For Type 2's Struggling to get BG Test Strips

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NiVZ

NiVZ

Well-Known Member
Relationship to Diabetes
Type 1
Hello,

Found this link to the latest NICE Guidelines for Type 2 Diabetes. Those of you struggling to get test strips from your GP may want to take a look at the "Self Monitoring of Blood Glucose (SMBG)" section on pages 47 and 48:

NICE Guidelines for Type 2 Diabetes (CG66)

And in particular to the paragraphs:

Self-monitoring is the only direct method by which a person with diabetes can be aware of their
level of control of blood glucose. It has utility when used with therapies of erratic effect, those
requiring considerable dose adjustment (notably insulin), and in those whose therapies put
them at risk of hypoglycaemia.
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and

Even though the Cochrane reviews37,38 were not able to meta-analyse the data (due to clinical
and methodological heterogeneity) the authors concluded that SMBG might be effective in
improving glycaemic control in patients with Type 2 diabetes who are not using insulin.
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and

The other review36 concluded that, ‘in the short term, and when integrated with educational
advice, self-monitoring of blood glucose as an adjunct to standard therapy, may contribute to
improving glycaemic control among non-insulin requiring Type 2 diabetes patients’.
Click to expand...



NiVZ
 
I was told by the nurse practitioner today that they are not allowed to prescribe test strips for anyone diet controlled. So I think these only count for those on medication/insulin. She said there's no need to test when you're at no risk of a hypo and on a healthy diet.
 
Peter C said:
Did you punch her in the mouth ?
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hahaa..brilliant.peter
this is so ridulous..i have no probs getting what i need as a T2, surely my practice follow the same guidelines as all others so why the huge difference in attitude ???:confused:
 
I think it is all down to what the surgery's budget is, so if they can read something like the NICE guidelines and work it round to diet controlled diabetics don't need to test...

I was diet controlled for 6 months and I bought a test meter and had no problems from the surgery I was with in getting test strips, I had to pay for them but got a pre-payment card. I am now insulin and tablet controlled and the surgery I am with now my GP has no problems in prescribing me anything I need, whether it's related to my diabetes or anything else.
 
Peter C said:
Did you punch her in the mouth ?
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I'm fairly certain that wouldn't work in my favour 😛

To be fair, my HbA1c was 6.4, so obviously I dont need to be testing as I'm doing ok without it. It's not her fault that there are restrictions on what she's allowed to prescribe.

If it weren't for all the people wasting test strips and doing nothing about the results, folks like me would still be allowed them. It's the people testing, complaining their bloods are high whilst not changing their diet/lifestyle and expecting the pills to do the work for them that have taken test strips away from people like me. So they're the ones deserving the punch in the mouth 😛
 
LisaLQ said:
I'm fairly certain that wouldn't work in my favour 😛

To be fair, my HbA1c was 6.4, so obviously I dont need to be testing as I'm doing ok without it.
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Er... not quite, The American Assoc of Clinical Endodrinologists ( the sine qua non of diabetic authorities) state that A1cs should be below 6.2 since complications start at that level.
A whole wad of research is also showing that post prandial spikes in bgs in the first couple of hours after a meal are just as indicative of complications to come as high A1cs. It's the post prandial spikes you need to know about and address ( by testing) aiming for a low spike diet ( established by testing).
Have you read Jennifer's smart advice ?
"Test,test,test" and "Eat to your meter".

What's a "nurse practioner" anyway ? She's not an Endocrinologist ( the specialist who SHOULD be guiding your diabetic care), she's not a Diabetologist, she's not a GPwSI in Diabetes ( a GP with a Special Interest in Diabetes), she is not a GP or even a Diabetic Specialist Nurse ( they are the bees knees but so expensive they are very rare).Sounds like you are way down the pecking order with cheap, poor quality care from a no-mark who clealry knows very little about the management of T2 diabetes.
 
Peter - you come across as someone who's been very unhappy with their own care, and somewhat aggressive and rude with it. I'm sorry if your care has been lacking, but it really is wrong of you to suggest I hit someone about my own, when you have no idea of my care.

You have no idea what qualifications the nurse practitioner has, but I'm sure they're much higher than that of the average patient (unless YOU'RE an endocrinologist?).

If my docs/nurse thought I needed to test they would tell me (they haven't ruled it out, just said not yet). The fact of the matter is - I fully intend to avoid medicine as long as possible by changing my lifestyle. If you want to complain about something - complain about those who sit on their bums wasting test strips and not changing their lifestyle - as that is who are taking them away from those of us who do want to take control.

