strips

[dave b]

I have had a metre for many years (freestyle lite) since being diagnosed t2 on 7th July I have been testing around six times a day.
as I have been put on metformin I asked the doctor if he could put the test strips on prescription to which he replied no because a body called NICE has told him not to prescribe strips for t2 patients on medication.
chemist charges £25 for 50 and around £15 to £25 on eBay.....
its proving expensive...

 

[Stitch147]

try the SD codefree meter. one of the cheapest around. A lot of type 2's are in the same boat. A pot of 50 strips is about £8. Available on amazon or homehealth.

 

[Bubbsie]

I have had a metre for many years (freestyle lite) since being diagnosed t2 on 7th July I have been testing around six times a day.
as I have been put on metformin I asked the doctor if he could put the test strips on prescription to which he replied no because a body called NICE has told him not to prescribe strips for t2 patients on medication.
chemist charges £25 for 50 and around £15 to £25 on eBay.....
its proving expensive...

Dave...I had a similar response from my GP...although he didn't quote the NICE guidelines...he used the local CCG (clinical commissioning group) directive who interpret the guidelines ...inaccurately in my opinion...always say NO...would echo the advice above...if you are going to self fund (for now)...the SD codefree meter & strips are the most economical...starter kit for around £12.99...strips £8 for fifty & Lancets £4.99 for 100...whatever meter/strips you buy...always best to buy extra strips/lancets since the starter packs only contain a small sample of both...I used the codefree for around 9 months...until I challenged the refusal (won it)...I now have my testing strips/lancets on repeat prescription...not difficult to challenge a refusal...if you are interested at any point in challenging the GP's refusal...let me know...be happy to give you a hand with that if needed.

 

[dave b]

try the SD codefree meter. one of the cheapest around. A lot of type 2's are in the same boat. A pot of 50 strips is about £8. Available on amazon or homehealth.

have ordered one and should have come yesterday....... i connect my freestyle yo my pc with a data cable so i can print reports ad such...... don't know if the sd metre can connect........

 

[Bubbsie]

have ordered one and should have come yesterday....... i connect my freestyle yo my pc with a data cable so i can print reports ad such...... don't know if the sd metre can connect........

You can do that with a codefree dave...although I bought the data cable...never got round to using it!

 

[dave b]

Dave...I had a similar response from my GP...although he didn't quote the NICE guidelines...he used the local CCG (clinical commissioning group) directive who interpret the guidelines ...inaccurately in my opinion...always say NO...would echo the advice above...if you are going to self fund (for now)...the SD codefree meter & strips are the most economical...starter kit for around £12.99...strips £8 for fifty & Lancets £4.99 for 100...whatever meter/strips you buy...always best to buy extra strips/lancets since the starter packs only contain a small sample of both...I used the codefree for around 9 months...until I challenged the refusal (won it)...I now have my testing strips/lancets on repeat prescription...not difficult to challenge a refusal...if you are interested at any point in challenging the GP's refusal...let me know...be happy to give you a hand with that if needed.

have ordered one and should have come yesterday....... i connect my freestyle yo my pc with a data cable so i can print reports ad such...... don't know if the sd metre can connect........ also ordered extra strips

dave b, 1 minute ago Edit Delete Report

 

[Bill Stewardson]

Probably yet another stupid question this,,

Is there anyone who can indicate the percentage of people who are having strips withdrawn, by which I mean had been accustomed to getting them, and then being told NO.

 

[everydayupsanddowns]

Probably yet another stupid question this,,

Is there anyone who can indicate the percentage of people who are having strips withdrawn, by which I mean had been accustomed to getting them, and then being told NO.

This has been happening for as long as I have been frequenting diabetes forums, so it is certainly not a new thing. The previous NICE guidance didn't support widespread self-monitoring for T2s either, much to the annoyance and bewilderment of many T2 forum-goers.

When the updated NICE T2 guidelines were published last year I had hoped that there would be a review of the evidence that came out in favour of wider use of self-monitoring for T2s not on insulin, but it wasn't to be. They still only seem to see BG strips as connected with checking for hypos.

As surgery budgets get more and more squeezed, it seems that many are seeing this guidance as an opportunity to reduce costs.

 

[Bill Stewardson]

This has been happening for as long as I have been frequenting diabetes forums, so it is certainly not a new thing. The previous NICE guidance didn't support widespread self-monitoring for T2s either.

When the updated NICE T2 guidelines were published last year I had hoped that there would be a review of the evidence that came out in favour of wider use of self-monitoring for T2s not on insulin, but it wasn't to be. They still only seem to see BG strips as connected with checking for hypos.

