemed to be more prone to developing severe illness than non-aboriginals.

But the study notes that First Nations people from Canada, Australian Aboriginals and Torres Strait Islanders, a separate group of aboriginals from Australia, don’t share a common ancestry.

The researchers say what those groups do have in common is a history of colonization as well as health disparities that stem from being economically and socially disadvantaged.

The authors, from the University of Manitoba, were looking for factors that might help explain why some people got severely ill with H1N1 while others did not.

Their study, which looked at nearly 800 confirmed cases of the pandemic flu in Manitoba, is published in the Canadian Medical Association Journal.

An Ontario farmer who operates a raw milk co-op was found not guilty Thursday of 19 charges related to selling unpasteurized milk.

Michael Schmidt, from Durham, Ont., defended himself in 2009 against the charges for dispensing milk straight from the cow.

While raw milk is legal to drink, it’s illegal to sell in Canada.

Schmidt’s legal battles sparked a heated debate over the safety of raw milk. Advocates have extolled its flavour and health benefits, while health officials and the province’s milk marketing board, the Dairy Farmers of Ontario, have argued raw milk isn’t fit for widespread distribution.

The farmer argued the charges laid against him under the Health Protection and Promotion Act and the Milk Act are unconstitutional and infringe on his rights and freedoms.

Schmidt operates a 150-cow raw milk co-operative venture, which allows members to own a portion of a cow to acquire raw milk. He argues that he sells milking and distribution services, not the milk itself.

At trial in Newmarket, Ont., earlier in the week, Schmidt argued that government officials and food scientists cannot guarantee the safety of any food, and suggested informed consumers should be able to buy raw milk.

Schmidt has stood by his actions since health officials carried out an armed raid of his farm in November 2006 and seized his milking equipment.

"The rich and sweet taste of unpasteurized milk would blow most people away," Schmidt has said. "I bet that 90 per cent of the people who would have the choice by blind tasting would all go for raw milk because that is the taste of milk and not what you buy on the shelf."

A private member’s resolution to create an all-party task force to examine the issues surrounding raw milk was debated but not passed in the Ontario legislature on Dec. 7.

The food at many popular U.S. chain restaurants and in the freezer section of the supermarket may contain a lot more calories than advertised.

A U.S. study of 10 chain restaurants, including Wendy’s and Ruby Tuesday, found that the number of calories in 29 meals or other menu items was an average of 18 per cent higher than listed.

And frozen supermarket meals from Lean Cuisine, Weight Watchers, Healthy Choice and South Beach Living had eight per cent more calories than the labels said, according to the study, published in this month’s Journal of the American Dietetic Association.

The researchers and other experts aren’t accusing restaurants and food companies of trying to deceive customers. They said most of the discrepancies can be explained by variations in ingredients, portion sizes and testing methods. For example, the teenager behind the counter might have put too much mayonnaise on one sandwich.

Still, "if every time you eat out, you get a couple of hundred calories or more than you think, that can add up really easily," said lead researcher Susan Roberts, a professor of nutrition at Tufts University. "There’s a big drumbeat for people putting calories on menus, but that’s only useful if the calories are right."

Marion Nestle, a professor of nutrition at New York University who was not involved in the study, said she was not surprised by the findings. People might think nutrition labels are scientifically precise, but they are mostly ballpark figures, she said.

"It would never occur to me that the calories posted on menu boards are anything close to reality," Nestle said.

The study showed most of the packaged food tested fell within the 20 per cent margin of error allowed by the U.S. Food and Drug Administration.

Some items, like Domino’s large thin-crust cheese pizza, came in low. It had one-third fewer than the reported 180 calories per serving.

Wendy’s Ultimate Chicken Grill was found to have nine per cent more calories than the reported 320. Ruby Tuesday’s baked potato with butter and sour cream came in on target, but researchers measured three per cent more calories in McDonald’s McChicken sandwich, which is said to have 360 calories.

Wendy’s spokesman Bob Bertini said: "Since our food is prepared to order by restaurant teams, there can be small variances in the calorie count. For example, one sandwich might have a bit more mustard or ketchup. The next sandwich, the customer might choose to leave off the lettuce and tomato."
Portion sizes vary

As the nation grapples with staggering obesity rates, local and state officials around the U.S. have considered requiring chain restaurants to post nutrition information about their food. New York City, neighbouring Westchester County, and King County in Washington state already have such regulations.

A private member’s bill in Ontario would require fast-food restaurants that do more than $5 million business to limit trans fats and provide nutrition labels on menus, and British Columbia restricts trans fat in foods prepared and served at restaurants.

