GP policy on test strips for Type 2 diabetics

Status
Not open for further replies.
im like a few i got a metre when i was diagnosed not off my gp tho as he said i was nto entitled to a free one but when i saw my nurse she gave me it , but last week i entered a comp and won a contour metre and it arrived yesterday so that was a nice surprise ( i never win nothing)

VBH i always wondered about re-using and i have been since Thursday, at first i was using a fresh one everytime

thanks x
 
Vanessa said:
Many thanks for your very helpful posts Wallycorker. I've learned more about what is the right food intake for me by reading round the issue, linking in to varous websites and from this forum than from the NHS. Initally, however, I did find the Diabetes UK food store very useful in getting me to think more clearly about what I was eating and things like portion sizes - as a start point it was useful. To be fair - when I did the local equivalent of DESMOND, the dietitician did mention "low GI" but then said that it was too complex for the session and if we were interested we could read further about it.

I think that is where one of the problems for the NHS and Diabetes UK lies as simple messages are often aimed very low and any more is left to a matter of personal choice of what and how the individual wishes to take action. I do wonder if those of us on this forum are more of a vociferous (or is that stroppy?) minority who are not content to accept that doctor/dietitician/research scientist always knows best?
Click to expand...


Hi Vanessa and thanks for your comments - its good to meet you.

I attended one of the DESMOND courses - but only after eight years as a Type 2. I had joined two local support groups and heard of the courses through conversations at those groups. I asked my GP about going on one and he didn't know anything about DESMOND or DAFNE courses despite the fact that Rotherham PCT funded and ran such courses.

I found the DESMOND course interesting and useful but by the time I had had to wait to go on the course I had read so much and new most of it already. Some of the other four people on the course didn't seem very motivated by what they were hearing and two of them couldn't be bothered to move to the table when the trainers were showing us how to look at food.

I agree with you that there was loads of stuff that wasn't covered - such as GI - and very little specific advice as to how to get your numbers down. Moreover, the trainers on the DESMOND courses didn't seem to like the fact that I was testing. I suppose because the local PCT isn't willing to fund the strips. They thought that I was in danger of going too low and having hypos - my GP says that isn't a danger so long as I'm only on Metformin.

I've learnt a lot through reading and I'm quite prepared to raise questions wherever I go next. The health professionals don't seem to like it but that's the way its going to be as far as I am concerned. When I was tackling my GP - someone I like and have always respected - about not being happy about not being allowed to start testing and personally get to grips with my own situation he said some quite strange things - "We all have to die some day"; "If I wasn't happy about not receiving test strips then I would have to move to a different GP" and "That he experienced blood sugar spikes after eating food". I was quite amazed by the last statement and asked how that had any relevance seeing that he wasn't a diabetic. He didn't give me an answer!
 
Wally,

I joined the NNTP newsgroups when I was first diagnosed 5 years ago and learned from experienced diabetics all over the world on every continent. The advice that drove me early on was condensed rather nicely by Jennifer:
http://www.diabetes-support.org.uk/joomla/jennifers-advice

In 5 months I went from a BMI of 33 to 25. My A1c went from 10.8 to 6.0 and has never been higher than 6.0 since, with a personal best of 5.5 although if I were really determined I am certain I could do better, but there's a life balance to consider. By the time I saw a dietician one month after diagnosis, I contradicted all of her advice because I already knew what her suggestions would do to my BG. I had the figures to prove it.

I've been passing Jennifer's advice on ever since. I'm heavily involved with another forum, so when you mentioned avoiding insulin it brought another chap to mind. Chris turned up in November and was concerned because he had been following all the official advice. Despite this he had never got his A1c below 7.1. He was on increasing amounts of drugs and was approaching the max for both metformin and Glic. We gave him a little general advice and pointed him principally at Jennifer's advice.

He now has an A1c of 5.9 and has halved his pills intake.

I've been pointing T2s at Jennifer's advice for years now and everyone who has given it a proper go has had a massive improvement. Most are in the 5% club.

Once you throw away the NHS/DUK recommendations and start to learn for yourself with a meter, you never look back.
 
sofaraway said:
Just wondering for those type 2's who are in good control and have had diabetes for a while (wallycorker, VBH, any others) test now. Do you test after tried and tested meals or only for new things exercise/food? how many tests does that work out in an average day?
Click to expand...

On average, less than one per day for me although perhaps I should test a little more often tbh.

It meant intensive testing originally, but I have enough accumulated knowledge of what various food combinations do to me that I know when I am well within safety limits and when I am pushing things a bit. I generally only test now when I am having a new food combination which is not really that often. Otherwise when I suspect low or high bg.

