Why can't I get blood from my fingers?

[Robin]

You don’t sign anything to say you will test, no guidance says you must test, and you don’t need to inform the DVLA. There can not be any consequences of driving without testing first when driving a car on gliclazide.

Of course you should stop driving if you feel unwell, just like anyone on the road should even if they don’t have a medical condition.

That’s why I said it was a grey area. There’s no mandatory rule, as you say, but if testing isn’t desirable, why does the official info mention it at all? Also, if your GP has advised you to test, which the rules for doctors may prompt them to, if you were in an accident and found to have low blood sugar, you could be guilty of driving against medical advice.

 

[Lucyr]

if you were in an accident and found to have low blood sugar, you could be guilty of driving against medical advice

You wouldn’t be driving with low blood sugar you’d stop as you felt unwell. Unless the drs actually written in your notes advised to test within x minutes of driving and every x minutes on route, which simply doesn’t happen, there’s no problem. Drs only give test strips on gliclazide so that you check when feeling unwell.

 

[victorhamesse]

You only fill that form (diab1) in to renew licence if on insulin or gliclazide and have had a severe hypo needing assistance or have eye complications etc. Everyone else just on gliclazide doesn’t report it to DVLA, as per the Diabetes UK information you linked yourself.

No. I had no hypo but as Gliclazide is a notifiable medication I had to complete the form, but without any problems in receiving a new licence. The prime source for this is the DVLA site not the Diabetes UK site.

But it does not damage fingers.
As I wrote, my fingers are fine after more than 20 years of finger pricking
And using all fingers has allowed more "finger rotation" to reduce the impact on each finger.

I guess so. As I don't do a lot of finger testing now that I have a Libre, I have never pursued the subject.

 

[Lucyr]

No. I had no hypo but as Gliclazide is a notifiable medication

No, it isnt. This is from the DVLA site which says the same as Diabetes UK

 

[Alan44]

Can we try to keep this thread on topic please ?

Alan

 

[Lucyr]

Can we try to keep this thread on topic please ?

Alan

It is on topic as the OP thinks they can’t drive until they can test their bg

 

[Alan44]

It is on topic as the OP thinks they can’t drive until they can test their bg

The OP's main question is

Can anyone help me get a decent blood drop? I've asked the surgery for an appointment with a diabetic nurse but they move very slowly and in any case that can't happen until at least Monday.

Alan

 

[Ieva DUK]

@debs248 if you need to test while on the go and no cup of tea is available, there are also those hand warmers/packs that hikers use, maybe those would work for you too? Just keeping a few in your bag/pockets for when you need them?

 

[Robin]

I think, @Alan44 , that the OP is asking for help in testing, because they have been provided with a kit by their GP and told to test, and have been given the information that they can’t drive until they can test.
@Lucyr 's statement in post 2 is incorrect, and should not go unchallenged.
Maybe it needs splitting off into a separate discussion, but Lucy’s assertion that you don’t need to test for driving might make the OP feel that they don’t need to bother, if they are finding it difficult.
The official wording in the government guidance is muddy, but clearly states a link between monitoring BG and driving, for people on Gliclazide. (The link to this page is given in my post above, if it’s difficult to read the screenshot)

 

[JimG]

You don’t sign anything to say you will test, no guidance says you must test, and you don’t need to inform the DVLA. There can not be any consequences of driving without testing first when driving a car on gliclazide.

Of course you should stop driving if you feel unwell, just like anyone on the road should even if they don’t have a medical condition.

The guidance says:
If your diabetes is treated by tablets carrying hypoglycaemia risk (for example Gliclazide, Glimepiride,Glipizide, Repaglinide or Nateglinide) you should monitor your blood glucose levels at times relevant to driving. Further details on testing are available in Assessing fitness to drive a guide for medical professionals. If you are unsure whether you should monitor blood glucose you should discuss this with your healthcare professional, as to whether this advice applies to you.

 

[louisew]

I finger prick at the side of the nail, always seems to work

 

[JimG]

I don't usually find difficulty but all of the suggestions on improving blood to the fingers are good. I sometimes find swinging my arms may increase blood flow if I cant find something warm. As somebody pointed out make sure that the water is not too hot, that can reduce the blood flow to the extremities. Hot is bad but warm is good. If you are running your hands under warm water make sure that you dry them properly to keep water out of the testing strip.

 

[silver minion]

I was newly diagnosed this week with A1c of 113, tested at the gp with BG 20.1, given medication and a monitor and told to test glucose 3-4 times daily.

Unfortunately I appear to have next to no blood in my fingers, at least none that is willing to come out. I can sometimes get a tiny droplet but not enough for the test. I've tried both hands, various fingers, two brands of lancing device and half a dozen tips found on the internet and am incredibly frustrated.

Until I can test I can't drive because I'm on gliclazide and can't measure for hypos (I'm not feeling well enough to drive this week but that's not the point).

Can anyone help me get a decent blood drop? I've asked the surgery for an appointment with a diabetic nurse but they move very slowly and in any case that can't happen until at least Monday.


Thanks

Hi I am also on gliclazide and use a BG meter to test blood.
I always have cold hands so soak them in a sink of very warm water for a minute or two then wash them till they go pinkish. Rub my hands vigorously together to improve circulation.
I have the lancet on 2nd deepest depth in the winter. In summer I can go one lighter.I don't like needles and have a tendency to flinch so I also hold the lancet quite firmly against the finger. Also against the normal advice I do prick towards the middle of the pad or I can't get enough blood.
If you are tense this can also affect blood flow. This has improved with practice. If I am feeling very stressed I ask hubby to do it.
My nurse advised me to check on waking daily and check before driving while my body was adjusting to the increasing doses and to check if I felt unwell.
I hope this helps you. Other tip of warm mug is also great.

