Strip request

[jalapino]

Well got a response today after my letter to the doc, I can have 100 strips a month, I guess it is better than none but still a bit naff!

But at the same time I think of all t2's not even being able to get them I think my self lucky to be honest.

I have been looking through the NICE guidelines for T2 and it says :

When starting insulin therapy, use a structured programme employing active insulin dose titration that encompasses: ? structured education
NICE clinical guideline 66 ? type 2 diabetes

? continuing telephone support ? frequent self-monitoring ? dose titration to target ? dietary understanding ? management of hypoglycaemia ? management of acute changes in plasma glucose control ? support from an appropriately trained and experienced healthcare professional.

Well I am sure it says frequent self-monitoring???

And im not sure about the last part about experienced healthcare professional ???🙄

Well I still have my appointment with doc in a week, so will jab him more and state driving etc etc!!

I have not given up!

 

[Pumper_Sue]

Ant you need to print off and show your GP the rules for driving. I would also ask him if he's insurers would be prepared to pay your taxi fare to work and back every day as you can not comply with the law which requires you to test no more than 30 mins before you drive and also every 2 hours on a journey.

 

[jalapino]

Ant you need to print off and show your GP the rules for driving. I would also ask him if he's insurers would be prepared to pay your taxi fare to work and back every day as you can not comply with the law which requires you to test no more than 30 mins before you drive and also every 2 hours on a journey.

Good idea sue, I have also jotted done a few things to back up my need for more strips that are clearly stated on the NICE guidelines which they SHOULD! be doing as I am now on insulin.

It makes laugh really, they have these guidelines yet they seem to go around them without no care to the to the person they are supposed to be caring for?

 

[Northerner]

What does he base his (less than) 25 strips per week on? What tests does he see as essential? He's just plucking a number out of the air and ignoring the fact that you ARE ON INSULIN!!!!! 😡 It strikes me he has no experience of insulin-controlled diabetes - the type of diabetes is irrelevant, you have as much need to test as any Type 1 (which I think you are anyway!). It's making me want to cme over to Stubbington to 'educate' him! And his nursey sidekick! Grrr! I'm angry, can't imagine how you must feel!

 

[jalapino]

What does he base his (less than) 25 strips per week on? What tests does he see as essential? He's just plucking a number out of the air and ignoring the fact that you ARE ON INSULIN!!!!! 😡 It strikes me he has no experience of insulin-controlled diabetes - the type of diabetes is irrelevant, you have as much need to test as any Type 1 (which I think you are anyway!). It's making me want to cme over to Stubbington to 'educate' him! And his nursey sidekick! Grrr! I'm angry, can't imagine how you must feel!

I COMPLETLY agree!!!....the good thing now is that I am ready for a strip war with him next week 😉

I have got to the point now where I am not testing in the day to conserve my test strips.....end of the day I am a type 2 on insulin twice a day so why should I test so much? even tho I have only been injecting for apx 1 month I only need to test morning evening and ...oh and if I feel funny!...well that is quite a bloody lot! 🙄

So yes my friend I feel let down by the NHS....BUT I will make my stand next week and take every ones advise FROM THIS FORUM and make them see sense! 🙂

I may even have to bring my wife to stop me getting....ermmm angry! :0)

 

[Northerner]

Simple maths:

Before injections: 2*7 = 14
Before bed (so you don't hypo): 1*7 = 7

So, this far we have 21 strips a week...

But! You need to test before driving (there and back, assuming work and weekend shopping etc.) = 2*7 = 14

Now we're at 35 strips a week...already that is 10 essential tests you can't do

But! What if you feel 'funny'? You need to test,treat if necessary, then test again to ensure your levels have come up. What if your journey is a long one? You need to test. What if you get poorly? You need to test. What if a strip fails? You need to use another. What if you aren't sure how a meal might affect you? You need to test to see its effect.

All these are very basic and essential reasons to test. Plus, this assumes that there are 28 days in a month, which is only true for one month a year, and then isn't true at all every 4 years.

How can someone with a medical degree, making decisions that have such potentially serious consequences for the lives of human beings not see this? Take an abacus in with you, you might need it! 😱

 

[jalapino]

Simple maths:

Before injections: 2*7 = 14
Before bed (so you don't hypo): 1*7 = 7

So, this far we have 21 strips a week...

But! You need to test before driving (there and back, assuming work and weekend shopping etc.) = 2*7 = 14

Now we're at 35 strips a week...already that is 10 essential tests you can't do

But! What if you feel 'funny'? You need to test,treat if necessary, then test again to ensure your levels have come up. What if your journey is a long one? You need to test. What if you get poorly? You need to test. What if a strip fails? You need to use another. What if you aren't sure how a meal might affect you? You need to test to see its effect.

All these are very basic and essential reasons to test. Plus, this assumes that there are 28 days in a month, which is only true for one month a year, and then isn't true at all every 4 years.

How can someone with a medical degree, making decisions that have such potentially serious consequences for the lives of human beings not see this? Take an abacus in with you, you might need it! 😱

I hope you don't mind Alan but I am going to print this of and show him?

Because you hit the nail on the head!!

The funny thing is my dn said at the EARLY stages they do not mind me going through a "lot" of strips, so I thought happy days, then when I spoke to her last week and told her all my numbers wake up before brekie 2 hours after etc etc she blew me out of the water saying why testing so much!!!!

I am thinking also can I get some sort of blood test to see what type I really am?

At 36 I do not think I am t1 only from the basis of what I have been told by my dn, but then I think how the hell have I come from metformin to insulin in one year! 😱

Also I have been getting really...and I meen REALLY bad cramps in my legs to the point I want to....well get upset...I wake up really quickly and it's like arrrahhhh!!! I have to get up and try and walk it off half asleep!