For example I know that I am somewhere between 4.0 and 5.5 fasting and that my breakfast options raise my bg by 1-2 mmol/l max. By testing I would not learn anything new. I've even found options on all takeaway menus that I can "get away with" under normal circumstances.
 
wallycorker said:
It is only after reading US literature (particularly Dr Bernstein's book regarding the bad effect of carbohydrates) and when I started testing my blood sugars (against my GP's wishes) that I began to understand why I had been having problems maintaining blood sugar control (with HbA1c levels such as 8.2%, 9.4%, 8.5% and suchlike).
Click to expand...
Yup I have to agree with pretty much everything you have posted. One quick word of warning on Bernstein though. Although he is very useful and talks a lot of sense, he tends to be quite extreme when it comes to targets and this is something to be careful of.

For example he claims that non-diabetic A1c is 4.2 to 4.6. This is misleading and due to the differences in standardisation of A1c around the world, I believe. The DCCT trial showed non-diabetic A1c as having a top range of 6.0 and other sources claim 5.7. All UK A1c tests are supposed to be standardised to DCCT so for us this is a more reliable measure. The way that A1c is measured differs around the world, so you have to be careful as to what you compare your A1c to.

Also his recommendation of 20 carbs per day is very restrictive and for most people total overkill. People will always want to rebel against anything that is too restrictive so there is far more chance of going off the rails.

I believe that everyone should find a way that works for them and while Bernstein and other authors are very useful in giving some pointers in that direction, it should not give rise to claims I have seen like "Bernstein is our bible". I think people should take the parts of books like his which help them, but not treat it like some holy book.

And of course the whole point of Jennifer's advice is along these lines- finding out what works for you personally and finding choices and a lifestyle that will work for you long term.
 
My testing varies depending on:

a) new food combinations
b) trying different forms of exercise
c) how often I'm driving as on gliclazide and keeping tight control of blood glucose means occasional hypos or levels below the 5.0mmol/l that mean I follow "have a snack" advice of DVLA
d) general health, or more particularly, illness
e) if I have signs of hypo (housework and gardening seem to have somewhat unpredictable effects!)

Many days though this means just one test now as I'm fairly predictable in terms of normal diet and exercise regime
 
sofaraway said:
I think that an individual assessment should be made in each case to see if they should have any test strips and how many.

Just wondering for those type 2's who are in good control and have had diabetes for a while (wallycorker, VBH, any others) test now. Do you test after tried and tested meals or only for new things exercise/food? how many tests does that work out in an average day?
Click to expand...
I only test when I am trying new foods and first thing in the morning - just to check my fasting blood sugar. Thus I only use just over one strip per day. I am also a member of the 5% club.

Regards Dodger
 
Last edited:
Wallycorker

I see you mention writing to Downing Street with regard to issuance of test strips to T2s. I organised a petition some while ago. The response can be found here http://www.diabetes-support.org.uk/joomla/blood-glucose-testing/test-strips-petition-and-response

It's the local PCTs who "advise" the Doctors not to prescribe the strips (on a cost basis) and on the basis of the Farmer et al study, which we all know to be severely flawed.

Like you and VBH I am totally dismayed at the appalling dietary advice handed out by the NHS and perpetuated by Diabetes UK. Even for a T1 it's appallingly bad advice. I find control and titration of insulin doses so much easier when carbohydrates are limited.

I have other issues I feel strongly about... such as the lack of diabetic education available to both T2s and T1s but if I get going this will turn into a rant! LOL!
 
sorry to jump in here folks, but i cant sit and listen to you slandering all those folks in the nhs who have more than helped all of us out. if they hadnt be able to figure out we were needing of insulin or changes to our diets then a lot of us wouldnt be here right now (me for 1). i think the diet advice i get from my local pct dietician is spot on. the lady is called lara and she used to be a part of the dietician's used by the springbocks ( south sfrican rugby union) team. she has dedication and is very able to advise on what foods will do what to me and what she thinks i should avoid at certain times of the day, but having been on a carb counting course i now have the options to do all the work myself. i understand things are a little different between type 2's and us type 1's but i have two family members who are type 2 and they follow the standard diets of a healthy person and both have A1c's of under 6% and on most tests are in the 5% club. just because something works for one person doesnt meen it will work for all.
 
I have to agree with Mikep1979

As per my earlier post on this subject, I have nothing but praise for my local PCT. I only wish each of you had the same support.

My local area was not always so good. When diagosed 8 years ago, I got my appt thru for my 1st annual hospital review, which was dated 2 years in advance, I thought that some numptie had misquoted the appt time - but no it was correct. Diabetes UK were equally shocked and suggested I write to Govt.

