Type 2 and in heart failure

[Okapis]

Hello all, new user at 72 looking for information on firstly how to get blood out of a finger for blood glucose tests and secondly on Dapaglifloz in.
I've been a type 2 diabetic for years maintained by the usual pills, never having to monitor my blood sugar. Along comes a cardiologist when I find myself in heart failure, prescribes Dapagliflozin with the comment your other diabetes medicine will need adjusting by your GP.
Unfortunately the practice declares themselves not competent with the drug and is unwilling to prescribe, refers me to the Community Diabetic Service. They promptly reject me, saying it's an inappropriate referral. Nobody tells me. I sit at home clutching a 4 week supply of pills from the consultant wanting to start the dapagliflozin. Eventually I email the Diabetic Service to find out when the appointment is, only to discover I don't have one and why. Can't contact a GO to discuss.
Coming up to 4 weeks after having been prescribed the drug, having researched online, I drop the Glicazide, retain Metformin and start Dapagliflozin by myself. I tell the practice what I've done. That gets an email response with some minimal information and a telephone appointment 3 weeks ahead by which time I'll have needed a repeatprescription. The gist of which is to start monitoring my blood glucose on a daily basis.
So I try, but unlike all other glucose tests I've ever had, can I get enough blood out of a finger now! Must be the very low blood pressure, artificially induced. Warm my hands on hand water, mill my arm around....nope! What do I do now? Get a larger size lancet?
So interested in hearing from people on Dapagliflozin and how to extract blood for a glucose test.

Help?

 

[Lily123]

Welcome to the forum

It’s quite strange that your GP has refused to issue the prescription as I would think if your consultant said you needed it then your GP wouldn’t get a say in the matter.

With trying to get blood for a finger prick, have you tried holding a mug of hot tea or coffee as this can help the blood get back at the fingertips

 

[Leadinglights]

Welcome to the forum
If you had been on the gliclazide then you should have had a monitor and test strips provided by your GP as that is a medication that could cause hypos but in any case many Type 2 do monitor their level on a daily basis.
As far as getting blood out of your finger, as said make sure your hands are warm, hold below your heart and massage the finger towards the tip, the best place to prick is just to the side of the middle of the pad, squeeze gently and the drop should appear. you only need a drop the size of a pin head.
There are some YouTube videos in technique which might help you.
I can't comment on the medication other than to say you might need to use the complaints procedure either with the GP or the hospital PALS system.
Have you had a recent HbA1C so you know where you are at with your diabetic management and what is your diet like as you may need to review that if your medication has changed.

 

[Okapis]

My glucose levels were previously checked regularly, coming out between 45 and 52 mmol with 3 monthly Ha1bcs, actually tested for another medical condition.The Tests at the GP 's are at 6 months or longer currently

I've used the deepest lancing level on the Lancet but read you can get thicker ones? I've tried pretty much everything suggested on a browser search. Straight after a hot shower has produced better results but I don't want two showers a day! Bit extreme

I've been caught between the Community Heart Failure CHFS team and it's consultant cardiologist and the General Practice. I'm playing pig in the middle in the dark too! The CHFS finds the GPS response a bit baffling as they haven't had such a response before from a practice.

It turns out there was a continuing education session offered by an expert consultant last November on the use of Dapaglifozin for GP'a and Nurses. Very few turned up, nurses no doctors. Mind you I'm not sure I would have during Covid pressures!

The G P telephone appointment duly arrived ( my self starting the Dapa caused a repeat prescription to be issued and a listing on repeat medication pretty fast.) Much to my surprise, I received an apology from the doctor for what had happened. It should not have happened. An issue still remains with getting medicines to me fast. Need to find myself a heart failure forum too!

Just how many of you are taking Dapaglifozin, please? What is your experience?

CHFS needs to change my meds from time to time, so far once urgently and uses software Systemonline, to communicate with GPs. My practice say they check the system every day but cannot guarantee to implement any prescription changes for 3/4 days, more if the weekend falls inconveniently. They expect a consultant to issue 4 weeks supply of any new drug and send a letter (huh, fat chance everyone has Covid)

In view of the apology I don't want to make a complaint at any level but if it happens again...and my health is jeopardized as it was...I won't hesitate

 

[janw]

I have noticed that on Amazon there are different sizes of lancet: eg 28g, 30g and 33g - but I'm unsure as to which might suit you better and the compatibility with your BG finger pricker, though most lancets I've looked at for my own use appear to be generic. Another tip is to let your hands hang down straight so the blood flows downwards toward the tips - sometimes an extra brisk rub on a hand towel can create extra warmth too (no heat in my bathroom, so I've had to think on my feet!). Hope you get everything straightened out - best of luck to you.

 

[trophywench]

Do you have spit in your mouth? - have you tried sucking the finger for a bit before drying it and bodging it? - or indeed washing in hot water and drying VIGOROUSLY.

 

[Lucyr]

I took empagliflozin which is similar but only for a few days as it caused ketoacidosis. Make sure you are aware of the symptoms of high ketones and check your levels or seek medical help if you have signs of ketones.