NHS Discrimination of type 2

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Neal Higham

Neal Higham

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Good afternoon all 🙂

I have been type 2 for around 2 years now and find more and more evidence of discrimination between the 'really ill' type 1 group and the 'self inflicted' type 2 group.
A great example of this is the availability and guidelines around CGM technology. All of the guidelines refer only to type 1 (Those overindulgent, greedy, fat type 2's don't deserve such recognition)
I finger prick around 8 times a day and my levels are proving really difficult to control, despite controlling carb intake quite well. (Blimey, a type 2 who is trying??? he must be lying.) I use a total combination of basal and bolus insulin of around 100 units a day, plus 1.5 mg weekly injections of Dulaglutide.
Maybe I am being over-sensitive, the constant pricking and monitoring is depressing me and restricting my activities. I truly believe that CGM would help me tremendously in both psychological and clinical terms. I also believe that guidelines and treatment excluding type 2 patients is discriminatory.
Has anyone else come across this and if so how did you deal with it?
Neal.
 
This technology is not universally available for Type 1 Diabetics, I believe I read this morning that only 60% of CCGs are prescribing the Libre at all, most have many restrictions on who is eligible.
Most Type2 can't even get prescriptions to monitor blood glucose unless on Insulin.
 
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Welcome to the forum Neal. No I don’t think you’re being over sensitive . I had a bit if a fight to get enough test strips even though I’m on insulin, a couple if GPs really thought a pot of 50 a month was enough, I disabused them of that idea.
I am sorry to say that people with all types of diabetes are being denied kit that could really help their control.
For instance many people with T1 can only get a CGM if they have lost hypo awareness, many areas will not fund a Freestyle Libre (a flash glucose monitoring system) under any circumstances. some GPs even try to restrict their test strips too. So it’s not just us with T2 being discriminated against.
People with LADA or MODY can be worse off than us T2s, starting with being misdiagnosed T2 as GPs / practice nurses have not heard of either

Something that really does get my goat at times and probably many others with T2 on insulin, is the assumption by some medics/nurses that I must be a bad diabetic because I am on insulin, it’s only when they can look up my Hb1ac results that they go all quiet with a look of supprise in their face that they begin to believe me.

Are you on fixed bolus doses or do you adjust your bolus accordingly .
 
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Thanks for the welcome🙂
I'm not sure what LADA or MODY are, but my diabetes nurse says I am indicative of type 1 not type 2, the GP says type 2. I bolus according to my pre-meal level and what I am going to eat, bit of a guestimate at times and caused a hypo during the night a few weeks ago.. that was scary.
 
Yes those hypo’s are scary, I can still remember my first one.
Are they doing any tests to find out what type you are, their are two tests that I know of but can’t remember their names , others here will know.

LADA is latent autoimmune disease in Adults, it’s like a slow onset type 1
MODY is Maturity onset diabetes in the young , I don’t know much about this one, except it’s different from T1 and T2 .

If you don’t mind telling us a bit more about your diabetes, any problems your having and questions you have , we’ll do our best to help
 
Even the highest profile diabetic in the country (the PM) doesn't have a clue. Just watched PMQ's where she said in parliament today, that the Freestyle Libre which she wears if now free and available on the NHS. Well I guess it's not a lie, if you have the right post-code and meet stringent criteria. If I want that system, I do meet the criteria, but would not get it free like Mrs May, because I live in the wrong area of the country. How stupid of me to have been born in Leicestershire.. and to be a pensioner who cannot afford one. I should have known better.
 
travellor said:
I would hope private health care comes with the job to be honest, so I wouldn't imagine she pays for any health care.
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Most private insurance in this country does not cover pre existing conditions and they don't pay for everything.
When I had my knee replacement it did not cover the cost of the medication I needed to come home with.
 
She can well afford it on her wage. I wouldn't be surprised if Libre supply them for promotion purposes. If nothing else her sporting one has raised awareness, although some may think the disk is a charging port where she plugs herself in at night 🙄
 
Somehow I don’t think she’ll be taking her carriers down the Food Bank so she can afford the Libre! :D
 
grovesy said:
Most private insurance in this country does not cover pre existing conditions and they don't pay for everything.
When I had my knee replacement it did not cover the cost of the medication I needed to come home with.
Click to expand...