I did, and recevied a very nice letter from Liam Fox (he had something to do with the health department), saying things would change. In Scotland they did, although according to the diabetes people in the hospital, they say more staff is still needed, but it has improved.

Surely the cost of strips and lancets is nothing in comparison to the costs of possible later diabetic complications?

I siincerely wish each of you all the very best

Hazel
 
Pattidevans said:
I see you mention writing to Downing Street with regard to issuance of test strips to T2s. I organised a petition some while ago. The response can be found here http://www.diabetes-support.org.uk/joomla/blood-glucose-testing/test-strips-petition-and-response
Click to expand...


Hi Pattidevans,

Thanks for that - it looks to be very useful - a great starting point!

Certainly, 10 Downing Street's response gives me plenty of scope to discuss the matter firstly with the Rotherham PCT - and then to take the matter up with the PALS service if I don't receive the responses that I'm looking for.

Best Wishes - John
 
There are always good medics/dieticians and I'm not saying that they are all bad. However, from the experiences of an awful lot of people, they get pretty standard advice along the lines of the Eatwell Plate and the standard recommendation of 230g carbs per day.

What I advocate is that people should be encouraged to find what works for them. Far too often at the moment, people are given a diet sheet and thats about it. And that diet sheet is commonly not aimed at glycemic control, but at achieving low total cholesterol - which is a blunt measurement in the first place.

And while there may be T2s who can get away with eating 230g of carbs per day, following the proportions given on the eatwell plate, I think they are a very small minority.

But if it works for them, thats the important bit and fine by me.
 
wallycorker said:
Thanks for the symathy Sugarbum - it's appreciated!

I agree with all that you write.

I'm one for trying to change things - just as soon as I know where to start the battle! It sounds as though I ought to be starting with the Rotherham PCT - my local MP is on my list too. Possibly also Downing Street!
Click to expand...

Yes! Good for you and I wish you every sucess.

I recently signed up to an "E-campaign" for diabetes UK about care of children in schools with diabetes (something I wasnt aware about but after some reading decided to join the cause), they gave a standard email for local MPs and I added in my own spheal about why I backed it etc (sorry, I may be preaching to the converted?!) but I wonder if there is a cause like this listed with the e-campaigning? I recieved letters at my home address from 3 MPs (2 of them were useless!) but may be worth enquiring about?

I had never considered writing to the PCT before reading this thread. Its excellent what things pop up on here that you never know may come in useful. All the best.
 
VBH said:
Wally,

I joined the NNTP newsgroups when I was first diagnosed 5 years ago and learned from experienced diabetics all over the world on every continent. The advice that drove me early on was condensed rather nicely by Jennifer:
http://www.diabetes-support.org.uk/joomla/jennifers-advice

In 5 months I went from a BMI of 33 to 25. My A1c went from 10.8 to 6.0 and has never been higher than 6.0 since, with a personal best of 5.5 although if I were really determined I am certain I could do better, but there's a life balance to consider. By the time I saw a dietician one month after diagnosis, I contradicted all of her advice because I already knew what her suggestions would do to my BG. I had the figures to prove it.

I've been passing Jennifer's advice on ever since. I'm heavily involved with another forum, so when you mentioned avoiding insulin it brought another chap to mind. Chris turned up in November and was concerned because he had been following all the official advice. Despite this he had never got his A1c below 7.1. He was on increasing amounts of drugs and was approaching the max for both metformin and Glic. We gave him a little general advice and pointed him principally at Jennifer's advice.

He now has an A1c of 5.9 and has halved his pills intake.

I've been pointing T2s at Jennifer's advice for years now and everyone who has given it a proper go has had a massive improvement. Most are in the 5% club.

Once you throw away the NHS/DUK recommendations and start to learn for yourself with a meter, you never look back.
Click to expand...


Hi again VBH,

Yes - I've read Jennifer's advice and can relate to all of it.

But what a shame we can't get similar and what is sensible advice from the NHS/Diabetes UK!!!

Best Wishes - John
 
Wallycorker
I have every respect for my doctor and my nurse... but I have to say my experiences on the internet over the past 6 years have revealed that by no means are all of them as good.
At my last review I said to my nurse "But if you only gave every newly diagnosed diabetic a copy of Jennifer's Advice and a supply of test strips, you'd see a huge difference"
She countered with "Ah but Patti, lots of people simply aren't interested, they're only looking for a magic pill"
She's probably right, but at least some would benefit!
 
