Insulin without prescription?

[Amity Island]

Many people with Type 2 progress to needing insulin - there are a lot of people with Type 2, hence the reason for the ones using insulin being much higher than the Type 1s (who all need insulin, but Type 1 is relatively rare) 🙂 Not all Type 1s are under hospital care - at my last surgery they decided to move me to GP care because my diabetes management was good and stable, although I still had 'access' to the hospital DSN and consultant should I need it. Since I moved house I have been seen at hospital clinic, but was told at my last review that they would probably be moving me to GP care. Fair enough, there's not a lot they can do for me (or need to) at the hospital.

I'd like to go under my GP. but my GP said they know absolutely nothing about Diabetes, so I guess there wouldn't be much point going via GP

 

[Docb]

I'd like to go under my GP. but my GP said they know absolutely nothing about Diabetes, so I guess there wouldn't be much point going via GP

One of the more knowledgeable might care to comment but I was under the impression that primary care for diabetes was the GP's responsibility. Maybe that only for T2's.

 

[Robin]

One of the more knowledgeable might care to comment but I was under the impression that primary care for diabetes was the GP's responsibility. Maybe that only for T2's.

I was moved back from the hospital clinic to my GP because I was told they had a specialist diabetic nurse at my surgery. I presume if they didn’t, I’d have remained under the hospital care. Turns out my 'specialist nurse' was the lovely nurse who does everything, (asthma clinic, travel jabs, all aspects of general nursing) who had been given some training in Type 2 diabetes. Most of what she knows about Type 1, she’s learned from me!

 

[Northerner]

I was moved back from the hospital clinic to my GP because I was told they had a specialist diabetic nurse at my surgery. I presume if they didn’t, I’d have remained under the hospital care. Turns out my 'specialist nurse' was the lovely nurse who does everything, (asthma clinic, travel jabs, all aspects of general nursing) who had been given some training in Type 2 diabetes. Most of what she knows about Type 1, she’s learned from me!

To be fair, when I was in Southampton I spent most of the time with the consultant chatting about the people here (no names, of course!) 🙂

 

[AndBreathe]

I don't quite see that, there's nowt you can do with insulin that's wasteful It shouldn't be overlooked, of course, that there are at least twice as many Type 2s on insulin as Type 1s in the UK (I seem to remember the numbers being in the region of 900k Type 2 and 420k Type 1). I suppose that the one possibility is that someone might get more than they need and then flog it to the Yanks! 😱 😉

It's an interesting proposition @Amity Island, and I guess that any minister thinking of putting it in place should be directed to read this thread first! 🙂

Not refrigerate it, not finish vials/pens, really simply not treat it with any form of economy.

 

[eggyg]

Hi Nonethewiser, i'm interested in what you said about everyone wanting to be under the care of a hospital diabetes clinic, does this mean that there are Type 1's who don't attend hospital? I didn't know this. I mentioned Type 1's in my original post as I've always understood them to require insulin. As far as I've understood (which it looks like i'm mistaken) type 2's using insulin is a more recent occurrence? I thought type 2 meant "insulin resistance" not "lack of insulin"?? My knowledge of type 2 is not very vast...

I was diagonosed in October 2010 and have NEVER seen a diabetic/ endocrinologist consultant or for that matter a GP! I have attended the diabetes clinic a couple of times and been seen by a DSN ( a very knowledgeable one I must say) and that was just the last year of so at my insistent. Of course I am a “ weird” diabetic ( Type 2/3c/1) and no one wants me!

 

[Northerner]

Not refrigerate it, not finish vials/pens, really simply not treat it with any form of economy.

Maybe, but that's perfectly possible under the current system

 

[mikeyB]

I was diagonosed in October 2010 and have NEVER seen a diabetic/ endocrinologist consultant or for that matter a GP! I have attended the diabetes clinic a couple of times and been seen by a DSN ( a very knowledgeable one I must say) and that was just the last year of so at my insistent. Of course I am a “ weird” diabetic ( Type 2/3c/1) and no one wants me!

