Refused Testing Strips by GP

[Bubbsie]

As

Being devils advocate, I have said elswhere and in this thread, where is the scientific study which supports the theory that self monitoring has a positive result? My GP reluctantly gave me a new prescription but would rather do an HBA1c test at shorted intervals than annual.

Ralph...scientific study or not...I know testing works for me...gives me reasonable control...helps me manage my diabetes...as for the HbA1c test at short intervals...every three months...six months...once a year...hardly 'short' intervals.

 

[Vicsetter]

Ralph...scientific study or not...I know testing works for me...gives me reasonable control...helps me manage my diabetes...as for the HbA1c test at short intervals...every three months...six months...once a year...hardly 'short' intervals.

Who is Ralph?

 

[Bubbsie]

Who is Ralph?

Good question Vic...who is Ralph?...clearly not you...more coffee needed...this is what happens when you tackle serious issues on a weekend with only one cup of coffee behind you...more coffee brewing...will report back later!

 

[Vicsetter]

In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels". I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use. I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion. I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.

 

[Bill Stewardson]

In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels". I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use. I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion. I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.

Everyone who enters "combat" with a GP regarding strips deserves every Ds thanks. Thing is, why should they have to ?

Seems to me that there has been a policy implemented to trigger this move by GPs to pressure patients into not testing, even to the extent of doing it in an underhanded manner.

Even IF not testing was the sensible thing to do, why has such a move not been publicised and put out for discussion ??

So, who is behind this policy decision ? More importantly, is there a national voice that can challenge it on behalf of Ds ??

I blame Ralph.

 

[john cuthbert]

.Hi ChrisJK,

GPS are facing pressure to cut down on 'unneccessary' prescriptions. Ive just lost my gluten free bread which costs me about £1 per day. Its not a 'nice to have'.

You are obviously taking care of yourself. You dont need test strips to see that. If you keep your weight down, eat a a sensible diet, get some, moderate exercise. Walk if you can instead of driving you may well find life less stressfull if you do not feel the need to keep testing. You already know which foods you should day no to. Apologies if you are already doing this. What was your recent HBA1c? How many test a day do you take? What is your exercise/diet regime? If you stop testing for 3months while doing all the other things you may find it actually better.

JohnC

 

[john cuthbert]

Oh, and are you overweight?

 

[Bubbsie]

In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels". I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use. I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion. I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.

Had the same from my GP & the DSN (who I now refuse to see)...pointed out even if that were the case...whilst no scientific evidence which quantified the benefit of testing for me...good evidence from my recent HbA1c test...which my they said indicated excellent control...so they could rely on that...will be using the same argument at my next review if the issue reoccurs.

 

[Bubbsie]

.Hi ChrisJK,

GPS are facing pressure to cut down on 'unneccessary' prescriptions. Ive just lost my gluten free bread which costs me about £1 per day. Its not a 'nice to have'.

You are obviously taking care of yourself. You dont need test strips to see that. If you keep your weight down, eat a a sensible diet, get some, moderate exercise. Walk if you can instead of driving you may well find life less stressfull if you do not feel the need to keep testing. You already know which foods you should day no to. Apologies if you are already doing this. What was your recent HBA1c? How many test a day do you take? What is your exercise/diet regime? If you stop testing for 3months while doing all the other things you may find it actually better.

JohnC

John...really... how have you come to that opinion knowing little about the individual circumstances of this member...state he does not need to test...any well motivated diabetic who uses testing strips to manage/control their diabetes should have access to the necessary equipment...if it has been provided for a continuous period...then withdrawn without discussion...consultation...that is not acceptable...diabetes is a life long chronic condition as you know...you gain control of it...you need to maintain that control...there are times when irrespective of how well you eat...follow the same routine your blood sugar levels can rise...type 2 diabetics in particular are often denied testing strips routinely...based on the inaccurate interpretation of the NICE guidelines by GP practices & local CCG's...the guidelines say testing for type 2's non-dependant on hypoglycaemic medications should not be routinely undertaken...it does not preclude them...clearly those comments indicate.it allows room for deviation...discretion...it's not just about keeping your weight down...eating a sensible diet...or exercise...the assumption this is all it takes to manage as a type 2 diabetic not dependant on hypo causing medication...is not dissimilar to the popular media myth that type 2's are all overweight...inactive... eat the wrong food...like you apologies if that is the wrong assumption...however there is nothing in the posters thread that says he wants to stop testing...clearly from his comments he wants to continue testing...I very much hope he does challenge the decision to withdraw his prescription...I would offer him every assistance to do that if he wishes... whilst we are all fighting diabetes...there are many differences between the medications/regime employed to manage our different types of diabetes... please as a type 2 managing her diabetes on a very small dose of Metformin...don't assume it is as simple as eating a healthy diet...exercising...losing weight...avoiding stress to maintain good control...consequently we have no need to test...we have enough barriers in our way already...from those health care professionals charged with our care who express similar.. .ill informed/unfounded views such as yours.

 

[Bubbsie]

Yes I am on Metformin , and my GP has Reduced this. At first she wanted to Reduce my Tablets from Four to Two Tablets a Day, but after we had a "Discussion" they were Reduced to Three a Day

Of course I should have added this to my response above...when medication is reduced...as it has been in this instance...important to continue to ensure good management/control of your diabetes is not affected by the reduced dose...by testing!

 

[Drummer]

I am over 6 months from diagnosis have not seen a doctor to discus my results, the nurses I have seem have no training in controlling by diet, just repeat that there is no need to test, and the doctor I was called in to see last week just wanted to persuade me to take statins again.
It is NHS policy not to supply meters or strips for testing - and things are being tightened up.
Yes it is an embuggerance, but that is the way things are at the moment.
It might prove to be a false economy at the moment but it is the coping mechanism at the moment and I'm not supposed to bother the surgery again for six months. I have reminded them twice that I have not had a thyroid check for almost two years, but that seem to be more than I am worth at the moment. Maybe next year.