When first diagnosed over 14 years ago my GP used to prescribe urine test strips :(
Then I saw a new GP and he was amazed that I was still using such antiquated testing and told me to test blood sugars and gave me some strips.
Next time I saw my own GP he refused to prescribe for me so I used to buy my own as I wanted to be able to adjust my diet if necessary. However I kept asking for test strips and got the usual reply that T2s did not need to test and one day he added 'and besides, they are expensive'. So I immediately asked him if that was the real reason he would not give me any and I added I knew how much they cost because I was buying them for myself. He then reluctanly added a box of 50 strips to my monthly prescription. Over time it was suddenly increased to 2 x 50 strips - don't know why but I did not complain.

So keep on asking and you might get a result in the end
rangj7.jpg


.
 
Pattidevans said:
Wallycorker
I have every respect for my doctor and my nurse... but I have to say my experiences on the internet over the past 6 years have revealed that by no means are all of them as good.
At my last review I said to my nurse "But if you only gave every newly diagnosed diabetic a copy of Jennifer's Advice and a supply of test strips, you'd see a huge difference"
She countered with "Ah but Patti, lots of people simply aren't interested, they're only looking for a magic pill"
She's probably right, but at least some would benefit!
Click to expand...

Hi Patti,

I fully agree with you on the "But if you only gave every newly diagnosed diabetic a copy of Jennifer's Advice and a supply of test strips, you'd see a huge difference". I'm one of your ones that would make a huge difference - as I have since I started working out what was really going on from reading US literature.

Similarl to you, I have always had respect for my doctor and since I started having problems (diabetes, colon cancer, seizure) between seven and nine years ago I make certain that I only see him - even if that means driving some miles to another surgery. However, he's losing me on this!

I'm thinking of looking for another GP - one more sympathetic to my condition.

Has anyone else done such a thing?

Best Wishes - John
 
Jennie said:
When first diagnosed over 14 years ago my GP used to prescribe urine test strips :(
Then I saw a new GP and he was amazed that I was still using such antiquated testing and told me to test blood sugars and gave me some strips.
Next time I saw my own GP he refused to prescribe for me so I used to buy my own as I wanted to be able to adjust my diet if necessary. However I kept asking for test strips and got the usual reply that T2s did not need to test and one day he added 'and besides, they are expensive'. So I immediately asked him if that was the real reason he would not give me any and I added I knew how much they cost because I was buying them for myself. He then reluctanly added a box of 50 strips to my monthly prescription. Over time it was suddenly increased to 2 x 50 strips - don't know why but I did not complain.

So keep on asking and you might get a result in the end
rangj7.jpg


.
Click to expand...


Hi Jennie,

I decided to do the same as you and buy my own strips.

I've not seen my GP since he refused me some time back and even at that stage I'd changed my eating habits and lost around 10kgs or so. At this stage I've lost 25kgs and made dramatic improvements in my BG, BP and I suppose in Cholesterol figs also (next check is due soon).

When I see him next, I'll show him all my readings and hope that he will change his mind.

Especially, when I tell him that I'm buying my strips from car boots etc!!! 😉

Seriously, money isn't a problem - but that's not the point here - it's the principle.

Thanks for the encouragement - I'll certainly "keep on asking" - there's no doubt whatsoever about that!

Best Wishes - John
 
wallycorker said:
Hi Jennie,

I decided to do the same as you and buy my own strips.

I've not seen my GP since he refused me some time back and even at that stage I'd changed my eating habits and lost around 10kgs or so. At this stage I've lost 25kgs and made dramatic improvements in my BG, BP and I suppose in Cholesterol figs also (next check is due soon).

When I see him next, I'll show him all my readings and hope that he will change his mind.

Especially, when I tell him that I'm buying my strips from car boots etc!!! 😉

Seriously, money isn't a problem - but that's not the point here - it's the principle.

Thanks for the encouragement - I'll certainly "keep on asking" - there's no doubt whatsoever about that!

Best Wishes - John
Click to expand...

HI there

Forgive my ignorance, i am purely just interested...where d you buy your testing strips? online? and if you were a person with type 2 diabetes and health insurrance would that mean you would get them paid for you?

Im interested in understanding a little more in the differences we come encounter.

(someone mentioned a great A1c result in thread BTW, well done!)
 
Sugarbum said:
HI there

Forgive my ignorance, i am purely just interested...where d you buy your testing strips? online? and if you were a person with type 2 diabetes and health insurrance would that mean you would get them paid for you?

Im interested in understanding a little more in the differences we come encounter.

(someone mentioned a great A1c result in thread BTW, well done!)
Click to expand...

Hi Sugarbum,

Been buying mine off eBay. 🙄

I'll probably find my HbA1c is 15 when I get some real strips.

I don't know how health insurance effects buying strips but wouldn't have thought that it did.

Best Wishes - John
 
Status
Not open for further replies.
Back
Top