The San Francisco Chronicle has an article about glucose meters for diabetics being reused without cleaning. People with diabetes have been found to face double the risk of being infected with hepatitis B compared to those without diabetes. The Centers for Disease Control recommend vaccinations against hepatitis B and other measures to reduce likelihood of transmission.
Dr Joseph Sonnabend sent me the article, pointing out that this is the situation in industrialized countries, where health services are in far better condition than in developing countries, where rates of hepatitis B and other blood borne viruses can be very high. In such scenarios, it would probably be advisable to test for hepatitis C and HIV also.
Dr Sonnabend points out that diabetes is a complication of some commonly used HIV drugs. But it is also very common in countries where poor diet and other factors lead to high disease burdens. Many people in developing countries who develop diabetes are unlikely to be tested until the condition has reached a critical stage and they are also less likely to receive treatment, because of cost, lack of access to health facilities or a combination of problems.
Apparently outbreaks of hepatitis B have been common among diabetics for many years. Therefore, those in developing countries who do have access to health facilities may face far higher risks from hepatitis B, C, HIV and perhaps other blood borne diseases. It just seems unlikely that infection control procedures in these countries will pick up the thread and deal with it adequately.
UNAIDS and other institutions seem keen to deny the possibility of reuse of contaminated skin piercing instruments in health facilities giving rise to infection with HIV or other diseases. But the only reason people in high HIV prevalence countries are unlikely to face such risks seems to be that many of them are unlikely to be able to afford treatment.