Perhaps there is a happy medium somewhere, but for now, I dont need to know my blood sugar levels as my average was fine. If you think you know better than a nurse practitioner who has my medical records and evidently lots of training in diabetic care, then perhaps you may want to look into training as a doctor or endocrinologist.

I'm not a dumb animal who will blindly follow what doctors tell me, I am capable of making my own choices - when I asked about testing my blood glucose levels several times a day, the nurse explained why it wasn't necessary at this stage, and it made sense.

What endocrinologists in the US think is frankly none of my concern.
 
Lisa ,
have you read Jennifer's Smart Advice yet ?..
http://jennifer.flyingrat.net/

It's probably the best advice any newbie T2 is going to get.
And if you want to avoid meds and change lifestyle then TESTING is the one sure and certain way of achieving those goals.
BTW - the HbA1c is NOT a measure of average bgs - they measure totally different things.
 
Cant say I have read it, as that's the first time I've seen the link (thank you - I shall read it). However, if she is not a doctor or endocrinologist, why should her advice be taken any more/less seriously than that of the medical professionals treating me? Anyone can make a website, I've done it myself (although I would never tell someone to ignore their doctor to follow MY advice).

Thank you for the link, I shall read it and ask my doctor/nurse accordingly 🙂
 
Hey Lisa. Before being diagnosed with Diabetes (actually, before I came on here) I thought of doctors, nurses etc as demi-Gods and thought they knew what was best for my health. Unfortunately you start to realise they don't know EVERYTHING and after having Diabetes for a few years you may end up knowing more about it than they do. I Don't think I do, but I know lot's of people around here who do know more about their Diabetes and what is best for them (or their children).

There is some information that doctors seem to either have to push, or want to push because they think it's best. A perfect example of this is dietary advice given to newly diagnosed type 2s. The "eat starchy carbs with every meal" thing. It seems crazy to me that they don't mention that perhaps it might be necessary to reduce carb intake in order to gain better control of glucose levels. It is also scary that they discourage people from testing and making changes. They even emphasise to type ones that you MUST test, but then get stingy with the prescriptions.

Remember that they have learnt from textbooks, but we are actually living with the condition everyday.
 
You've jumped to the conclusion from my posts that I trust my medical team implicitly and blindly, but in reality I've had to fight for the correct treatment for other health issues so I know doctors dont know everything (you think diabetic docs are bad - you should try gynaes and pain management docs!).

My nurse said about the carbs - she said it works for some, especially those who have more trouble controlling their levels, and even told me that they do carb counting at the local hospital for me to consider should I struggle in future. But for now whatever I'm doing, I'm doing it right, as she expected my HbA1c to be higher, and it's acceptable.

I wasn't saying that doctors are always right, I'm just saying that it's rude to come on and suggest you hit someone based on one message on an internet forum and absolutely no idea what kind of education my nurse has had, or even what she's suggested. She actually seems much more open compared to other peoples' experiences.

I just am sceptical when someone says "Your nurse has no clue, but trust this amateur website with your medical care". I'm not idolising my doctor/nurse, but likewise I'm not going to trust someone enough to give up the nurse's advice based on a less than professional looking website that covers someone else's very personal experience. It could be dangerous to give up trained medical advice to follow that of an anonymous amateur website.

If anyone has any concerns about my treatment, they can always respond to my thread about my care. Sorry to the OP for this one going off topic.
 
I wasn't jumping to conclusions. I was just talking about what ive learnt from being on here. I certainly wasn't backing up Peter C's replies to you either, which I thought were slightly aggressive and quite rude, as you said.

I didn't say you are idolising your doctors/nurses, I said I used to. To a degree I still do, I think good doctors and nurses are amazing and wish I could do their job.
 
Sorry Katie, I came across very rude there too, sorry about that. It's just so confusing when you dont know what's best and you're getting contradicting advice. 😱
 
ok lets chill everyone. I think the advice on the forum is useful as it makes me understand the D better often because it is in plain ordinary life terms. Everyones experiences are different but by sharing them we are more equiped to ask better questions of our medical staff.
Also people who are getting a rough deal...i still dont understand why there is stuff huge differences in quality of care......get some support here to ask why?
 
Lisa - you are doing really well and I am so pleased for you.

It is difficult to find your way through the maze of contradictory and often conflicting advice and then work out what works for you. I think that much of the frustration for some people comes from poor experiences of care or finding that the traditional advice doesn't seem to work.

