• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

T2DMs prescribed a glucometer: how often are you required to test?

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

Becka

Well-Known Member
Purely out of curiosity, but if you are T2DM and prescribed a meter, how often are you asked to test (whether or not you test more or less)?

When searching for information on this and that I can come across different N.H.S. trust guidelines. Amongst other things this includes their guidelines on prescribing glucometers, and it is a little interesting to see which ones different areas recommend. But I have become a little fascinated by their testing requirements when given.

For type 1 they are pretty consistent in saying patients should test at least four times a day but be allowed to test as much as necessary, which is why I am only asking about T2DM. Because they all seem to suggest that, excluding special requirements, T2DM patients taking medications that can cause hypos or on insulin should test around three times a week. And so the prescription guidelines are usually one box of strips every two or three months. Some do say those on M.D.I. therapy should test as per T1DM guidance, but some do not! Hopefully that omission is only because specialists will be handling such prescriptions and not surgeries.

So I am just curious whether this is actually what happens?

When I was diagnosed I was prescribed Gliclazide, given a glucometer and told to test twice a day. So I did. And if a strip was wasted or I had to retest it made me anxious, because it meant I would be going beyond my prescription. I did not even realize at first I was supposed to test before suspected hypos, and only much much later still that I was supposed to also test after treating them.

But my surgery threw test strips at me, thankfully metaphorically, that it was never actually a problem to request more whenever I needed them. And the only time I was told to do anything different was at one review when they said I only needed to change lancets daily and not with every test. Which, as with most people, would have meant doing so more often. One time they even removed lancets from my repeat prescription list as I left it too long since the last one.

I have not seen any documents for my local C.C.G. come up online, but I assume they are not a strange exception to the rest of the N.H.S. But surely my surgery are also not a similarly strange exception who prescribe far beyond what they are supposed to. Which is why it has got my wondering if this is one of those policies that only exists on paper, once you print out the PDFs, but that in practice is ignored by everyone.

Fifty test strips to last ninety days, though.
 
I was originally expected to use one box of 50 per month when I started MDI. I’ve managed (with difficulty!) to get that increased since so I now get 200 every 2 months, so 3 per day.

Edit to add: and 100 per month is not enough. If testing only before eating it’s fine but I also test after eating if I feel high, before bed, before and after exercise, before and during driving, before and after hypos, when I feel hypo and it turns out to be anxiety…
 
I was only prescribed 50 strips a month and they were withdrawn when I was no longer on Glicliazide. I also self fund more strips.
 
Mine advised 2x per day when mine was prescribed with no real info as to when. I went through my allotted 50 strips in 3 days. Since then I've self funded.
 
Mine advised 2x per day when mine was prescribed with no real info as to when. I went through my allotted 50 strips in 3 days. Since then I've self funded.

Seventeen times a day!? I am sure there must be a point where my surgery would say no, but I have never been close to needing that many.
 
I had a lot of false starts - but ok might have been 5 days. I couldn't figure out how to arrange a repeat prescription and the cost to pay for the prescription was less than self-funding. Didn't know about prescription card thingies at that point either.
 
I was originally expected to use one box of 50 per month when I started MDI. I’ve managed (with difficulty!) to get that increased since so I now get 200 every 2 months, so 3 per day.

Edit to add: and 100 per month is not enough. If testing only before eating it’s fine but I also test after eating if I feel high, before bed, before and after exercise, before and during driving, before and after hypos, when I feel hypo and it turns out to be anxiety…

Wow, fifty per month sounds almost impossible, for many of the reason you have mentioned. I guess at an average of three per day they do not expect any routine monitoring, just using them for specific events. Surely the driving requirements means you legally require a larger prescription, though. Denying you one would potentially restrict you from driving without any medical justification.

The weather is not up to a nice day out for me, but if it were and I was out on my bike I would be testing six to eight times just to meet the D.V.L.A. requirements, as well as a fasting test when waking up and before and after eating when I get back home.

My prescription used to be three boxes at a time, which went to four when they changed the meter, but are 'use as directed' so there is no set limit on when it can be repeated.

Only a small sample size, but given EllsBells has a similar experience to mine and yours being like that of grovesy, it sounds like there really is a two-tier system of prescribing test strips.
 
I had a lot of false starts - but ok might have been 5 days. I couldn't figure out how to arrange a repeat prescription and the cost to pay for the prescription was less than self-funding. Didn't know about prescription card thingies at that point either.

I was given no education on hypos or even what to do with my testing, just given my prescriptions, told what to do with them, and booked on a DESMOND course (which was of no help for me). But they completed the prescription exemption form at the appointment, so that was never a problem. I am not sure they mentioned the process for repeat prescriptions, but I was already booking appointments online so I guess I just saw the option there are followed the instructions. I think, at least for some, I still had to go to the surgery to pick up a paper one!

