NHS which strips?

[Alexandra100]

I'm seeing my GP on Thursday and hoping against hope to persuade her to prescribe me some glucose testing strips. However, I don't imagine she could prescribe strips that work with my TEE2. As the strips are so dear, I would be willing to buy a new machine in order to get free strips. (I believe there is no hope that the NHS will give me a machine, as my recent HbA1c was only 41.) IF she agrees to prescribe me strips and IF there is a choice of machine to which they are tied, WHICH should I ask for? I presume there are certain machines that the NHS supplies? My criteria for a machine are that it should need the minimum size of blood sample and that it should be at least as accurate as the TEE2. Advice and info. would be welcome.

 

[Bluetit1802]

You are being very optimistic I'm afraid. She is unlikely to give you anything at all. The most you could hope for is a free meter from her store cupboard, but you would have to buy your own strips and they won't be cheap. You would't have a choice at all. Each surgery prescribes a particular meter or variations of this on contract from the manufacturer. They tend to be given the meters free from the manufacturer on condition they prescribe the strips. Only Type 1s and T2s on insulin or certain strong drugs will get meters . As far as I know, the Tee2 is not supplied by surgeries.

 

[Diabeticliberty]

A lot of surgeries are misquoting NIHCE Guidelines in an effort to have someone else carry the can for their fumbled attempts at saving a little bit of money. The guidelines actually say that type 2 diabetics not on medication likely to cause hypoglycemia should not be routinely prescribed test strips. They do not say that all type 2 diabetics should be denied. Doctors are provided latitude to prescribe if you can offer a reasonable enough case to be prescribed them. The casing point is that if it appears that you test and do nothing about the results then you won't receive prescriptions. If you are able to demonstrate that testing has a positive affect on your blood sugar control then they should not in all conscience deny you and if they do threaten to appeal directly to your local CCG which is the authority at local level that attempts to enforce these stupid draconian rules. If you are prepared to fight them then you have a better than average chance of getting them to back down. A number of us have provided some support to type 1's and type 2's that have been denied or restricted and we have had some good results. A very good starting point is to download and thoroughly read the guidelines. Knowledge is power

 

[Bluetit1802]

These are the current NICE guidelines

Self-monitoring of blood glucose
1.6.12 Take the Driver and Vehicle Licensing Agency (DVLA) At a glance guide to the current medical standards of fitness to drive into account when offering self‑monitoring of blood glucose levels for adults with type 2 diabetes. [new 2015]

1.6.13 Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  
  
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]
  

1.6.14 Consider short-term self-monitoring of blood glucose levels in adults with type 2 diabetes (and review treatment as necessary):

• when starting treatment with oral or intravenous corticosteroids or
  
  
• to confirm suspected hypoglycaemia. [new 2015]
  

1.6.15 Be aware that adults with type 2 diabetes who have acute intercurrent illness are at risk of worsening hyperglycaemia. Review treatment as necessary. [new 2015]

1.6.16 If adults with type 2 diabetes are self‑monitoring their blood glucose levels, carry out a structured assessment at least annually. The assessment should include:

• the person's self-monitoring skills
  
  
• the quality and frequency of testing
  
  
• checking that the person knows how to interpret the blood glucose results and what action to take
  
  
• the impact on the person's quality of life
  
  
• the continued benefit to the person
  
  
• the equipment used. [2015]
  

 

[badcat]

All health trusts have a list of 'approved' meters and accompanying strips to supply to diabetics deemed as needing one, some include the Tee2

 

[Butterfly1960]

A lot of surgeries are misquoting NIHCE Guidelines in an effort to have someone else carry the can for their fumbled attempts at saving a little bit of money. The guidelines actually say that type 2 diabetics not on medication likely to cause hypoglycemia should not be routinely prescribed test strips. They do not say that all type 2 diabetics should be denied. Doctors are provided latitude to prescribe if you can offer a reasonable enough case to be prescribed them. The casing point is that if it appears that you test and do nothing about the results then you won't receive prescriptions. If you are able to demonstrate that testing has a positive affect t on your blood sugar control then they should not in all conscience deny you and if they do threaten to appeal directly to your local CCG which is the authority at local level that attempts to enforce these stupid draconian rules. If you are prepared to fight them then you have a better than average chance of getting them to back down. A number of us have provided some support to type 1's and type 2's that have been denied or restricted and we have had some good results. A very good starting point is to download and thoroughly read the guidelines. Knowledge is power

Thanks @Diabeticliberty!
Not just a pretty face eh?!
I was aware of NICE but not read guidelines.
Luckily I have a very good DN!! At my 1st review _April she advised I test BG but apologised as NHS unlikely to give free test kit to a type2. But now I'm taking gliclazide 2x 80mg doses daily. So... I might qualify.... And will ask for appt. To see her before My review date. I think she might agree to NHS free stuff!
Ta everso!

