400 test strips per 3 months max.

[DaftThoughts]

This is something that annoys the heck out of me super bad.

In the Netherlands, people who inject 4 times a day (or more) are only allotted a total of 400 test strips per 3 months. This is the maximum, there is no insurance company that covers more than this. If your DNS deems it medically necessary, you can get a temporary increase (up to 6-7 strips a day) for 6 months. After that your DNS has to resubmit the form. The DNS also has to back up this decision with their records, so if the records show you're doing fine, you can say goodbye to 2 extra strips a day.

This means you only get to test about 4 times a day, only before meals and before bed time, providing you have 3 meals a day and no snacks. Or if you do, well, you better guess what your value is!

This is madness. If you want more test strips, they come out of your own pocket. Meanwhile they're moaning and groaning how poorly controlled diabetics are over here. Well no &$#* Sherlock! We get told to take x units per meal on Novorapid, we're not taught how to count carbs or how to work with i:c ratios, we're not given any flexibility on how to manage our diabetes, but we get the stink eye when our values are poor and increasing our risks for complications.

I'm mad about this. I'm angry that our premiums are increasing every year but we get less and less in return. I'm mad that the system doesn't promote health the way it should.

I'm on disability and paying for extra strips every 3 months is very very hard on my budget - but it's a necessity. I wish they would wake up and see what they're doing to us over here.

 

[mist]

I'd send you some strips if I could

Hope things change and that you get allocated more strips.

 

[Snapsy]

I'm so sorry to hear this, @DaftThoughts , and I'm feeling very grateful to have what I have. I don't blame you for being mad about it - I would be too!

 

[DaftThoughts]

I'd send you some strips if I could

Hope things change and that you get allocated more strips.

I'm seeing my nurse at the beginning of March and will see if we can wiggle some more strips out of the insurance company every 6 months. I also volunteer for the Dutch Diabetes Association and will see if I can do anything at all to make that change happen!

I'm so sorry to hear this, @DaftThoughts , and I'm feeling very grateful to have what I have. I don't blame you for being mad about it - I would be too!

The first time I saw mention of people getting 250 strips a month in the UK my jaw kind of hit the floor! I'm really really hoping we can get 'as many as needed' instead of this stupid fixed amount.

What meter do you use? Can't someone from here send you any of their spares? I know we always have a box or 2 spare.

I use the CareSens N POP (insurance's choice), though I'm not sure I could take anyone else's spares. It still costs money to send over after all. For now I'm managing if I'm careful enough.

 

[ME_Valentijn]

Rant warning

It gets even better. With the 380 euro own-risk deductible in the Netherlands (or whatever it's currently up to), it pretty much exactly covers the cost of my LADA fiance's testing for the entire year. So insurance is paying for almost nothing anyhow.

The Dutch system sent me home very symptomatic with 22.2 blood sugar at diagnosis on January 12, with 500mg of metformin, no information at all, no testing equipment, and a followup visit in 2 months. Not even testing for Type 1, despite sudden onset and mild symptoms of DKA. Going back a week later, I had moderate ketones and symptoms of moderate DKA, probably due to the contribution of dehydration from the rather impressive diarrhea I got from starting the metformin. The only thing that kept me out of the hospital was eating as few carbs as possible for the first couple weeks, and testing on my fiance's old meter with strips that expired 2 years ago.

The crazy thing is that the GP was pretty much following the guidelines given to GPs in diagnosing diabetes. It can only be Type 1 if someone is under 27 and normal weight, based on rather outdated research. The diagnosis might be reconsidered after meds don't work for 6 months or more, presumably to ensure we have as many complications as possible 4-5 blood tests were run to see if it was probably safe for me to take metformin, and 0 tests run to see if I even had the disease which the drug is used for.

The GP did drop the ball in ignoring my symptoms combined with the hyperglycemia - but that's a rather small paragraph buried in huge document. I just don't see how GPs with 5-10 minute appointment slots could possibly learn enough to diagnose and manage endocrine diseases. And her most consistent advice the first few weeks was to stop testing ketones in my urine, and to not test my blood sugar every day - while I was still 13.5+ most of the day with moderate-large amounts of ketones, and starting on and increasing a med which can cause hypoglycemia Another gem - "You shouldn't be in a hurry to get your blood sugar down quickly. It's fine to have it at 13 for a few more weeks."

