• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

testing strips

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

New-journey

Well-Known Member
Relationship to Diabetes
Type 1
Pronouns
She/Her
I have just come off the phone from speaking with my DSN and need to rant. There is no one taking on the role of DSN so after today, there will be just a nurse who understands insulin.

On my notes it says I am using test strips at 280% more than I should. She told me to only test 4 times a day, that is all type ones need. I said NICE guidelines say up to 10 is fine and she looked it up and was surprised but agreed it said that. They are told to not prescribe test strips more than 150 a month and that was as they had no money. She said there are thousand of diabetic patients they cover.

We spoke of the new consultant and she told me he would think my control is too tight as well. I explained how I am working in line with NICE guidelines to never go higher than 9 after two hours after eating and be back between 4 and 7 before the next meal. How would I know this if I didn't test. She said they recommend to not test two hours after a meal, just before taking the rapid insulin which means most is 4. What about before bed I said, as having hypo in night is not a great idea. 😡

I shared I know someone in Somerset who gets 500 at a time and she says that is impossible. I explained that I drive often and have to test, I regularly speak to a audience sometimes for an hour and half and have to check before, I test more when I am ill, have hypos, take exercise, so it can go up to 10 times a day. She put it up to 300 but thinks it will be challenged. So cross and upset!
Thanks for listening. 😡
 
Last edited:
OMG! I am so sorry to read this NJ, I'm fine with the 200 a month I get but I'd be testing much more if I was driving etc, they also have to think of the fact that you do get bad strips, I had that incident just the other day and a few months ago almost a whole pot was displaying the bad strip message, I'm glad to see that they have upped it to 300 but I hope you aren't challenged on this xx
 
OMG! I am so sorry to read this NJ, I'm fine with the 200 a month I get but I'd be testing much more if I was driving etc, they also have to think of the fact that you do get bad strips, I had that incident just the other day and a few months ago almost a whole pot was displaying the bad strip message, I'm glad to see that they have upped it to 300 but I hope you aren't challenged on this xx
Imagine being told you should only test four times a day! Never after a meal and never before bed, so shocked.
Thanks, so upset but will get over it soon.
 
Imagine being told you should only test four times a day! Never after a meal and never before bed, so shocked.
Thanks, so upset but will get over it soon.
There is one of the DSN's in my team that doesn't believe in post meal testing either and I disagree with her but I haven't seen her since last year and I rather wouldn't see her, understandable that you are upset but it IS a positive result in a way xx
 
I understand your frustration New-journey, it is a stupid situation where nurses are doing the job of DSNs in doctors practices, I have had this situation for 10 years now, and what annoys me is they thing they know it all, one who tried to force her point on me when challenged said that she had a diploma in diabetes, I was so annoyed I told her that I had a First Aid Certificate but it did not make me a heart surgeon. 😱 Having said all that, I must admit I have never had any problem with test strips, I am type2 and on MDI and get 200 strips a month. PS. I am close to Somerset, in Bristol :D

John.
 
There is one of the DSN's in my team that doesn't believe in post meal testing either and I disagree with her but I haven't seen her since last year and I rather wouldn't see her, understandable that you are upset but it IS a positive result in a way xx
True, it is positive I know. I will calm down!
I have no one in my team who supports me, luckily I have this forum.
 
:( That’s terrible! I don’t know what else to say? I don’t really do hugs but, I’m thinking of & feeling for you!
 
:( That’s terrible! I don’t know what else to say? I don’t really do hugs but, I’m thinking of & feeling for you!
That's lovely! Thanks.
I rarely get upset like this but I am very good at calming down and being my normal happy self!
 
We were told the ABSOLUTE MINIMUM is mealtimes and bedtime, but obviously you need to test more if you are driving, feeling unwell etc etc. Our consultant also once said that "it's not possible to work too hard at trying to control your diabetes". We are obviously lucky and have a great team, we are hospital based though with properly trained DSNs who do actually know what they are talking about. We seem to have a good GP surgery too, who so far have never argued about how much stuff we ask for. It breaks my heart to hear of so many people whose only help comes from penny-pinching so-called experts who have done a one-day course and think they know everything :(. Sending big HUGS x
 
We were told the ABSOLUTE MINIMUM is mealtimes and bedtime, but obviously you need to test more if you are driving, feeling unwell etc etc. Our consultant also once said that "it's not possible to work too hard at trying to control your diabetes". We are obviously lucky and have a great team, we are hospital based though with properly trained DSNs who do actually know what they are talking about. We seem to have a good GP surgery too, who so far have never argued about how much stuff we ask for. It breaks my heart to hear of so many people whose only help comes from penny-pinching so-called experts who have done a one-day course and think they know everything :(. Sending big HUGS x
I love your consultant! I might use that quote at my appointment which is end of May as that is not the message I will be getting.
Thanks and I am calming down, will find out about the one other surgery here, to see if it is worth changing. Appreciate the hugs and your understanding.
 
Well done for helping the nurse understand what intensive insulin therapy involves @New-journey - as it seems they had no idea!

It might be eye-opening for them to read the health economic analysis that went into the NICE guidance, that shows that in general higher frequency of BG checks associate with improved outcomes. The reason 2x a day is not cost effective in T1 is because the outcomes that usually follow are so much more costly.

