NICE recommending withdrawal of blood glucose test strips

[alan horner]

Hi all!
I've had a letter from my GP practice saying that following revised advice from NICE they will no longer supply blood glucose strips to Type 2 patients (except for very limited groups).
Does anyone know if this is correct, and if there is any way to overturn this decision, either in general or on an individual basis.

 

[grovesy]

Hi all!
I've had a letter from my GP practice saying that following revised advice from NICE they will no longer supply blood glucose strips to Type 2 patients (except for very limited groups).
Does anyone know if this is correct, and if there is any way to overturn this decision, either in general or on an individual basis.

Are you on any medication?

 

[Martin Canty]

Different healthcare system here in the States, however, we are encouraged to test.... One assumes that the actuaries in the insurance companies decided that testing was better than uncontrolled BG levels leading to complications down the road.
Downside to moving insurance companies was that my previously free test strips are now $18/100

 

[Northerner]

Hi all!
I've had a letter from my GP practice saying that following revised advice from NICE they will no longer supply blood glucose strips to Type 2 patients (except for very limited groups).
Does anyone know if this is correct, and if there is any way to overturn this decision, either in general or on an individual basis.

Did they give any detail e.g. what the advice was before, when the revision was made and what the 'limited groups' are? I'm not aware of any changes to NICE advice, it tends to only change once in a blue moon. I suspect that it is your CCG that is choosing to interpret the current NICE guidelines in a way which suits them i.e they think they have spotted some short-term savings to be made. Self-testing is supposed to be decided on an individual basis, in consultation with the patient, not a blanket ban.

 

[MargB2]

I was diagnosed in 2010 and my practice does not believe in T2s testing - so I never have. I could have started testing but without knowing what the results meant then I would probably just scare myself.

It seems strange that if you have been set up to test, then the facility is suddenly withdrawn. I remember past discussions where people would buy strips off the internet and fund the testing themselves so it has always been a bit of a lottery.

 

[alan horner]

Okay, to answer a couple of questions, yes I am on medication -Metformin.
The acceptable requirements are 😛rescribed insulin; prescribed sulphonylureas; on a specialist management plan, eg HGV drivers.
My concern that as I also have a cancer, currently in remission, I keep going on different medications and I like to keep a check on sugar levels. The GP Practice suggestion of "regular HbA1c blood tests" is not a solution to me,especially as their idea of regular is once every 12/14 months.

 

[Robin]

Okay, to answer a couple of questions, yes I am on medication -Metformin.
The acceptable requirements are 😛rescribed insulin; prescribed sulphonylureas; on a specialist management plan, eg HGV drivers.
My concern that as I also have a cancer, currently in remission, I keep going on different medications and I like to keep a check on sugar levels. The GP Practice suggestion of "regular HbA1c blood tests" is not a solution to me,especially as their idea of regular is once every 12/14 months.

I think the NICE guideline wording is that Type 2s not on insulin or hypo-inducing drugs should not routinely be prescribed strips. And that's where the grey area is. Some GPs interpret this as never prescribing them, but I don't think that's what it means, I think it means that if you can make out a case for why you should have them, then they should be prescribed for you.

 

[Mark Parrott]

I think this whole thing is disgusting. IMO, it's making Type 2's second class citizens. They are really short sighted if they believe that not prescribing test strips will save money. It's a short term fix for them. In the long run it will cost them more money due to complications.😡

 

[grovesy]

Okay, to answer a couple of questions, yes I am on medication -Metformin.
The acceptable requirements are 😛rescribed insulin; prescribed sulphonylureas; on a specialist management plan, eg HGV drivers.
My concern that as I also have a cancer, currently in remission, I keep going on different medications and I like to keep a check on sugar levels. The GP Practice suggestion of "regular HbA1c blood tests" is not a solution to me,especially as their idea of regular is once every 12/14 months.

Some have managed to get there Gp to prescribe , by seeing them in person to fight their case. Bubsie who has not posted for a few weeks offered to help people with a letter. If you do a forum search for Type 2 test strips you should find a leghthy thread from about it. The thread I am thinking of was only a few weeks ago.

