Test strip restrictions

[Northerner]

Today Diabetes UK attended a meeting of the All Party Parliamentary Group for Diabetes about access to test strips. It focused on people with Type 1 diabetes and those with Type 2 on insulin. This is what people had to say:

http://storify.com/diabetesuk/test-strip-restrictions

Hopefully, there will also be discussion on how self-monitoring can help those not on insulin too, especially in the early months after diagnosis.

 

[Robster65]

It was good following it on twitter. DUK ( @diabetesUK ) were actually pushing our cause strongly and putting some of our comments across. Possibly the first time a parliamentary committee has had access to the views of the people affected in real time.

I think they said they were going to address T2 access as a separate issue in the near future. Once they understand the need to test, maybe it'll be easier to gain broader access to strips and education for both GPs/nurses and patients alike.

Interestingly, the move towards more frequent testing seems to go against the DAFNE recommendations. I wonder if this will see an overhaul of their teachings.

Rob

 

[Northerner]

Interestingly, the move towards more frequent testing seems to go against the DAFNE recommendations. I wonder if this will see an overhaul of their teachings.

Rob

That's something I've never really understood when I've heard it about DAFNE - it's important to know when spikes are likely so you can tailor your insulin timing (or avoid the food items responsible!). In the early months after diagnosis I would inject immediately prior to eating and never test until just before the next meal unless I felt hypo - it was only when I did start post-meal testing that I realised my BG was often shooting up, and something I have been able to improve through testing.

 

[randomange]

That's something I've never really understood when I've heard it about DAFNE - it's important to know when spikes are likely so you can tailor your insulin timing (or avoid the food items responsible!). In the early months after diagnosis I would inject immediately prior to eating and never test until just before the next meal unless I felt hypo - it was only when I did start post-meal testing that I realised my BG was often shooting up, and something I have been able to improve through testing.

I found the course really rewarding, but this was one of my frustrations with DAFNE as well. However, I think it's done in a effort to simplify things for people at first. DAFNE can be quite a revolutionary way of managing their diabetes for some people, and there are a lot of new ideas and concepts to grasp. I think the idea of adding in tests between meals would somewhat complicate matters initially. I also think they're worried about people over-correcting, or not taking account of IOB and then swinging from high to low, something that DAFNE is very much aiming to avoid.

However, I definitely think it's something that should be added in at a later date, either by learning from your DSN, or maybe having a second "advanced" DAFNE some time after the first course. One thing that the people running our course emphasised was that DAFNE is a starting step, and that it gives you a set of guidelines to adjust to *your* diabetes, and that testing in between meals was something that could be used for this.

 

[Robster65]

Agree totally. And I suspect many HCPs have taken the DAFNE regime to be the best way and are surprised and alarmed when patients demand more than 4 strips per day! 🙄

It's good as a means of getting people who are struggling to test regularly, understand how to adjust their ratios to obtain better results at mealtimes, but then comes the refinement that drives the HbA1c down below 7 or 6.5, which is where the consultants want it.

This move by DUK should better publicise the need for at least 6 tests per day and up to 10 or so for certain situations.

I was pushing some of the arguments and justifications I've read on here over the last couple of years. Difficult to condense those into less than 140 characters but I think the point was made quite well.

Rob

 

[Robster65]

I found the course really rewarding, but this was one of my frustrations with DAFNE as well. However, I think it's done in a effort to simplify things for people at first. DAFNE can be quite a revolutionary way of managing their diabetes for some people, and there are a lot of new ideas and concepts to grasp. I think the idea of adding in tests between meals would somewhat complicate matters initially. I also think they're worried about people over-correcting, or not taking account of IOB and then swinging from high to low, something that DAFNE is very much aiming to avoid.

However, I definitely think it's something that should be added in at a later date, either by learning from your DSN, or maybe having a second "advanced" DAFNE some time after the first course. One thing that the people running our course emphasised was that DAFNE is a starting step, and that it gives you a set of guidelines to adjust to *your* diabetes, and that testing in between meals was something that could be used for this.

Haha. You beat me to it!

Rob

 

[Northerner]

I can certainly see the argument against testing/overcorrecting with IOB, I have seen a lot of people having problems with this over the years on the forum, when often the solution is not to correct, but change timing of insulin when the meal is repeated - a subtlety that may be difficult to take in initially. 🙂