I bought a new meter, with new non-expired test strips. My parents are paying (I'm chronically ill and fully disabled). I still get a headache every morning when my blood sugar is 10-11. I eat about 20 carbs per meal to keep my blood sugar from getting too high during the day, but it always goes high at night regardless. I might get to try insulin after another month of slowly increasing Gliclazide doses. Though I fully expect the GP will push me to try Metformin again first, since she's in complete denial that it's even capable of causing symptoms of lactic acidosis, much less that it's what triggered those symptoms in me. It's been 3 weeks since I started and quickly stopped the 1000mg metformin dose, and I'm starting to wonder if my shoulder muscles are going to fully recover from it. I still can't focus my eyes on anything within about 2 feet of my face, though maybe that's a more general diabetes onset issue.

Dutch health care is a mess. It's all about short-term reductions in spending, to keep the insurance and pharmaceutical companies happy. The so-called health minister doesn't even really try to hide it. The result of saving a few pennies now is huge long-term costs in terms of health, quality of life, medical care, and likely social welfare support of those who become too disabled to work. It's incredibly stupid. I hope health insurance gets properly nationalized again, and the anti-health care parties get the boot at the upcoming elections.

 

[DaftThoughts]

@ME_Valentijn I have nothing but sympathy for you! It baffles me that this is how diabetics are treated when this is literally life and death, and quality of life, for us.

I'm still amazed at how my diagnosis went. My diabetic nurse suspected LADA on my first visit due to my age, despite classifying as obese, and because type 1 runs in my family as well, and she had me tested which was great. Having the right diagnosis saved me a lot of grief.

But once it was time to be switched to insulin because the gliclazide failed me and made everything worse, the specialist I had to see for that completely ignored my story and tried to push Victoza on me (which only works if you still have beta-cells left, which wasn't the case for me. Better yet, it's specifically for type 2 diabetics, not type 1, which LADA is, but half the medical systems still say I'm type 2 because my doctor's initial diagnosis was wrong). I'm suspecting financial gain was the reason for ignoring my needs and pushing their wants onto me when I made it clear I wasn't interested and that it didn't suit my situation. Then he proceeded to prescribe me insulin cartridges for pumps because he had no idea what to pick from the list..... The incompetence is astounding.

I had to teach myself how to do carb counting, find my i:c ratio and figure out what my basal rate needed adjustment wise because there was never any initiative from my healthcare team on how to handle any of that. Just 'take 4 units with every meal, and 10 every evening before bed' and that's.... it. He only bothered checking if I knew how to inject, which I did because I was on basal for 6 months before the bolus, but nothing else. Boggles my mind.

For me, the deductible is gone within the first 4-6 months now. The insulin adds up super fast, and so do my checkups and oral meds, so I'm not paying entirely out of pocket, which is great. At the same time, our deductibles are going up and the care we get in return is becoming less. I'm cautiously optimistic about the elections next month...

 

[ME_Valentijn]

One thing my fiance and I were surprised to learn from this forum is that Type 1 (well, insulin users) should be testing before driving, according to UK law. Any idea if there's a similar law or recommendation in the Netherlands, @DaftThoughts ? Between my mediocre Dutch skills, chronic cognitive dysfunction, eye issues, and daily headaches, I'm currently having a lot of trouble reading Dutch documents.

 

[DaftThoughts]

One thing my fiance and I were surprised to learn from this forum is that Type 1 (well, insulin users) should be testing before driving, according to UK law. Any idea if there's a similar law or recommendation in the Netherlands, @DaftThoughts ? Between my mediocre Dutch skills, chronic cognitive dysfunction, eye issues, and daily headaches, I'm currently having a lot of trouble reading Dutch documents.

I'm fairly certain this is not a law. I haven't been able to find anything that says it's a requirement, although it's always encouraged. (Which makes the 4 strips a day thing even worse.)