As surgery budgets get more and more squeezed, it seems that many are seeing this guidance as an opportunity to reduce costs.

Yes I fully understand all of that. Taking myself as a case in point, I had a Hypo ( or so I was led to believe. BG 2.1) and a GP went mental. If it wasn't for me testing myself that escapade may have ended in a mess.
Shortly after that another GP told me self testing was a waste of time.
Anyway, this is just more "echo chamber" stuff.

I keep asking this, what is DUKs position regarding T2s and self testing ? Not the NICE stance, or anyone else, DUK ??

The forum pointing people individually at how to contest this withholding of strips is good to a degree,,,, what about the thousands of others ??

 

[pav]

I have been told I am testing to much, but I am on hypo causing meds and drive for various time intervals. One test a day on waking, as need to see what the ball park figure is for the start of the day, depending if going out soon after breakfast this will start as my pre driving test. More often or not I don't go straight out after breakfast so end up testing again to meet DVLA requirements. then there's testing when feeling something is not right, which most of the time confirms I am close to hypo or hypo.

One DN's approach was to ignore all driving requirement testing and just test if when feeling not right , I also can't leave testing until 2 hours after testing to retest if driving as I can drop 10 points easily within the two hours, thankfully have hypo symptoms and test around the 1 1/2 hours interval, resulting in more strips being used. Plus I can be in and out various times during the day especially at the week ends, one can't always win, when you are trying to manage ones levels and complying with DVLA and the docs wanting to cut costs down.

 

[everydayupsanddowns]

I keep asking this, what is DUKs position regarding T2s and self testing ? Not the NICE stance, or anyone else, DUK ??

Not sure if you have read the advocacy pack Bill? (I havent recently so can't remember the details)

Alternatively the DUK website is often a good source of information about their view on things. A quick search of 'self monitoring blood glucose' revealed this position statement from March this year which you might find answers some of your questions.

https://www.diabetes.org.uk/Profess...ucose-levels-for-adults-with-Type-2-diabetes/

Members here may particularly warm to this phrase:

For people not in these treatment groups [ie people who are on D&E and Metformin], SMBG should be available based on an individual assessment of need. Arbitrary withdrawal of SMBG in those who clearly benefit from doing so should not occur. People have the right to ask for a review and challenge these decisions if necessary.

Short version: DUK recognise that there is 'conflicting' evidence for self-monitoring in T2. They recognise that for some people not on insulin/hypoglycaemic meds SMBG works really well, informs dietary and lifestyle changes and supports emotional and physical wellbeing. Those people should be supported in using test strips.

 

[Bill Stewardson]

Not sure if you have read the advocacy pack Bill? (I havent recently so can't remember the details)

Alternatively the DUK website is often a good source of information about their view on things. A quick search of 'self monitoring blood glucose' revealed this position statement from March this year which you might find answers some of your questions.

https://www.diabetes.org.uk/Profess...ucose-levels-for-adults-with-Type-2-diabetes/

Members here may particularly warm to this phrase:

Yes I get all that, and applaud it.

Real world, Ds are having a stop put on their strips without even being consulted !!! Shoving aside the "medical evidence" angle ( which I will not) we have an ongoing situation where Ds find out when they go to get their scripts renewed, this is not acceptable.

The explanations for this are owned by the NHS, I ask them, they trot out "try DUK",, I don't like doing that, however, I need to do this for if/when I manage to get it into an appropriate arena.

Right, here I go again. If somebody in an appropriate position is willing to sit opposite me and go through this, I will get there, fund myself, and turn up open minded. One thing though, "ask DUK" is not permitted.

They may well be correct, explaining it and doing it in a grown up even handed manner should not be too much to ask.

 

[everydayupsanddowns]

Right, here I go again. If somebody in an appropriate position is willing to sit opposite me and go through this, I will get there, fund myself, and turn up open minded. One thing though, "ask DUK" is not permitted.

I'm afraid you've lost me there ???

 

[Bubbsie]

This has been happening for as long as I have been frequenting diabetes forums, so it is certainly not a new thing. The previous NICE guidance didn't support widespread self-monitoring for T2s either, much to the annoyance and bewilderment of many T2 forum-goers.

When the updated NICE T2 guidelines were published last year I had hoped that there would be a review of the evidence that came out in favour of wider use of self-monitoring for T2s not on insulin, but it wasn't to be. They still only seem to see BG strips as connected with checking for hypos.