Aye, but fortunately there’s now a NICE protocol for treating Creonistas, though they call it pancreatic diabetes, so you never were T2 really. Trouble is, many diabetes consultants haven’t read the NICE protocol yet. 3c diabetics should always be under consultant care. GPs and surgery DSNs are almost completely ignorant on the subject, because it’s so rare.

 

[AndBreathe]

Maybe, but that's perfectly possible under the current system

Of course it is, but at least there is some form of control there.

Don't get me wrong, I don't grudge T1s their life preserving medication for an instant, but there is waste out there, just like in every walk of life.

 

[Northerner]

Of course it is, but at least there is some form of control there.

Don't get me wrong, I don't grudge T1s their life preserving medication for an instant, but there is waste out there, just like in every walk of life.

The control would come from the hospital clinic, who would be aware of how much was being ordered (and would know whether it was reasonable, whereas the GP may not have a clue). If all you need is insulin then no need to involve the GP. 🙂

 

[AJLang]

How would the consultant know what is reasonable when levels even for an individual diabetic as they can change dramatically over a short amount of time which has happened to me recently. As Jenny said there are also testing strips. Should it also include disposable needles and pens? What about Type 1s on metformin? Where would collecting directly from the pharmacist stop? What if you cant’t see a consultant for 18 months which can happen, eg this happened to me through no fault of mine. Also, if we’re talking about ID what about if you rely on somebody else to collect your insulin?

 

[Sally71]

My daughter has always been under hospital care, although that might change when she becomes an adult! (My mum has always been under GP care for as long as I can remember.) The hospital team are fab, but don't do any prescribing, that has to go via the GP. I think so that it can all be controlled in one place, could be dangerous if the hospital is prescribing one thing and the GP another and they don't talk to each other! We recently got the go-ahead to get Libre sensors on prescription having self-funded them for 2 1/2 years, when we collect those now the instruction on the chemist's label says "use as per hospital instructions" or something like that, and the letters that go from the consultant to the GP every time we've had a check up now say "please continue to prescribe Libre sensors" every time! (I know because they always send us a copy).

Last year I finally managed to get the amount of insulin we get per prescription increased, because the original amount which used to last 2 months now doesn't even last one, and I had to go through quite a palaver to get it changed, so there are checks in place. And curiously, every time I ask for a glucagon kit, this stops the whole prescription from being sent electronically to the chemist and I have to faff about picking it up from the surgery and then waiting while the chemist gets it ready. The GP said it's because glucagon is a restricted drug. But the pharmacist says it isn't, insulin is far more dangerous than glucagon if it falls into the wrong hands and that comes through automatically! So I can only assume that it's a glitch in their system that nobody has got round to correcting, after all you don't need glucagon kits very often!

 

[Madeline]

One of the more knowledgeable might care to comment but I was under the impression that primary care for diabetes was the GP's responsibility. Maybe that only for T2's.

My primary care is hospital based, might be a regional thing?

 

[mikeyB]

In your case, Madeline, it might be co-morbidities. That’s hospital speak for other interacting conditions.

 

[Madeline]

In your case, Madeline, it might be co-morbidities. That’s hospital speak for other interacting conditions.

Ah yes, they do treat me like I’m made of glass tbh. Got a few stares when I got given a cup of coffee in the waiting room

 

[Deleted member 21371]

Ah yes, they do treat me like I’m made of glass tbh. Got a few stares when I got given a cup of coffee in the waiting room

I get treated like I'm an imposter everywhere.
I order salad, my partner gets it.
I order diet drinks, I need to chase them to other tables.

Coffee, no one believes I don't take sugar.
Let alone double espresso and at least two cubes!

 

[Madeline]

I get treated like I'm an imposter everywhere.
I order salad, my partner gets it.
I order diet drinks, I need to chase them to other tables.

Coffee, no one believes I don't take sugar.
Let alone double espresso and at least two cubes!

People are weird though. So weird.

 

[Deleted member 21371]

People are weird though. So weird.

They're normally good though

And to be honest, I don't look like a salad person!

 

[Madeline]

They're normally good though

Unless they’re stealing your salad

 

[Deleted member 21371]

Unless they’re stealing your salad

Then, I feel justified to steal their chips !!!
There is only so far I can go.