But I had no prior experience with diabetes, my diagnosis was quite unexpected, so I would never have even guessed testing was something people could self fund. It was a long time after diagnosis I discovered people did voluntarily test to control their diet. But I had gone over fifteen years without taking a single tablet, not even over-the-counter, so just having to deal with physical health was all quite new to me. Now I get my prescriptions in a carrier bag, need blood tests every two week (for another condition), and get fed up that I cannot just do those myself.
 
One of the problems is that if you look up the NICE guidelines is that they recommend supplying a blood glucose meter if a T2 is prescribed anything that could promote the pancreas to promote insulin but say nothing about what test regime should be adopted. As a result GPs/DSNs all do their own thing which can vary from "you do not need to monitor" through to supplying enough a meter and a repeat prescription for a couple or more pots of strips a month. What seems to be clear from numerous postings on the forum is that there is no consistency. It all depends on the prejudices of the prescriber.

It seems to me that it might be something that DUK could take up and try to get something sorted out so that the guidelines say something about the reasons when glucose monitoring should be encouraged and what testing regime should be adopted. The test regime will depend on what the testing is aimed to achieve.
 
I had a lot of false starts - but ok might have been 5 days. I couldn't figure out how to arrange a repeat prescription and the cost to pay for the prescription was less than self-funding. Didn't know about prescription card thingies at that point either.
When you have medication to treat diabetes you no longer pay for prescriptions - you should have been given the paperwork at the surgery and got a card to show that you are exempt.
 
One of the problems is that if you look up the NICE guidelines is that they recommend supplying a blood glucose meter if a T2 is prescribed anything that could promote the pancreas to promote insulin but say nothing about what test regime should be adopted. As a result GPs/DSNs all do their own thing…

That is not really a problem though as local G.P.s and diabetes clinics take their lead from the local C.C.G. because, as with any healthcare matter, they dictate which treatments are preferred as they provide the funding for the prescriptions.

And they all do seem to have policies on how their money is spent, on which meters should be used and on how many strips should be provided.

Walsall is a good example of a more extreme one:


Sulphonylureas – "No need to routinely test" with a recommend repeat prescription of "1 box [of strips] per 3 months".
Insulin — "once daily when stable" with "1 box per month", and no distinction made for M.D.I. therapy.

Although they do offer a larger range of supported of meters, as some only have two or three preferred options.
 
When you have medication to treat diabetes you no longer pay for prescriptions - you should have been given the paperwork at the surgery and got a card to show that you are exempt.
I'm not on medication so not exempt.
 
Only a small sample size, but given EllsBells has a similar experience to mine and yours being like that of grovesy, it sounds like there really is a two-tier system of prescribing test strips.
To be honest most things diabetes related seem to be a two tier system, not just test strips but Libre, pumps, carb counting training, access to MDI rather than mixed insulin and access to specialists rather than the nurse at the GP are all things I know of T2s being denied. Obviously some exceptions as not all T1s can access those things either, but it’s definitely more common to be restricted for T2s
 
I am feeling quite anxious about my appointment with the consultant for that reason. As the diagnosis he makes will have an impact beyond the specific treatment required which will be the same regardless.

But it is just interesting how much local difference there is within the treatment provided for type 2 even where it presents the same. Almost scary that people being treated with something which can cause hypos how so little control to monitor to try to avoid them.
 
Years ago now in Coventry, I said to my GP, Sooooooo Dr E, which days are you telling me not to go to my office, and can you write and tell them why please? And he went ' Uhh????' so I started cataloguing all the possible times I might need to test - before I'd finished thinking of possibilities he just sighed and asked me How many each repeat would you like, then?

I'd absolutely do it if I lived in Walsall and also were I @Lucyr - but I know she's not quite as confrontational as I can be sometimes when I want to! (sometimes it's not worth having a battle with an unarmed person though ....)
 
I was getting just 50 strips a month on prescription before
then when I started regular testing (towards the end of last year) I pointed out to my GP that I needed more he reluctantly upped it to 100 strips a month,
however I was having nighttime hypos due to my HbA1c having halved
we were trying to get my insulin levels reduced
and I explained how I was testing pre & post meals plus on waking he agreed to increase the prescription to 200 strips a month, which I’ve had for a few months now,

still hoping to come off insulin and just go back on tablets but I’m finding I still need some insulin twice a day, but I’m not having night time hypos anymore.

I’ve found self testing is the key to understanding and managing my diabetes through eating the right things for me,

good news next week I have my first ever appointment with a dietitian.
then the following week diabetic review with a specialist at hospital (both are phone calls)
 
Last edited:
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Back
Top