Urine sticks ...... bad advice???

[CathyN]

Hello all

Just did my first diabetic clinic. On the whole it was ok. The actual explanation of what it is, how you got it etc was good. But I was worried by some advice given and the general reaction to it. We were given urine sticks to use to test for glucose. The nurse told us that, if we got a negative result ( testing at different times of day) then our Type 2 was deemed to be under control. However, i know that the strips are negative up to 10mmol/l and only go positive after 10mmol/l. Am i right in thinking then, that these sticks cannot be relied upon for accurate monitoring, as 10mmol/l is too high - even 2hrs post prandial?? The worrying part was that many of the group were relieved to hear that a negative urine stick meant that they needn't worry - and that basically, their diabetes would be under control. I thought, especially to the newly diagnosed, this advice was not helpful.
As I expected from being on this forum, the carb advice seemed less than sound. I didn't expect a dietician to advocate that if you like white bread there's no harm in having it .................

Anyway, to get back to my question ... should I bother relying upon sticks??? I have a meter and test my BG regularly anyway.


CathyN

 

[ll1000]

I was put on metformin two weeks ago and given urine sticks at the same time. It sounds like standard NHS practice. Makes you think you're doing something useful to manage the condition.
As my appointment then I got my "official" diagnosis of Type 2 ( I had been close to borderline for 3 - 4 years), I was a bit shocked and not taking much in. Also I was last appointment of the day and clinic was running late so it was all a bit rushed. I too don't understand the point of the urine sticks when my HbA1c was only 48 (Highest was 3 months ago at 49). I was told to test first thing in the morning. Never had a positive reaction in 2 weeks. Even if I had a positive reaction, I can't see how the level in urine relates to blood sugar. Even when my facting BG level has been a bit on the high side, nothing has ever shown in a urine sample taken at the same time.

 

[Dillinger]

Hi Cathy,

I think you've hit the nail on the head; the consensus on here suggests that a blood sugar reading of above 7.8 mmol/l is going to cause problems in terms of increasing the likelihood of complications.

I have heard elsewhere that the glucose shown in a urine reflects blood sugars above 10 mmol/l (and by the way if your blood sugar is elevated there is a 'renal threshold' for blood glucose above which your kidneys start to remove the sugar from your body - that's the connection between blood and urine).

So, testing for urine could show no glucose at all ever and you could still be just shy of the renal threshold building up problems for the future.

Did the dietician really say eat white bread if you want to? Astonishing...

Best

Dillinger

 

[CathyN]

Hello again!!

Yes, the dietician really did say, eat white bread if you want to. I was amazed. I think her mission was to soften the blow of being diagnosed - so the white bread thing went down very well. But you see, not one person there had a meter or any idea of their Blood Glucose readings before/after eating or at any other time except their diagnosis readings. After being on here for a week, I was armed with my food diary, my taramasalata experiment results (!) etc etc. Acres of data! I felt in some way, there was an attempt to shield the patients from the nitty gritty.
I have had it hinted to me, by a health professional, that I am taking it all far too seriously - that there is no need for me to use a meter etc etc. but when you feel like s**t it seems to matter greatly. I know I'm at the easy end of the scale and that it could be so much worse - but I'm trying to be proactive here!!! I want my body to last.......
So, anyway, the dipstix are pretty pointless, aren't they?? Might as well **** into the wind!

Thanks for your replies to my posts

best

CathyN

 

[lucylocket61]

My DSN only uses dipsticks for testing when I go. And as my appointments are always around 3 hours or so since I last ate, and they only show over 10mmol. I am always considered to be wasting her time as my levels are normal by then. (by normal I mean under 7.8 which, according to her, is normal)

She assures me that only over 10mmol is a problem. That I am over-anxious. That I dont need to test with my meter (the doctor over-road her advice at my request and made her give me one and 50 strips a month) and that I can eat anything, including white bread. I can even have the odd chocolate bar, like a Mars bars sized one, if I dont do more than once a week. I only have a touch of diabetes, not serious diabetes :crazy:

Thank heavens for this forum or I would be in real trouble very quickly, I think.

 

[Defren]

My DSN only uses dipsticks for testing when I go. And as my appointments are always around 3 hours or so since I last ate, and they only show over 10mmol. I am always considered to be wasting her time as my levels are normal by then. (by normal I mean under 7.8 which, according to her, is normal)

She assures me that only over 10mmol is a problem. That I am over-anxious. That I dont need to test with my meter (the doctor over-road her advice at my request and made her give me one and 50 strips a month) and that I can eat anything, including white bread. I can even have the odd chocolate bar, like a Mars bars sized one, if I dont do more than once a week. I only have a touch of diabetes, not serious diabetes :crazy:

Thank heavens for this forum or I would be in real trouble very quickly, I think.

A touch of diabetes? That's like a touch of pregnancy, just not possible.

Your DSN needs lessons in nursing and common sense Lucy!

