Diabetes is the opposite of a one-size-fits-all disease. Each patient’s circumstances are unique and require different types and levels of management.

But in its drive to save money on health care, Oregon’s Health Evidence Review Commission, known as HERC, is considering reducing the supplies that allow Medicaid diabetes patients to manage their disease. It’s a choice that could easily backfire, leading to emergency-room visits and more long-term debilitating medical complications. Better to let doctors consult with patients and make the choices about day-to-day management and the needed supplies.

Diabetes is divided first between Type 1 (always insulin dependent) and Type 2 (sometimes insulin-dependent), but the treatment regimen varies widely. Many patients must make constant adjustments throughout every day to account for the effects of varied amounts and types of food, exercise and medication. To make those choices well, they need to use test strips frequently to determine their blood sugar level.

HERC is considering reducing the number of test strips available for those who don’t take insulin, saying some patients use them unnecessarily and the change could save the state money. Advocates for the revision say use of too many strips can cause problems in some cases.

Critics of the rule change say the cutback would leave patients in the dark, unable to manage their disease, leading to more illness and hospitalization.

Blood sugar levels allowed to stay too high over time can lead to serious complications, from blindness to amputation. Blood sugar levels that go too low can lead to an immediate crisis, such as a seizure. A diabetic is in a constant struggle to keep levels just right, knowing that a morning run will affect blood sugar for hours thereafter, and that the amount of fat in a meal will affect the speed of digestion and therefore how soon sugar reaches the blood stream. It’s a 24/7 self-management process.

The necessary number of test strips for an individual diabetic can’t be decided wisely by a state commission. We support the American Diabetes Association recommendation to let physicians decide.