Despite the inaccuracies, Nestle said she believes nutrition information is useful. But she said people need to realize that a bagel listed at 303 calories could contain dozens more, or dozens fewer.

Researchers used a calorimeter to test food from Boston-area restaurants and grocers. They compared their results with calorie counts available from the companies in 2007 and 2008.

In a statement, a Denny’s spokeswoman said variations in portion sizes can occur from restaurant to restaurant. The company also said it uses local vendors for bread, dairy and produce, each of which could have different product formulations and sizes.

Denny’s questioned the study’s contention that its grits and butter had three times the 80 calories listed on the menu — the largest fluctuation of all foods tested. Denny’s said the researchers tested a 270-gram serving instead of the 113-gram one used in its own analysis.

"It would bother me if I counted on it to make my decision on what to get," Audrey Ledford, 55, of Torrance, Calif., said after having coffee with her son at a Los Angeles Denny’s. "It should be correct."

WASHINGTON — In case the prospect of nearly $4,000 in prescription assistance isn’t enough to perk up low-income seniors, the government is using ’60s singer Chubby Checker to publicize "the twist" in the Medicare drug program.

As of Jan. 1, more than 1 million low-income seniors are newly eligible for more generous prescription drug benefits under the "extra help" program. Benefiting from a new law are those with life insurance policies and those who regularly get money from relatives to help pay household expenses but were previously disqualified because of too many assets or too much income.

"The safety net is frayed and this is a way to start stitching it back together again," said Hilary Dalin, associate director for benefits at the National Council on Aging.

Income limits are $16,245 a year for singles and $21,855 for married couples living together. Assets such as stocks, bonds and bank accounts must be limited to $12,510 for singles and $25,010 for married couples. The value of homes and automobiles are excluded.

Under the old law, applicants had to include the value of life insurance policies in calculating their assets. They also had to include as part of their income money received on a regular basis from relatives and friends to help pay household expenses.

Social Security Commissioner Michael J. Astrue urged seniors who were rejected for the program in the past to reapply.

To help promote the new twist in the law, Astrue enlisted Chubby Checker, who danced and sang "The Twist" to the top of the pop charts in the early 1960s. Those too young to remember Checker probably don’t qualify for the 65-and-up health care plan.

"It’s extra help," Checker said in an interview, "and this is what I’m all about." He is scheduled to unveil an ad campaign Friday in New York City, including posters, brochures and a television public service announcement.

About 32 million seniors are enrolled in the Medicare Part D prescription drug program. About 30 percent of them are enrolled in the extra help program, also known as the low-income subsidy.

Benefits vary by income. For many, the extra help program eliminates premiums and annual deductibles and charges copays as low as $1.10 for generic drugs and $3.30 for brand names.

Robert Sachs of New York City said his prescription drugs would cost at least $2,000 a month if he had to pay full price — an amount he couldn’t afford. Sachs, 67, has multiple sclerosis and other medical problems and must take several medications.

Under the extra help program, Sachs said, he pays $6 a prescription for name-brand drugs and less for generics. "I wouldn’t be here if I couldn’t have this benefit," he said in an interview.

Sachs said he learned of the program from the Medicare Rights Center, a consumer group based in New York.

"Even with Part D drug coverage, many folks can’t afford the drugs that they need," said Joe Baker, president of the Medicare Rights Center. "Extra help gives them what they need to make the drug benefit affordable."

Low-income seniors can apply for the program online at socialsecurity.gov, or by calling 1-800-772-1213. Seniors can also apply at their local Social Security office.

FRANKENSTEIN, Mo. — The mystery started the day farmer Russ Kremer got between a jealous boar and a sow in heat.

The boar gored Kremer in the knee with a razor-sharp tusk. The burly pig farmer shrugged it off, figuring: "You pour the blood out of your boot and go on."

But Kremer’s red-hot leg ballooned to double its size. A strep infection spread, threatening his life and baffling doctors. Two months of multiple antibiotics did virtually nothing.

The answer was flowing in the veins of the boar. The animal had been fed low doses of penicillin, spawning a strain of strep that was resistant to other antibiotics. That drug-resistant germ passed to Kremer.

Like Kremer, more and more Americans — many of them living far from barns and pastures — are at risk from the widespread practice of feeding livestock antibiotics. These animals grow faster, but they can also develop drug-resistant infections that are passed on to people. The issue is now gaining attention because of interest from a new White House administration and a flurry of new research tying antibiotic use in animals to drug resistance in people.