It's hard work this diabetes eh? 🙂

But I am in good spirit as I feel all this agro fuels me to get this sorted rather than letting it get to me

 

[Northerner]

I hope you don't mind Alan but I am going to print this of and show him?

Because you hit the nail on the head!!

The funny thing is my dn said at the EARLY stages they do not mind me going through a "lot" of strips, so I thought happy days, then when I spoke to her last week and told her all my numbers wake up before brekie 2 hours after etc etc she blew me out of the water saying why testing so much!!!!

I am thinking also can I get some sort of blood test to see what type I really am?

At 36 I do not think I am t1 only from the basis of what I have been told by my dn, but then I think how the hell have I come from metformin to insulin in one year! 😱

Also I have been getting really...and I meen REALLY bad cramps in my legs to the point I want to....well get upset...I wake up really quickly and it's like arrrahhhh!!! I have to get up and try and walk it off half asleep!

It's hard work this diabetes eh? 🙂

But I am in good spirit as I feel all this agro fuels me to get this sorted rather than letting it get to me

Yes, by all means print it and show him 🙂 As for not being T1 at 36, well I was 49 when diagnosed and a friend of mine was 35. We have members here who were diagnosed T1 in their 60s - age is simply a rough indicator of which type you might be, not absolute definite proof! There is a test that can give a better indication of your type, in fact there are two - the GAD antibody test and the C-Peptide test. Ask him what he bases his diagnosis on, and if it's simply age and the fact it's taken a year for you to need insulin, then point out you can be Type 1 at ANY age, and the older you are, the slower the onset tends to be. Also point out that you probably needed insulin several weeks, if not months, before you were given it, because you were not responding to oral medications. In fact, the fact that gliclizide didn't work for you would also indicate Type 1 since it works by getting your pancreas to make more insulin - if it can't do that, then it won't work!

Obviously, I'm not a doctor, but I would say that all this would at least warrant investigation so that you can get appropriate treatment at the right sort of level (consultant and fully-trained DSNs, not GP and practice nurse).

You're a young man with a young family, it's essential that you get the right level of care so that you can stay fit and healthy throughout your life!

 

[AlisonM]

I really think you need to insist on being seen at the nearest Diabetic Clinic, on the grounds that your GP clearly has no idea of the relevant portions of the NICE Guidelines/legal issues surrounding the use of insulin and cannot therefore make sensible clinical decisions regarding your treatment.

I had a number of run-ins with Dr Idiot after I was finally put on insulin and, if it hadn't been for the clinic flatly contradicting her in writing combined with a formal letter of complaint from me that got her a slap on the wrist, I'd be in deep trouble diabetes wise. Now, when she starts up, I just tell her I'm doing what the clinic tells me and she shuts her mouth. Not that I see her often now I've been 'taken over' by the practice MD who is also their senior GP. He's really good, a total contrast to madam.

Sadly, I couldn't use NICE as it doesn't apply up here, we have something called SIGN, which is a much watered down version and virtually useless as ammunition.

 

[AlisonM]

The GAD/C-Peptide test might be a good idea, if you can persuade them to do them. If not actually T1, you may be a slow onset type 1/LADA like what I am. Metformin, Glucophage, Gliclazide and Sitagliptin didn't work for me either, they just made me very ill.

 

[jalapino]

Yes, by all means print it and show him 🙂 As for not being T1 at 36, well I was 49 when diagnosed and a friend of mine was 35. We have members here who were diagnosed T1 in their 60s - age is simply a rough indicator of which type you might be, not absolute definite proof! There is a test that can give a better indication of your type, in fact there are two - the GAD antibody test and the C-Peptide test. Ask him what he bases his diagnosis on, and if it's simply age and the fact it's taken a year for you to need insulin, then point out you can be Type 1 at ANY age, and the older you are, the slower the onset tends to be. Also point out that you probably needed insulin several weeks, if not months, before you were given it, because you were not responding to oral medications. In fact, the fact that gliclizide didn't work for you would also indicate Type 1 since it works by getting your pancreas to make more insulin - if it can't do that, then it won't work!

Obviously, I'm not a doctor, but I would say that all this would at least warrant investigation so that you can get appropriate treatment at the right sort of level (consultant and fully-trained DSNs, not GP and practice nurse).

You're a young man with a young family, it's essential that you get the right level of care so that you can stay fit and healthy throughout your life!

Thank you Alan for your advise...I think my best bet is to ask if for the test that you have stated so I ....sorry HE can be 100% what type I am....then maybe I can finally get there attention?....maybe🙄

Either way....lets hope next week visit to the doc will pay off....if all fails I will ask to be referred...which I think they may go for to get me of there backs!!!

 

[jalapino]

The GAD/C-Peptide test might be a good idea, if you can persuade them to do them. If not actually T1, you may be a slow onset type 1/LADA like what I am. Metformin, Glucophage, Gliclazide and Sitagliptin didn't work for me either, they just made me very ill.

Thank you Alison....seams you have had your fair share of grief to!

I personally think im just odd....that's what my wife tells me

 

[pav]

As Alan says use his figures to help back you up, plus have a pick through this DVLA info for extra bits to add in.

http://www.npc.nhs.uk/rapidreview/?p=4937

I picked up my repeat prescription which included test strips, bearing in mind I am on type 2 on glizlazide and had to justify why I wanted strips. I picked up my full quota, I order as and when required not as a per month request. Though I will need to speak to the doc before they will reissue any more and expect them to be drastically reduced.

Today I have been reading in the 10.0's for most of the day, I have had 5 driving trips out spaced out over most of the day. Due to the spacing I did a lot of tests, which is what you need to stress to the doctor. If my BS was where it was supposed to be I would of nearly doubled the qty of tests.