There are some variables with having a driver's license and diabetes. I was diagnosed 3 years after obtaining my license, so I never reported it to the CBR and I don't have to when I renew my license. The CBR thinks it is my moral obligation to, but it's not required by law. I do believe that if I don't report my diabetes with my renewal, and I cause a car crash due to my diabetes because of a hypo, the insurance might not cover anything for me. But on the other hand, if my DSN doesn't think it necessary based on my history and control, then that might not be an issue at all.

If I were to get a new license now, I would be obligated by law to report it and the CBR would assess (with independent medical professionals) whether I'd be fit to operate the vehicle for that license or not. Not reporting it in this case would be illegal.

It's a very weird law structure that most native speakers struggle with lol. Usually the DSN will make a recommendation on whether to report it or not. If the DSN is someone you trust and who listens to you, I'd take their advice on this.

The annoying thing with reporting diabetes is:

1. Even if you had your checkups and tests done a week ago, the CBR will still require you to go through tedious medical tests to assess your health.
2. Lots and lots of paperwork that can cost €300 or more because the medical tests are out of pocket, NOT covered by health insurance.
3. Your license only gets renewed for 5 years instead of 10. That means you dish out that much money every 5 years.
4. There are no statistics that diabetics cause more car accidents than non-diabetics because of diabetes related problems, so I think this whole thing is utter nonsense. Only extreme cases of hypo-unawareness need to have extra measurements put into place or be denied a license, but I honestly don't understand why we have to pay extra for the tests we get every 3 months, alongside the written statements from our health team. It feels like robbery, and in many cases, severely unnecessary.

I think it's just generally a good thing to test before driving no matter what. I'll have to tighten the belt a little on other things to fund it, but my life and those of others are more valuable than that in the long run. I treat it like it's the law so I don't forget.

 

[miszu]

Same thing here, its actually a law here that we cant get more than 450 strips in 3 months, thats for people who inject 4 or more times a day. If u inject 3 times a day it reduces to 300.

Also what bothers me a lot is that my doctor refused to give me her number.. everytime i need something i have to ask her in email, she replies quite fast, withing 1-2 hours, but really if i were to pass out i cant call her for help. And its a lot different having a conversation and being able to talk to her about my problems related to diabetes or write an email and wait an hour or 2 for her reply. Its a bit upsetting, and on top of that theres only 1 day a week when i can go for an appointment to her. I asked her where does she work the other days of the week, she said if i need to meet her then shes free on that one day. Also only before noon coz after noon she goes home. Not long ago I needed to meet her to get advice about injecting, it was tuesday, she said next monday i can visit her. Waiting a whole week when i dont know how to use the injector is crazy. I just cant wait to change docs and never see this current one again...

 

[coleyd]

My dn gave me 50 for a month and I don't know if I'll get a repeat prescription she doesn't want me to keep testing. I'm so ****** off about thr way I've been treated

 

[Interaud]

I'm sorry that I can't offer to send you tester strips, but due to Doctor error in signing a repeat prescription, I most certainly can offer you Glucomen Lx Ketone test strips (if they suit your meter). I have more than I need and living in Scotland I don't have to pay the same extortionate expense - please feel free to let me know if you wish these sent which I'd be happy to do at no cost to you.

 

[ME_Valentijn]

I'm sorry that I can't offer to send you tester strips, but due to Doctor error in signing a repeat prescription, I most certainly can offer you Glucomen Lx Ketone test strips (if they suit your meter).

There aren't any ketone or combined ketone/glucose meters sold in the Netherlands, based on extensive online searching by me and my fiance. The companies which produce them in the EU won't ship here, so I'm guessing there's a regulation restricting them. My GP was outraged that I was able to test my own urine with ketone sticks (Bayer's Ketostix) and demanded to know where I bought them - bol.com by the way

 

[DaftThoughts]

I'm sorry that I can't offer to send you tester strips, but due to Doctor error in signing a repeat prescription, I most certainly can offer you Glucomen Lx Ketone test strips (if they suit your meter). I have more than I need and living in Scotland I don't have to pay the same extortionate expense - please feel free to let me know if you wish these sent which I'd be happy to do at no cost to you.