Researchers say the overuse of antibiotics in humans and animals has led to a plague of drug-resistant infections that killed more than 65,000 people in the U.S. last year — more than prostate and breast cancer combined. And in a nation that used about 35 million pounds of antibiotics last year, 70 percent of the drugs went to pigs, chickens and cows. Worldwide, it’s 50 percent.

"This is a living breathing problem, it’s the big bad wolf and it’s knocking at our door," said Dr. Vance Fowler, an infectious disease specialist at Duke University. "It’s here. It’s arrived."

The rise in the use of antibiotics is part of a growing problem of soaring drug resistance worldwide, The Associated Press found in a six-month look at the issue. As a result, killer diseases like malaria, tuberculosis and staph are resurging in new and more deadly forms.

In response, the pressure against the use of antibiotics in agriculture is rising. The World Health Organization concluded this year that surging antibiotic resistance is one of the leading threats to human health, and the White House last month said the problem is "urgent."

"If we’re not careful with antibiotics and the programs to administer them, we’re going to be in a post antibiotic era," said Dr. Thomas Frieden, who was tapped to lead the Centers for Disease Control and Prevention this year.

Also this year, the three federal agencies tasked with protecting public health — the Food and Drug Administration, CDC and U.S. Department of Agriculture — declared drug-resistant diseases stemming from antibiotic use in animals a "serious emerging concern." And FDA deputy commissioner Dr. Joshua Sharfstein told Congress this summer that farmers need to stop feeding antibiotics to healthy farm animals.

Farm groups and pharmaceutical companies argue that drugs keep animals healthy and meat costs low, and have defeated a series of proposed limits on their use.

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America’s farmers give their pigs, cows and chickens about 8 percent more antibiotics each year, usually to heal lung, skin or blood infections. However, 13 percent of the antibiotics administered on farms last year were fed to healthy animals to make them grow faster. Antibiotics also save as much as 30 percent in feed costs among young swine, although the savings fade as pigs get older, according to a new USDA study.

However, these animals can develop germs that are immune to the antibiotics. The germs then rub into scratches on farmworkers’ arms, causing oozing infections. They blow into neighboring communities in dust clouds, run off into lakes and rivers during heavy rains, and are sliced into roasts, chops and hocks and sent to our dinner tables.

"Antibiotic-resistant microorganisms generated in the guts of pigs in the Iowa countryside don’t stay on the farm," said Union of Concerned Scientists Food and Environment director Margaret Mellon.

More than 20 percent of all human cases of a deadly drug-resistant staph infection in the Netherlands could be traced to an animal strain, according to a study published online in a CDC journal. Federal food safety studies routinely find drug resistant bacteria in beef, chicken and pork sold in supermarkets, and 20 percent of people who get salmonella have a drug resistant strain, according to the CDC.

Here’s how it happens: In the early ’90s, farmers in several countries, including the U.S., started feeding animals fluoroquinolones, a family of antibiotics that includes drugs such as ciprofloxacin. In the following years, the once powerful antibiotic Cipro stopped working 80 percent of the time on some of the deadliest human infections it used to wipe out. Twelve years later, the New England Journal of Medicine published a study linking people infected with a Cipro-resistant bacteria to pork they had eaten.

Johns Hopkins University health sciences professor Ellen Silbergeld, who has reviewed every major study on this issue, said there’s no doubt drug use in farm animals is a "major driver of antimicrobial resistance worldwide."

"We have data to show it’s in wastewaters and it goes to aquaculture and it goes here and there," agreed Dr. Stuart Levy, an expert on antibiotic resistance at Tufts University in Boston. "Antibiotic use in animals impacts everything."

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Farmer Craig Rowles remains unconvinced.

It’s afternoon in one of his many rural Iowa pig barns, roaring with snorting and squealing pigs. Some snooze in corners, while others hustle toward their troughs, their slop laced with a steady supply of antibiotics.

"If there was some sort of crossover between the use of the antibiotics in animals and the antibiotics in humans, if there was in fact a real issue there, wouldn’t you think we would have seen it?" said Rowles, also a veterinarian who sells 150,000 hogs a year. "That’s what the science says to me."

The modular modern barn, home to 1,000 pigs, is a hygienic place. Manure plops through slatted floorboards; an invisible funk steams back up. Rowles dons a sanitary white paper jumpsuit and slips plastic booties over his shoes; he’s anxious that his 100-pound pigs aren’t exposed to outside germs. A few sick swine are isolated, corralled in a pen near the entrance.

Antibiotics are a crucial part of Rowles’ business, speeding growth and warding off disease.