I would still expect the woman who holds the UK's nuclear arsenal at her beck and call not to be bunging a few quid into Bupa care every month to be honest.
I suspect an upgrade came with the job.
 
Private health care doesn’t cover pre-existing conditions or anything related to them eg diabetic retinopathy. If a chronic condition is subsequently diagnosed it will only deal with it in the initial stages and certainly not long-term treatment, Libre etc. I looked into this because I could have been added to my partner’s policy for £500 a year but with all of the exclusions it wasn’t worth it.
 
AJLang said:
Private health care doesn’t cover pre-existing conditions or anything related to them eg diabetic retinopathy. If a chronic condition is subsequently diagnosed it will only deal with it in the initial stages and certainly not long-term treatment, Libre etc. I looked into this because I could have been added to my partner’s policy for £500 a year but with all of the exclusions it wasn’t worth it.
Click to expand...

I doubt she's on normal private health care.
I suspect she'll have her own hospital wing if she needs it, and anything up to that.
And beyond.
 
Lucy Honeychurch said:
I wouldn't be surprised if Libre supply them for promotion purposes. If nothing else her sporting one has raised awareness,
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I think to accept it free from the manufacturer would be quite awkward for her to do (there's lots of rules about gifts). My guess is she just pays for it. I seem to remember the first photo of her using it was shortly after it was made available (technically, at least) for prescription on the NHS, and it wouldn't surprise me if it was timed for that. (I'm imagining she used it for a while before, but was careful not to show it until the NHS sort of offered it.)
 
Official extract from PMQ's today, note the PM gives the clear impression that it is freely available on the NHS and fails to mention the hundreds of thousands of people denied this opportunity.

Steve McCabe (Birmingham, Selly Oak) (Lab)
Q2. Even the Prime Minister’s fiercest critics—I believe she has a few—must be full of admiration for the way in which she manages her diabetic condition and holds down such a tough and demanding job. I understand that she benefits from a FreeStyle Libre glucose monitoring system. Wouldn’t it be nice if she did something to make that benefit available to the half a million people who are denied it because of NHS rationing? Perhaps we could call it “help for the many, not the few”. [907106]

The Prime Minister
I thank the hon. Gentleman for his comments. I do use a FreeStyle Libre, and it is now available on the national health service, but it is not the only means of continuous glucose monitoring that is available on the NHS. Yesterday I saw a letter from a child—a young girl—who had started on the FreeStyle Libre, but, because of the hypos that she had been having, had been moved to a different glucose monitoring system. There is no one system that is right for everyone; what is important is that those systems are now available on the NHS.
 
Neal Higham said:
note the PM gives the clear impression that it is freely available on the NHS and fails to mention the hundreds of thousands of people denied this opportunity.
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Indeed, but notice that (as far as I can see) she doesn't say anything that's not technically true. So yes, she's being deliberately misleading, but isn't actually lying. It's very much a political answer, obviously carefully worded. (It's the kind of careful choice of words that, in the context of an interview, she might just reuse if the interviewer tried pressing the issue.)
 
Neal Higham said:
Even the highest profile diabetic in the country (the PM) doesn't have a clue. Just watched PMQ's where she said in parliament today, that the Freestyle Libre which she wears if now free and available on the NHS. Well I guess it's not a lie, if you have the right post-code and meet stringent criteria. If I want that system, I do meet the criteria, but would not get it free like Mrs May, because I live in the wrong area of the country. How stupid of me to have been born in Leicestershire.. and to be a pensioner who cannot afford one. I should have known better.
Click to expand...
I also live in Leicestershire and find it scandalous that the Libra is not available, after all it manages the illness and could potentially save your life. I know someone who lives in a £400,000 house and drives a brand new car who had a boob job on the NHS. It’s all wrong in my opinion!
 
Elaine B-S said:
I also live in Leicestershire and find it scandalous that the Libra is not available, after all it manages the illness and could potentially save your life. I know someone who lives in a £400,000 house and drives a brand new car who had a boob job on the NHS. It’s all wrong in my opinion!
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Well said Elaine. x
 
Hi Neal. I don’t think you are being over-sensitive. However, as someone who is heavily involved with paediatric diabetes, I can promise you that technology is also very hard to access for this group as well, be they T1 or T2. I was at a hospital in a different area on Friday and was told that there are 7 criteria that need to be met for a child to be given a libre! The cynic in me knows that the criteria are designed to limit prescription to an absolute minimum.
 
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