 

[Lucyr]

The guidance says:
If your diabetes is treated by tablets carrying hypoglycaemia risk (for example Gliclazide, Glimepiride,Glipizide, Repaglinide or Nateglinide) you should monitor your blood glucose levels at times relevant to driving. Further details on testing are available in Assessing fitness to drive a guide for medical professionals. If you are unsure whether you should monitor blood glucose you should discuss this with your healthcare professional, as to whether this advice applies to you.

It applies to people who have to tell the DVLA about their diabetes ie who have had a severe hypo, and as the front cover of the leaflet states, you don’t have to inform the dvla about being on gliclazide unless you have had a severe hypo. There are no rules saying “you must test x hours before driving and have a bg of y and test again after z hours” for people on gliclazide. The OP can drive without notifying the DVLA, stop scaremongering them

 

[Lucyr]

Here is the form for if you drive a lorry and take gliclazide. You can clearly see that in this scenario the DVLA say you must agree to test within 2 hours of starting driving (doesn’t need to be immediately before driving).

You are advised not to fill in a form like this if driving a car and taking gliclazide, unless you’ve had a severe hypo. Therefore you have not been required to test before driving. https://assets.publishing.service.g...vdiab1dg-confidential-medical-information.pdf

 

[silver minion]

It applies to people who have to tell the DVLA about their diabetes ie who have had a severe hypo, and as the front cover of the leaflet states, you don’t have to inform the dvla about being on gliclazide unless you have had a severe hypo. There are no rules saying “you must test x hours before driving and have a bg of y and test again after z hours” for people on gliclazide. The OP can drive without notifying the DVLA, stop scaremongering them

This is broadly similar to what my nurse told me when I asked her. Fortunately I have only had a few false hypos and one fairly mild actual hypo at home because I went too long between meals. Easily sorted with a couple of jelly babies then lunch.

 

[Robin]

It applies to people who have to tell the DVLA about their diabetes ie who have had a severe hypo, and as the front cover of the leaflet states, you don’t have to inform the dvla about being on gliclazide unless you have had a severe hypo. There are no rules saying “you must test x hours before driving and have a bg of y and test again after z hours” for people on gliclazide. The OP can drive without notifying the DVLA, stop scaremongering them

You don’t have to inform the DVLA. We are agreed on that.
There isn’t the same mandatory instruction to test BG every 2 hours. Also agreed.
But the first paragraph of the main body of the text, after the front cover, states as @JimG quoted.

If your diabetes is treated by tablets carrying hypoglycaemia risk (for example Gliclazide, Glimepiride,Glipizide, Repaglinide or Nateglinide) you should monitor your blood glucose levels at times relevant to driving

There is nothing in the leaflet that says this only applies to people who have previously had a severe hypo.
We are not scaremongering, we are just drawing attention to the wording of the official leaflet.
I do not see how it is possible to put an interpretation on it that suggests it only applies if you’ve already had a severe hypo. Yes, notifying the DVLA in that case kicks in, but the advice to test is already in place from the moment you start Gliclazide.
Normally, I’d say, we 'agree to differ' but in the case of someone potentially falling foul of the law through advice given on this forum, I can’t let it go.

 

[JimG]

Hi I am also on gliclazide and use a BG meter to test blood.
I always have cold hands so soak them in a sink of very warm water for a minute or two then wash them till they go pinkish. Rub my hands vigorously together to improve circulation.
I have the lancet on 2nd deepest depth in the winter. In summer I can go one lighter.I don't like needles and have a tendency to flinch so I also hold the lancet quite firmly against the finger. Also against the normal advice I do prick towards the middle of the pad or I can't get enough blood.
If you are tense this can also affect blood flow. This has improved with practice. If I am feeling very stressed I ask hubby to do it.
My nurse advised me to check on waking daily and check before driving while my body was adjusting to the increasing doses and to check if I felt unwell.
I hope this helps you. Other tip of warm mug is also great.

In all the discussion about how to improve blood flow, the question of the setting on the lancet may be overlooked. I said in another post that I don't usually have difficulty but silver minion's post reminded me that, when first diagnosed, I didn't always produce blood. That was due to the setting - too light - and not holding the lancet firmly enough against the finger.

 

[JimG]

It applies to people who have to tell the DVLA about their diabetes ie who have had a severe hypo, and as the front cover of the leaflet states, you don’t have to inform the dvla about being on gliclazide unless you have had a severe hypo. There are no rules saying “you must test x hours before driving and have a bg of y and test again after z hours” for people on gliclazide. The OP can drive without notifying the DVLA, stop scaremongering them

I didn't scaremonger. I simply quoted the guidance. I used the exact words of the guidance. No interpretation, no amendment. If you don't like the post, take it up with the writer of the leaflet, the DVLA.

 

[Martin.A]

I was newly diagnosed this week with A1c of 113, tested at the gp with BG 20.1, given medication and a monitor and told to test glucose 3-4 times daily.

Strange that you and I were diagnosed with near-identical levels (114 & 20.5 for me) but whereas you've been prescribed Gliclazide I was prescribed Metformin, and after a few weeks my DN decided I probably didn't even need that (she was right). Not for the first time no consistency in the NHS.

If you'd seen my DN and I'd seen yours.......