For interest, the reason that the 2hr post-meal checks are not recommended a standard is a DAFNE thing. DAFNE do not recommend post-meal monitoring because post-meal checks are notoriously tricky to interpret. It is easy for people to get freaked out by high BG (or low range BG!) soon after meals and forget how much insulin and/or carbohydrate they still have on board. This can lead to overcorrection and possible hypoglycaemia. Additionally once people start sprinkling corrections in all over the place it can be very hard to work out quite what is going on with dose stacking, basal need changes and carb:insulin / insulin sensitivity.

So you should feel able to check post meal if you find it helpful (and especially all the other times you mention like driving, confirming possible hypoglycaemia/recovery and around illness) but just be careful when interpreting those 2hr checks as there is a lot more to take into consideration.
 
Well I wouldn't do a 2 hour check unless there was a specific reason for it like how much carb did I actually eat, was my guesstimate of Xg carb about right or not - which the pump specific meter will calculate since it communicates with the pump so knows how much IOB I still have left and given what I told it about the amount of carb when it calculated the bolus, will tell me if I need a correction or not.

Or if it was something I wasn't used to eating or a bigger portion of whatever to see if my tolerance for eg pasta or rice has increased or reduced?

Otherwise, I'd just test before next meal, and the meter will build in any adjustment needed to bring the pre-meal BG up or down to 'target', into the bolus for the meal I'm about to consume.
 
I love your consultant!
LOL - she definitely knows her stuff, but is also one of those people who REALLY doesn't mince her words - I wouldn't like to be on the receiving end if she thought we weren't trying hard enough! But fortunately she thinks we're doing brilliantly, which is a relief 🙄. I wish I could lend her to you!
 
There are a few consultants and DSNs who need cloning.
You will be armed with good evidence for your next appointment and ready for any questions.
 
...there will be just a nurse who understands insulin...
...I explained that I drive often and have to test, I regularly speak to a audience sometimes for an hour and half and have to check before, I test more when I am ill, have hypos, take exercise, so it can go up to 10 times a day... 😡

Wow. Fully appreciate your rant!
So your new nurse understands insulin? She obviously doesn't understand T1.
How can you be limited to 4 strips per day? How the heck are you supposed to maintain good control if you don't know what's going on?
I'm not sure they can limit you to 4 anyway:
NICE NG17 Clause 1.6.11 states: "Support adults with type 1 diabetes to test at least 4 times a day, and up to 10 times a day".
So that should stop all this nonsense straight away.
Good luck with your battle and I hope your new nurse takes on board your comments & the NICE guidelines.
 
We had this at my surgery when the CCG imposed a limit of 100 a month.

I went and made an appointment specifically to ask for exact instructions on which ones my GP wanted to me to miss out. The pre-driving and the whilst driving ones) When I thought I was hypo? After treating it to see if it had worked?
When I felt high? Before meals prior to bolusing? If I happened to be otherwise ill?

He had given up and surrendered well before I'd finished LOL

I recommend it as a strategy, especially with clueless folk like the surgery nurse !
 
We had this at my surgery when the CCG imposed a limit of 100 a month.

I went and made an appointment specifically to ask for exact instructions on which ones my GP wanted to me to miss out. The pre-driving and the whilst driving ones) When I thought I was hypo? After treating it to see if it had worked?
When I felt high? Before meals prior to bolusing? If I happened to be otherwise ill?

He had given up and surrendered well before I'd finished LOL

I recommend it as a strategy, especially with clueless folk like the surgery nurse !
This made me laugh and it is what I did in the end, added a few others too!
 
Wow. Fully appreciate your rant!
So your new nurse understands insulin? She obviously doesn't understand T1.
How can you be limited to 4 strips per day? How the heck are you supposed to maintain good control if you don't know what's going on?
I'm not sure they can limit you to 4 anyway:
NICE NG17 Clause 1.6.11 states: "Support adults with type 1 diabetes to test at least 4 times a day, and up to 10 times a day".
So that should stop all this nonsense straight away.
Good luck with your battle and I hope your new nurse takes on board your comments & the NICE guidelines.
Thanks and at the moment I have my new prescription, how long till they change it back I don't know. I have now devised several plans which I can start depending on the appointment with my new consultant. I was rather surprised the DSN didn't know that clause and looked it up whilst she was speaking with me, pity it was her last day as a DSN so bit late to find it out!
I am down as someone who has too good control and get judged for that. After two and half years with no support from health professionals, I am determined to now get better support.
 
There are a few consultants and DSNs who need cloning.
You will be armed with good evidence for your next appointment and ready for any questions.
Thanks and very true. This forum has given me so much supoort and information I need, means I can take them on!
 
LOL - she definitely knows her stuff, but is also one of those people who REALLY doesn't mince her words - I wouldn't like to be on the receiving end if she thought we weren't trying hard enough! But fortunately she thinks we're doing brilliantly, which is a relief 🙄. I wish I could lend her to you!
She does sound she could be scary if she thought you weren't doing well, glad to hear she thinks you are doing brilliantly, please can you lend her to me!
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Back
Top