As surgery budgets get more and more squeezed, it seems that many are seeing this guidance as an opportunity to reduce costs.

Mike you and I have been at odds on this point before...it is possible to challenge the NICE guidelines being interpreted narrowly & inaccurately by CCG's & GP practices in this way...the guidelines do not say 'NO'...they say 'do not routinely prescribe'...there is room for GP's/DSN's to exercise their discretion and provide strips...mine has/does...we need to encourage more type 2's non dependant on medication which can induce a hypoglycaemic episode (and diet & exercise only)...it's not that difficult to 'set out your case'.

 

[Bill Stewardson]

I have been told I am testing to much, but I am on hypo causing meds and drive for various time intervals. One test a day on waking, as need to see what the ball park figure is for the start of the day, depending if going out soon after breakfast this will start as my pre driving test. More often or not I don't go straight out after breakfast so end up testing again to meet DVLA requirements. then there's testing when feeling something is not right, which most of the time confirms I am close to hypo or hypo.

One DN's approach was to ignore all driving requirement testing and just test if when feeling not right , I also can't leave testing until 2 hours after testing to retest if driving as I can drop 10 points easily within the two hours, thankfully have hypo symptoms and test around the 1 1/2 hours interval, resulting in more strips being used. Plus I can be in and out various times during the day especially at the week ends, one can't always win, when you are trying to manage ones levels and complying with DVLA and the docs wanting to cut costs down.

I wouldn't dream of assuming that I can give advice regarding when to test or not. What I can do is say common sense dictates caution. Caution which cannot be exercised without testing.

Well done you.

 

[Ralph-YK]

Test strips prescriptions stopped!!!! I'm surprised and wonder at anyone getting any at all in the first place.
I've met people on insulin who weren't self testing.

 

[Bill Stewardson]

I'm afraid you've lost me there ???

I lose a lot of people.

Seems simple to me. ANYBODY in a relevant position who wants to convince me that withholding testing equipment is a reasonable course of action is welcome to do just that. I class myself as reasonable and will listen.

On the other hand, I expect the other person to afford me the same courtesy.

We hear from DUK that they have contacts, liaise with the powers that be, have input, affect change etc. I have struggled to hear them saying that they support T2s being encouraged to self test though. If that is not the case, fine, you may be correct, why the silence ??

There is potential for wiggle room with this issue, seems to me it is not being looked for.

I have asked high and low, same answer, now I am asking here. There is a convenient circle, ask the local CCG, pushed to DUK ,, ask DUK pointed at CCG or NICE.

Not good enough.

 

[Bill Stewardson]

Test strips prescriptions stopped!!!! I'm surprised and wonder at anyone getting any at all in the first place.
I've met people on insulin who weren't self testing.

Good for them. I would never want to infringe on anyone's personal choice regarding their health.

 

[pav]

Test strips prescriptions stopped!!!! I'm surprised and wonder at anyone getting any at all in the first place.
I've met people on insulin who weren't self testing.

Unfortunately, there are numerous people who probably don't test even when taking hypo causing meds as well as insulin. Some times caused by the I can't be bothered to test brigade and others who may of been told not required to test and rely on the hba1c tests to keep you on track. What could be worse is that some may not be aware of DVLA's guide lines on testing and are risking their driving licence.

 

[everydayupsanddowns]

Mike you and I have been at odds on this point before...it is possible to challenge the NICE guidelines being interpreted narrowly & inaccurately by CCG's & GP practices in this way...the guidelines do not say 'NO'...they say 'do not routinely prescribe'...there is room for GP's/DSN's to exercise their discretion and provide strips...mine has/does...we need to encourage more type 2's non dependant on medication which can induce a hypoglycaemic episode (and diet & exercise only)...it's not that difficult to 'set out your case'.

I still find it bewildering that you believe we are at odds over this @Bubbsie.

You and I both believe in test strips being used by people with T2 to improve their self care. You and I both recognise that NICE say this should not be a routine part of T2 care, that 'a case' needs to be made. You and I both recognise that there is 'wiggle room', that it is not an absolute 'No'. Even the studies that NICE based their decision on were not conclusive (DUK mention 'conflicting' evidence) and talk about 'specific sub-groups' where self-testing can be shown to be advantageous.

The OP that said that his Dr had said 'NICE say no'. Previously I have attempted to explain why Drs say what they say, and I think you have taken that to mean that *I* do not support SMBG for T2s on D&E and Metformin, which is not the case at all.

We are consistently arguing the same points!