Graeme Macey will have to pay more for blood sugar test strips following the subsidy removal. Credit:Carl Muxlow But diabetic Graeme Macey said many patients would be priced out of the strips under the changes, which would limit their ability to keep their condition under control. "These are essential for us," Mr Macey said. "I try to control my blood sugars by testing before and after meals a couple of days a week and I watch my diet and exercise because I'm in the luck group that's not severely affected yet. "You have to eat good foods and not get extreme readings and the more you disobey the simple rules the quicker the deterioration of your organs.

"But if I and other people like me can control our health, nothing will happen and we will die of old age." About 900,000 people with type two diabetes are registered with the National Diabetes Services Scheme and more than two-thirds of them are not insulin dependent. In removing the subsidy, the government followed the recommendation of the Pharmaceutical Benefits Advisory Committee which found in a review that there was little evidence that blood glucose test strips improved glucose control, quality of life or long-term complications. The Department of Health said the research it evaluated included a 2012 review by the internationally respected Cochrane Collaboration and a Canadian report on optimal medication prescribing. "The 2013 Review for Blood Glucose Test Strips looked at all available evidence, not just submissions provided by individual clinicians and support groups," a spokeswoman said.

Diabetes Australia argued that the premise of the review was misguided, and that measuring the effectiveness of test strips to control blood glucose was akin to using a thermometer to bring down a fever. "Clinical outcomes and benefits cannot reasonably be expected to arise from the use of a measurement tool," the submission said. The risks of removing access to the strips included hypoglycemia and hyperglycemia, delay of treatment and new costs related to those complications. Diabetes Australia chief executive Greg Johnson said there had been universal access to the strips for 28 years and no evidence that they were being used wastefully. "It sends the wrong message," Mr Johnson said.

"If the government wants people to take responsibility and it wants them to look after themselves, you've got to give them access to these things. The risk is that some people who no longer have access, their diabetes management will suffer and that may have a cost to the health system in the future." University of Sydney metabolic health professor Stephen Colagiuri, a world authority on diabetes, said in his submission that the strips were an "integral" component of diabetes self care. The single most effective way to control blood sugar levels was medication, he said, but the strips supported the drug therapy by providing objective feedback to patients on how their lifestyle habits affected their glucose levels. "The key point is better use of [self-monitoring of blood glucose], not abandoning its use," Professor Coligiuri's submission said. The Australian Medical Association also argued against the removal of the subsidy on the strips, which it said had played an important role in diabetes management in that they allowed patients to take control over their health care through self-monitoring.