 

[trophywench]

Okay, to answer a couple of questions, yes I am on medication -Metformin.
The acceptable requirements are 😛rescribed insulin; prescribed sulphonylureas; on a specialist management plan, eg HGV drivers.
My concern that as I also have a cancer, currently in remission, I keep going on different medications and I like to keep a check on sugar levels. The GP Practice suggestion of "regular HbA1c blood tests" is not a solution to me,especially as their idea of regular is once every 12/14 months.

Alan, tell your GP that it's vital to your cancer treatment to CONSTANTLY keep your BG within a narrow margin of 'normal' otherwise it is quite likely to compromise your body's ability to fight the cancer - and you are pretty gobsmacked at the surgery telling you they won't in future help you do that !!

If necessary enlist the support of your Oncologist to endorse that.

 

[Amigo]

Hi Alan, the guidance says type 2’s are not to be ‘routinely’ prescribed testing strips and many surgeries simply interpret this to be no testing strips for type2’s who are not subject to hypos.
I get an appropriate amount of testing strips and am a type 2 not on medication. I suspect it’s mainly because my GP supports this approach but you can argue ‘exceptionality’ if there’s a compelling case that uncontrolled and unmonitored diabetes could impact on your cancer. Thankfully you’re in remission and they may be unconvinced unless you and your oncologist can provide clinical reasons as Jenny recommends.

I have as yet untreated cancer and because it’s of my immune system, I can demonstrate that uncontrolled blood glucose levels would feed and exacerbate the infections I’m very prone to. My monitor almost acts as a barometer to infection because my bg’s spike if I’m fighting an infection. I argue that it’s keeping me out of hospital but as yet my surgery haven’t issued this diktat. I suspect your surgery have suddenly decided to follow CCG’s recommendations but I’m not aware of any change in NICE guidance. Ask the Practice Manager for a copy of the revised NICE guidance.

Try to enlist the help of your GP and Consultant (if you still have one).

 

[alan horner]

Many thanks for all your helpful replies and I am certainly going to pursue this. As a matter of interest, to paraphrase from the letter I received," I can make an appointment to see the clinical pharmacist from Interface Clinical Services who are running the project." who are pleased to inform me that you no longer need to monitor your blood glucose and the test strips have been removed from your prescriptions" - so another NHS outsource cost cutting exercise.

 

[Northerner]

Many thanks for all your helpful replies and I am certainly going to pursue this. As a matter of interest, to paraphrase from the letter I received," I can make an appointment to see the clinical pharmacist from Interface Clinical Services who are running the project." who are pleased to inform me that you no longer need to monitor your blood glucose and the test strips have been removed from your prescriptions" - so another NHS outsource cost cutting exercise.

No decisions should be made without consulting you - it is my belief that anyone motivated to monitor their levels, and know how to use the information to improve their health and reduce risk, should e given the means to do so - it's just common sense! Good luck, I think you have an excellent case 🙂

 

[Amigo]

Many thanks for all your helpful replies and I am certainly going to pursue this. As a matter of interest, to paraphrase from the letter I received," I can make an appointment to see the clinical pharmacist from Interface Clinical Services who are running the project." who are pleased to inform me that you no longer need to monitor your blood glucose and the test strips have been removed from your prescriptions" - so another NHS outsource cost cutting exercise.

Good luck with this Alan. Many surgeries have gone down this ‘outsourcing’ preventative work to clinical pharmacists because I had one ringing me about my b/p. Strangely enough, her advice was for me to home monitor my b/p and send her the results. This personal monitoring seems to apply to some things and not others.
It’s laughable that they announce that they are ‘pleased to inform you no longer need to monitor your blood glucose’. I’d have been tempted to write back and say, ‘Eureka, I’m cured. How did that happen?’ 🙄

 

[everydayupsanddowns]

In my opinion it is also incorrect to suggest that this is somehow newly announced. The T2 guideline was issued in 2015 and BG monitoring section remains unchanged even though there was a tweak in 2016 (I think). Completely agree that while the guidance suggests this should not be ‘routine’ there is no reason why you as an individual should not be able to secure strips on prescription by explaining how you use them, why they are important and how they improve your outcomes.

Good luck with your battle. Diabetes UK have an advocacy pack that might give you some ideas for ways to put your case together - as night members here who have managed to persuade reluctant surgeries to provide them test strips on an individual basis.