 

[hanadr]

The kidneys retrieve most of the glucose that gets into the blood plasma, so to appear in the urine, there has to be too much of it for the kidneys to get back. his happens at about blood glucose 10 mmol/l. It does vary a bit from individual to individual and is called the renal threshold.
All a urine dip stick can tell you is how much glucose has escaped your kidneys since the last time you emptied your bladder.
this isn't actually a very useful bit of information in relation to your control.
You can still have quite high BG and no glucose in the urine if you have a high renal threshold. and for people with an average renal threshold of about 10, ANY glucose in the urine is a sign of HIGH bg.
Blood glucose measuring tells you what your blood glucose is NOW. and most meters can give reasonable accuracy.
Hana

 

[CollieBoy]

Looks like the DSN is the real dipstick! :twisted:

 

[viviennem]

I'm shocked! :shock: . My practice does not use urine test strips at all in testing for diabetes.

To quote my lovely practice nurse - who is not officially a DSN but knows more about it than some of that specialism who have been quoted on here - "they are nowhere near accurate enough for use in testing blood glucose in diabetics."

From what Hanadr says, she is quite correct.

Viv 8)

 

[CathyN]

Amazingly bad, isn't it. Especially this patronising "you're over-reacting, dear" attitude. I may have it all wrong, but I presume that these doctors and nurses may want to preserve their heart, kidneys, eyes etc. And yes, thank goodness for this forum. I'm a bit of a diabetic bore at the moment, but I really do feel it has been the best resource I have yet encountered.I'm really grateful that people are happy to share so much and give out advice, tirelessly. It beats the NHS by a long chalk.

Cathy x

 

[wiflib]

I actually checked the date this was posted as I couldn't believe what I was reading! Sadly, this means that every single diabetic she comes in contact with will get exactly the same shoddy treatment and advice and will end up in a very early grave.

I thought we had somehow gone back in time to 1978

wiflib

 

[Grazer]

Can't add more. Urine sticks :?:
:thumbdown: :thumbdown: :thumbdown:

 

[noblehead]

Urine sticks £3-£5 bg sticks £15-£20........there lies the reason!

 

[evilhamster]

Urine sticks £3-£5 bg sticks £15-£20........there lies the reason!

guess the nhs dosn't know about the sd codefree meter test strips cost about the same as the urine sticks :crazy:

 

[Defren]

Urine sticks £3-£5 bg sticks £15-£20........there lies the reason!

guess the nhs dosn't know about the sd codefree meter test strips cost about the same as the urine sticks :crazy:

As a T2 I am lucky I get all my strips prescribed, but I didn't initially. When my GP agreed to prescribe I had already bought an SD Codefree, he looked for strips for that meter and they are not available on the NHS. In the end I was given an Accu Chek Aviva and prescribed the costly strips for that. So the answer to your question - No, the NHS don't know about the SD Codefree.

 

[BlindFaith]

Cathy - I'm fairly convinced that you went to the same clinic with the same two nurses that I went to!

I had the "you can eat whatever you want" speech, the "even white bread if you like it" part and the general feeling of patronization.
When I went back to see them again on a one-to-one basis, the diabetes nurse was really nice but talking to the diabetes dietician felt like banging my head against a brick wall while watching said nothing useful at all and I had to really prod her to answer questions.

I'm glad of this forum and the internet - I did my own research in the end!

 

[ll1000]

Had my three week check after diagnosis on Wednesday and raised the subject of urine sticks (for glucose)- what's the point? I was told they are to see if anything is "going wrong". But the body language told me there was no real reason apart from the fact they were cheap and made me feel I was monitoring something.
Since my HbA1c has been oscillating between 43 and 49 for several years (49 was only one reading and in March this year and has since dropped to 48 in June - 6.5 in old money), I doubt if I'm likely to show a sudden problem. On metformin I lost 4 pounds in 1st week on my normal reasonably healthy diet, fortunately I don't like high fat and sugary things. Then I read the leaflets I was given and realised I should be eating more starchy carbs and eggs and cheese. So in 2nd week lost no weight despite upping the metformin to 2 per day from 1 per day (as instructed). Went back to old diet and lost a further 3 pounds in 3rd week. DSN pleased, although if I'd ignored the dietary advice I would probably have lost another 2 -3 pounds by now.
No joy on getting a meter and test strips through NHS so I'll need to research what's best. Had a quick BG check done at surgery - result 5.5 - late afternoon appt so several hours since last meal, but had some no added sugar squash a couple of hours before.

 

[JTL]

Can't remember where I read it but I came across an article that said back in bygone days diabetes was diagnosed by getting you to pee near an ants nest and if your pee was full of sugar the ants would swarm over the wee patch.
I haven't tried it yet.

 

[Brunneria]

And physicians used to taste urine too.
If it was sweet, you had the sugar disease.

 

[Jaylee]

I have to admit. I often wonder how I surved without "complications" as a T1 child & teen using vague fizzy tablets in a test tube then moving on to pee sticks...

Say what you like about a stab in the finger. But I know which I prefer!