Thank you for the offer! That meter is no longer available in the NL so I'm afraid I'll have to pass on that, but I appreciate the thought.

There aren't any ketone or combined ketone/glucose meters sold in the Netherlands, based on extensive online searching by me and my fiance. The companies which produce them in the EU won't ship here, so I'm guessing there's a regulation restricting them. My GP was outraged that I was able to test my own urine with ketone sticks (Bayer's Ketostix) and demanded to know where I bought them - bol.com by the way

I actually found one, but the prices make me wallet cry and then spontaneously combust...

https://www.diabetescentrale.nl/meters-startpakketten/statstrip-xpress-meter-1-st?sku=1702
https://www.diabetescentrale.nl/tes...ip-xpress-ß-ketonen-teststrips-50-st?sku=1716

Thankfully they do offer urine sticks too!
https://www.diabetescentrale.nl/teststrips-urine/ketostix-urine-teststrips-50-st?sku=1368

 

[DaftThoughts]

Same thing here, its actually a law here that we cant get more than 450 strips in 3 months, thats for people who inject 4 or more times a day. If u inject 3 times a day it reduces to 300.

Also what bothers me a lot is that my doctor refused to give me her number.. everytime i need something i have to ask her in email, she replies quite fast, withing 1-2 hours, but really if i were to pass out i cant call her for help. And its a lot different having a conversation and being able to talk to her about my problems related to diabetes or write an email and wait an hour or 2 for her reply. Its a bit upsetting, and on top of that theres only 1 day a week when i can go for an appointment to her. I asked her where does she work the other days of the week, she said if i need to meet her then shes free on that one day. Also only before noon coz after noon she goes home. Not long ago I needed to meet her to get advice about injecting, it was tuesday, she said next monday i can visit her. Waiting a whole week when i dont know how to use the injector is crazy. I just cant wait to change docs and never see this current one again...

I'm sorry you're having such a rough time with that. My DSN is only available on Mondays and Fridays, so anything that needs immediate attention has to wait, or I'll need to schedule a short term appointment with a DSN in the hospital. Often times I can get things taken care of over the phone though, thankfully. Doesn't your DSN forward you to another person who can take your call on time sensitive issues?

That said, don't be afraid to call your emergency number (like 999, 911, 112 etc.) if you're about to pass out and can't make it to your glucose stash or insulin etc. You'll want an ambulance immediately, no delays!

My dn gave me 50 for a month and I don't know if I'll get a repeat prescription she doesn't want me to keep testing. I'm so ****** off about thr way I've been treated

That's an issue for virtually any non-insulin dependent diabetic. I wasn't insulin dependent for the first 1.5-2 years of my diagnosis and had to scrape the strips together myself, as insurance won't cover them if you don't take insulin. And yet they still complain that people can't get their diabetes under control... It really sucks, would you be able to buy your own strips at all?

 

[miszu]

I'm sorry you're having such a rough time with that. My DSN is only available on Mondays and Fridays, so anything that needs immediate attention has to wait, or I'll need to schedule a short term appointment with a DSN in the hospital. Often times I can get things taken care of over the phone though, thankfully. Doesn't your DSN forward you to another person who can take your call on time sensitive issues?

That said, don't be afraid to call your emergency number (like 999, 911, 112 etc.) if you're about to pass out and can't make it to your glucose stash or insulin etc. You'll want an ambulance immediately, no delays!

I can only call the hospital where i was taken when i was diagnosed. But there nobody can really answer my questions, they just ask me whos my doctor, then they tell me that shes available there on mondays only which i already know, thats all they tell me all the time. I ll have to bear with it for 1 more month then i can change docs and hopefuly the other one ll be nicer. sigh.

 

[Daibell]

Hi. Well, I'm going to take a slightly different view and upset a few people but based on my diabetes (and others will be different) I easily get by with 100 per month, so there is a wide range of usage between insulin users. The strips are expensive and in the UK cost the NHS a lot of money. I think we all need to ensure that each test strip use has an objective and I get the impression from a few posts over the years that may not always be true. Frequent car drivers or similar may certainly need to use a lot.