"Now the public doesn’t see that," he said. "They’re only concerned about resistance, and they don’t care about economics because, ‘As long as I can buy a pork chop for a buck 69 a pound, I really don’t care.’ But we live in a world where you have to consider economics in the decision-making process of what we do."

Rowles gives his pigs virginiamycin, which has been used in livestock for decades and is not absorbed by the gut. He withdraws the drug three weeks before his hogs are sent for slaughter. He also monitors his herd for signs of drug resistance to ensure they are getting the most effective doses.

"The one thing that the American public wants to know is: Is the product that I’m getting, is it safe to eat?" said Rowles, whose home freezer is full of his pork. "I’m telling you that the product that we produce today is the safest, most wholesome product that you could possibly get.

Strict federal rules against trans fats are needed in Canada, health and restaurant groups say.

The groups were reacting Wednesday to a new review by Health Canada that found few small restaurants, fast food chains, hospitals or school cafeterias came close to meeting the goal of limiting trans fats.

Trans fats raise the levels of low-density lipoprotein, or "bad" cholesterol, in the body and can lead to clogged arteries and heart disease.

The Heart and Stroke Foundation of Canada said consumption of trans fats accounts for 3,000 to 5,000 deaths from heart disease annually.

And Canadian food manufacturers who won’t change their ways voluntarily should be forced to, said Stephen Samis, director of health policy with the foundation.

Voluntary limits of no more than two per cent trans fats in oils such as margarine and no more than five per cent in all other foods were established two years ago in a partnership between Health Canada and the Heart and Stroke Foundation of Canada.

But the authors of the Health Canada report released on Tuesday still found high levels of trans fat in:

* 21 per cent of french fries.
* 26 per cent of chicken products.
* 50 per cent of bakery products.
* 60 per cent of cookies.

Some of the highest levels were found in hospitals and school cafeterias and in foods marketed to children, such as chicken strips, Samis said.

"We’ve seen many more who haven’t changed practices and that’s why we think regulations should be put in place.," Samis said.
Flavour remains after switch

Some restaurants have changed their ways, however. More than a year ago, the owners of a fast-food joint in north Toronto, for instance, decided to move away from hydrogen fats to pure canola oil to make fries and onion rings.

"A lot of people the last couple of years, they used to ask, ‘What kind of oil do you use?’" said John Batshon of the Burger Shack. "You tell them ‘We don’t use trans fat.’ Right away they’ll order the fries."

Denmark has already banned trans fats, and Danish authorities said it made no difference to the price, taste or shelf life of foods.

The Canadian Food and Restaurant Association backs the Heart and Stroke Foundation’s call for a federal ban on the production of trans fats. At present, restaurants often don’t have much choice about using trans fat, spokesperson Joyce Reynolds said.

"The typical restaurant has hundreds of thousands of ingredients," Reynolds said. "So for them to guarantee that every product that they buy and that they use to make menu items are free of trans fat is very challenging."

The industry association wants national standards on trans fats so there won’t be a patchwork of local regulations. Some provincial and municipal authorities, such as British Columbia and Calgary, are moving to ban trans fats, the group said.

Health Canada said it will continue to include interested parties in future discussions about trans fats.

Consumers taking a weight-loss product should avoid an unauthorized product sold online that contains BZP, Health Canada says.

The capsules are called RevolutionDS Weight Loss and contain a synthetic substance known as benzylpiperazine, or BZP, the regulator said Thursday.

BZP may cause:

* Increased body temperature.
* Increased blood pressure.
* Dilated pupils.
* Increased euphoria.
* Alertness.
* Paranoia.

Health Canada is assessing whether to add BZP to a list of substances included in the Controlled Drugs and Substances Act.

People who take the recommended dose on the label of the products could be associated with serious and life-threatening health consequences, Health Canada warns.

There is a Canadian report of cardiac arrhythmia or abnormal electrical activity of the heart associated with the use of RevolutionDS Weight Loss.

BZP may also negatively interact with alcohol and prescription drugs, and scientific data suggests it has abuse potential given its amphetamine-like effects, Health Canada said.

The products is distributed by a website called revolutionds.com. Health Canada said the contact person listed on the website "has not been forthcoming in providing all required information to effectively recall the unauthorized product."

Anyone who has used the product and is concerned is advised to consult a health-care practitioner.

All drugs and natural health products that are authorized for sale in Canada carry an eight-digit identification number on the label.

The Grinch likely suffers from some well-defined mental health conditions that others might be able to identify with, some psychologists say.