Personally I started out with a really good play with the Diabetes UK virtual supermarket and then tweaked over 18 months until I hit on the balance that, at present, seems to keep me more-or-less on track. Currently I'm doing an Open University course on "Challenging Obesity" - so far I'm amazed at how little we really know about how our bodies really work on utilising our food and that has helped me appreciate a little more why there are so many views out there. When we also recognise that even the expert diabetic clinician's work to different guidelines across the world then it is no surprise that many find their GP has difficulty in keeping up to date. It is not unusual for people with chronic conditions to believe that they come to know more than the generalist team over time

I take my GP's advice seriously and am fortunate that he is the practice team expert on diabetes and has a real interest in the topic. If something he suggests doesn't work for me then we have a debate about the right action for me to take - it may be that something that would be "best" for my diabetes management would be "bad" for another part of me (perhaps in terms of stress, for example) and he will help me reach a balanced decision.
 
LisaLQ said:
I was told by the nurse practitioner today that they are not allowed to prescribe test strips for anyone diet controlled. So I think these only count for those on medication/insulin. She said there's no need to test when you're at no risk of a hypo and on a healthy diet.
Click to expand...

I don't know if Scotland is any different, but although my practice nurse wasn't keen to give me a meter and have me getting strips on prescription she conceded and gave me one. She mentioned about the cost of the strips but (reluctantly) arranged for them to be added to my repeat script (50 at a time).

My brother-in-law has been diet controlled for 9 years, but he does either have hypo's (on a weekly basis) or suffer from hypo like symptoms. I'm not sure that his healthcare team are aware of this though!!

I was diagnosed on 9th November after recurring infections. I was shocked 😱 , but determined to take control wherever I was able. I've been testing regularly and have discovered among other things that cereals are not my friend.. with tweaks and adjustments I have reduced my fasting levels from 7.2 to between 5 and 6. I'll be taking this information with me when I meet with my gp tomorrow and one of the things I will be asking for is a referral to a dietician and to a diabetes clinic.

Each of us needs to deal with this in the way that we feel is best suited to our needs, and our healthcare teams should support us as much as possible.
For me, this means that I will be pushing my doc to give me the strips I need to do the best that I can do to ensure that as far as is humanly possible, I can avoid/delay complications for as long as I can.

Karina 🙂🙂
 
I was diagnosed Type 2 in October this year and i have tried to get my test strips on prescription but i can't, my DN and GP have said that i don't need to test with them and have given me urine sticks on prescription instead but i'm not happy with that so i am having to buy my test strips and lancets. My lancets cost me ?8 for 100 which is not too bad but the test strips are very expensive but i have actually bought some recently on a well known online marketplace site and 100 strips have cost me the same price as 50 would have done from a chemist. At the moment i tend to test times a day but i wish we Type 2's could get these on prescription
 
carina62 said:
I was diagnosed Type 2 in October this year and i have tried to get my test strips on prescription but i can't, my DN and GP have said that i don't need to test with them and have given me urine sticks on prescription instead but i'm not happy with that so i am having to buy my test strips and lancets. My lancets cost me ?8 for 100 which is not too bad but the test strips are very expensive but i have actually bought some recently on a well known online marketplace site and 100 strips have cost me the same price as 50 would have done from a chemist. At the moment i tend to test times a day but i wish we Type 2's could get these on prescription
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I think its the old postcode lottery regarding healthcare, when i was a diet controlled diabetic the surgery i was with had no problems in prescribing diabetic supplies.. and the surgery i am at now is great, mind you i am on insulin now.
 
LisaLQ said:
Sorry Katie, I came across very rude there too, sorry about that. It's just so confusing when you dont know what's best and you're getting contradicting advice. 😱
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Hello again,

Sorry you are suspicious of Jennifer's Smart Advice - it is actually legendary among the international online diabetic community.

here's another legendary source of information as well ...David Mendosa
http://www.mendosa.com/advice.htm

Not on the same scale but another major contributor to the online diabetci community is the Aussie called Alan S. Read his "test, Review, Adjust" advice here ...
http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html

Hopefully this kind of material will help you to put the "nurse practitioners" advice about not needing to test "yet" into perspective. Hmmmm... "yet", when will she recommend testing - when the damage is done ?

if you need a book to read kick off with Gretchen Becker, "Type 2 Diabetes : the First Year".

All this year Accuchek having been giving away their meters FREE ( because they make their money from the strips ). If you go into a Pharmacy and chat to the pharmicist ( not the shop assistant) you might be able to blag a free meter ( or contact Accuchek and just ask for one ). The meter comes with an initial dozen or more strips to start you off on. Why not do a bit of experimentation like this with testing ?
 
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