 

[Derek Stubbs]

it's strange that they are quick to prescribe drugs & tablets (things which the big pharma companies are in bed with the Government ) because the big pharma companies pay £billions to governments who then set agenda's which GP need to follow in order to get paid. Yet, if they prescribed everyone with meters & test strips so we can control it ourselves with diet (I am talking type 2 here), it would mean less need for tablets etc, & the government then loose out if the big pharma companies reduced payments as their "products" weren't being used. Companies that produce test strips are just peanuts compared to the big drug companies. So money talks. Drugs & money, not test strips , rule this world

 

[Bill Stewardson]

.Hi ChrisJK,

GPS are facing pressure to cut down on 'unneccessary' prescriptions. Ive just lost my gluten free bread which costs me about £1 per day. Its not a 'nice to have'.

You are obviously taking care of yourself. You dont need test strips to see that. If you keep your weight down, eat a a sensible diet, get some, moderate exercise. Walk if you can instead of driving you may well find life less stressfull if you do not feel the need to keep testing. You already know which foods you should day no to. Apologies if you are already doing this. What was your recent HBA1c? How many test a day do you take? What is your exercise/diet regime? If you stop testing for 3months while doing all the other things you may find it actually better.

JohnC

So, just exactly how do you balance a cost saving against the peace of mind the patient enjoys by testing ?

How do you then have the ability to brush aside the obvious benefits of a patient taking control of their health care on a day to day basis ?

Where does the higher position required to class strip prescriptions as unnecessary come from ?

What do you think Mr Majeed ( my pancreatic surgeon) would have to say if I just stopped monitoring my BG levels ?

How much would my not being in a position to spot problems developing potentially cost the NHS ??

In what way would the potential for Ds to be extra susceptible to infections be reduced by taking away strips ? ( and that's ignoring the underhand way it is being done).

Sorry to put you on the spot, just wanted you see how the original poster must be feeling.

 

[mikeyB]

This thread depresses me. This is not an argument we should having among ourselves. We know that this is just money saving, and nothing to do with ideal diabetic control.

It's something that DUK should be banging on the government's door to put right. It's a discussion that crops up regularly on the forum, members are regularly complaining. I've said before, this a false economy, and it is a backward step in diabetes management, and will cost the NHS dear. Why this is not a priority in DUKs plans is completely beyond me. Are they making any effort at all to convince the powers that be that this is crazy? If not, who will?

 

[Bill Stewardson]

This thread depresses me. This is not an argument we should having among ourselves. We know that this is just money saving, and nothing to do with ideal diabetic control.

It's something that DUK should be banging on the government's door to put right. It's a discussion that crops up regularly on the forum, members are regularly complaining. I've said before, this a false economy, and it is a backward step in diabetes management, and will cost the NHS dear. Why this is not a priority in DUKs plans is completely beyond me. Are they making any effort at all to convince the powers that be that this is crazy? If not, who will?

Understood Mike.

If anyone has any ideas as to who should be written to, I will do that.

Not much comes out of us telling each other in here, time to tell those out there, if we' don't do it nobody else will.

 

[Bubbsie]

Understood Mike.

If anyone has any ideas as to who should be written to, I will do that.

Not much comes out of us telling each other in here, time to tell those out there, if we' don't do it nobody else will.

Bill...please please please don't assume nothing comes out of us telling each other here...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.

 

[CHRISJK]

Bill...please please please don't assume nothing comes out of us telling each other here...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.

Hi , Sorry I havn't been on here for a while but I am on Holiday for a few days, but when I get back I will write to my GP regarding this. Any help with this will be appreciated . Thank You all for the replies...... Chris

 

[Bubbsie]

Hi , Sorry I havn't been on here for a while but I am on Holiday for a few days, but when I get back I will write to my GP regarding this. Any help with this will be appreciated . Thank You all for the replies...... Chris

Enjoy your break Chris...when you get back...will be happy to provide some information for you...let me now when you're ready

 

[Bill Stewardson]

Bill...please please please don't assume nothing comes out of us telling each other here...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.

There is no assumption here that individuals taking issue is of no value, more that dealing with the policy makers may carry more value, if it turns out not to, at least that tactic can be crossed off the list.

It is disappointing that a different plan being put forward is classed as being dismissive. We are all in this together.

 

[Bubbsie]

There is no assumption here that individuals taking issue is of no value, more that dealing with the policy makers may carry more value, if it turns out not to, at least that tactic can be crossed off the list.

It is disappointing that a different plan being put forward is classed as being dismissive. We are all in this together.

Bill...I've made my position clear on this issue...you deal with your management your way...I deal with my diabetes my way...anything...anything at all we do to challenge unfair inequitable decisions is of value...whether that be policy makers or any others involved in diabetes management at any level in the NHS...if my GP refuses me testing strips/medication I will ask him why...similarly if the DSN were to adopt the same approach...I would ask her why...the policy makers set the policy (NICE)...the policy most often is misinterpreted...misapplied by our surgeries...the local CCG committees...that's where the problem begins...there is every point in 'us' talking to each other about this...sharing information...we have to change the views of those we deal with directly...those that actually say 'No'...point to the guidelines...give a critique if necessary (lord knows most GP's DSN's need one)...your plan is not dismissed...whatever action you decide to pursue is a matter for you...as for your disappointment...many of us here have faced disappointment struggling to get what we need...for me a hard fought/won concession from my local CCG that my GP can prescribe testing strips & a meter proved invaluable...for me and others here I have shared that with...I wish you good luck with your battle....I sincerely hope it comes to fruition.