The Grinch is a fictional holiday bad guy who sits atop Mount Crumpit plotting how to prevent Christmas from coming to Whoville.

"It could be perhaps that his shoes were too tight," the Dr. Seuss story, How The Grinch Stole Christmas, reads. "It could be his head wasn’t screwed on just right."

More likely, the Grinch is depressed, said Cynthia Bulik, a psychologist with the University of North Carolina at Chapel Hill.

"When people think about depression they often think about people being sad," said Bulik. "But that’s not always how depression expresses itself. Sometimes people who are depressed might get really irritable, and really grumpy and they can really withdraw socially."

The Grinch certainly wants to be left alone, irritated by thoughts of the noisy fun Whoville residents will have on Christmas morning, playing with their new toys.

It’s hard to be part of the holidays when everyone else appears to be so happy, agreed Susan Kilbride Roper, who suffers from seasonal affective disorder — depression that strikes as the days grow shorter.

"When we don’t have those feelings inside ourselves, being around people that are happy, and excited and feeling very social is really difficult and painful because you don’t feel you can contribute to any of the conversations in the room," she said.

The Grinch appears to be suffering from an almost textbook case of antisocial personality disorder with depressed mood, said Todd Hill, a clinical psychologist in Halifax.

Symptoms include:

* Failure to conform to social norms.
* Deceitfulness.
* Irritability.
* Aggressiveness.

Christmas can bring out the worst in most people, said Hill, noting all of his clients in the last three weeks have complained about the stress and pressure they feel to buy, visit and fulfil some impossible ideal of holiday happiness.

"It’s interesting to kind of identify with the Grinch and say, ‘Me too, I hate Christmas at times, I hate the expectations,’" Hill said.

The treatment, Hill said, is to forget the Martha Stewart-type Christmas and realize you’re not the only one feeling the pressure.

It’s worth remembering the grinches encountered at Christmas might actually be depressed and need someone to extend a hand, Bulik advised.

Asking diabetics who don’t take insulin to monitor their own blood glucose levels is a waste of health resources, two new studies suggest.

The studies, appearing in this week’s issue of the Canadian Medical Association Journal, conclude that the costs of the test strips outweigh the modest benefits that glucose monitoring provides to patients with type 2 diabetes who don’t need insulin.

The authors of one study say Ontario could save tens of millions of dollars by cutting back on the number of unnecessary glucose tests.

Patients with diabetes who need insulin take tiny blood samples several times a day to measure levels of glucose in their blood and adjust their insulin accordingly. But the benefits of monitoring blood glucose in patients who manage their Type 2 diabetes with medications and not insulin has often been questioned.

"The degree to which patients can adjust the dose of oral antidiabetes drugs in response to readings is limited," the CMAJ authors note.

To measure the costs of the test strips, researchers at the Institute for Clinical Evaluative Sciences and St. Michael’s Hospital looked at how much test strips cost the Ontario Public Drug Programs, which cover health care costs for Ontario seniors, residents of long-term care homes, those who receive home care and social assistance, and people who have high drug costs compared to their income.

They noted that the use of test strips has increased by almost 250 per cent from 1997 to 2008. The strips are now the third largest cost for Ontario drug programs, accounting for $100 million, or 3.3 per cent, of drug spending in 2007-08.

More than 50 per cent of patients with diabetes over the age of 65 received a prescription for test strips in 2008 at a total cost of $85.5 million. And with diabetes rates rising and the population aging, they project that the cost of the strips for older Ontarians would exceed $500 million between 2009 and 2013.

And yet, they say, almost half of those prescribed test strips were at relatively low risk for what’s called "drug-induced hypoglycemia" — low blood sugar from medication — and therefore may not have benefited from the monitoring.

"Routine use of blood glucose test strips may not actually improve outcomes and quality of life among most adults with type 2 diabetes treated by oral hypoglycemic agents [diabetes medications]," Tara Gomes, principal investigator and ICES epidemiologist said in a statement.

The authors of the second CMAJ study say that for most Type 2 diabetics not using insulin, using test strips seven or more times a week is unlikely to be a good use of health care resources. They note that periodic testing, perhaps one or two times per week, would be more cost-effective in many cases.

The authors say new policies should allow more selective and less frequent testing, to make test strip use more efficient. The cost savings could then be redirected to "more effective interventions for patients with diabetes."

"In light of the overall costs and questionable benefits of blood glucose self-monitoring in many patients, more focused policy decisions regarding test strips have been proposed in several jurisdictions," says Muhammad Mamdani, a co-author and Director of the Applied Health Research Centre at St. Michael’s Hospital.