 

[Butterfly1960]

These are the current NICE guidelines

Self-monitoring of blood glucose
1.6.12 Take the Driver and Vehicle Licensing Agency (DVLA) At a glance guide to the current medical standards of fitness to drive into account when offering self‑monitoring of blood glucose levels for adults with type 2 diabetes. [new 2015]

1.6.13 Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  
  
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]
  

1.6.14 Consider short-term self-monitoring of blood glucose levels in adults with type 2 diabetes (and review treatment as necessary):

• when starting treatment with oral or intravenous corticosteroids or
  
  
• to confirm suspected hypoglycaemia. [new 2015]
  

1.6.15 Be aware that adults with type 2 diabetes who have acute intercurrent illness are at risk of worsening hyperglycaemia. Review treatment as necessary. [new 2015]

1.6.16 If adults with type 2 diabetes are self‑monitoring their blood glucose levels, carry out a structured assessment at least annually. The assessment should include:

• the person's self-monitoring skills
  
  
• the quality and frequency of testing
  
  
• checking that the person knows how to interpret the blood glucose results and what action to take
  
  
• the impact on the person's quality of life
  
  
• the continued benefit to the person
  
  
• the equipment used. [2015]
  

Oh! My goodness! So much info out there! I checked DVLA guidelines for my medication at time was metformin but since August been trying out gliclazide. So will have to recheck DVLA again. thanks @Bluetit1802 for brill info

 

[Diabeticliberty]

Thanks @Diabeticliberty!
Not just a pretty face eh?!
I was aware of NICE but not read guidelines.
Luckily I have a very good DN!! At my 1st review _April she advised I test BG but apologised as NHS unlikely to give free test kit to a type2. But now I'm taking gliclazide 2x 80mg doses daily. So... I might qualify.... And will ask for appt. To see her before My review date. I think she might agree to NHS free stuff!
Ta everso!

Awwwwwwww shucks Madam Butterfly you make me blush. I think the thing is that test strips are there or at least should be there to enable us all type 1's and type 2's to better manage our blood sugars in the hope of a better long term outcome. The possible complications associated with poor management are just as relevant for type 2 diabetics as the type 1 condition. There is a quite wrong suggestion that testing is only there for hypo prevention or correction. We are all diabetic and should be treated fairly and with parity. The way some tyoe 2 diabetics achieve excellent control without insulin makes me quite envious. They have far better self control than I could ever dream of having. The thing is though the medical profession spank them on the backside like naughty children and deny them the stuff that they need. Type 2 does not and should not mean 2nd class

 

[Alexandra100]

All health trusts have a list of 'approved' meters and accompanying strips to supply to diabetics deemed as needing one, some include the Tee2

Thanks, that's very interesting.

 

[Alexandra100]

You are being very optimistic I'm afraid. She is unlikely to give you anything at all. The most you could hope for is a free meter from her store cupboard, but you would have to buy your own strips and they won't be cheap. You would't have a choice at all. Each surgery prescribes a particular meter or variations of this on contract from the manufacturer. They tend to be given the meters free from the manufacturer on condition they prescribe the strips. Only Type 1s and T2s on insulin or certain strong drugs will get meters . As far as I know, the Tee2 is not supplied by surgeries.

I'm not being optimistic at all. I did say, "hoping AGAINST hope", and that even if I got some free strips I accepted I would have to buy my own meter to go with them. I'm actually expecting to be told to go away and stop fussing and come back when I'm a "proper" diabetic.

 

[woodywhippet61]

I was surprised that I was given a meter and told to test about times 3 but not to worry about testing. (not surprised about the last bit). On my 2nd visit to the DN (3 weeks later) I told her about my Libre and said that I was chuffed at having the Jazz as I could check using it if I got low readings on the Libre so was using it as a safety backup to check to see if the hypo readings were real. I also asked if I could have more testing strips. DN wrote out a prescription for another 50.

 

[Diabeticliberty]

I'm not being optimistic at all. I did say, "hoping AGAINST hope", and that even if I got some free strips I accepted I would have to buy my own meter to go with them. I'm actually expecting to be told to go away and stop fussing and come back when I'm a "proper" diabetic.

I do personally know some type 2 diabetics who are provided with test strips on prescription. It is not optimism to expect them. It is merely expecting your own doctor to honour his contract with the Secretary Of State For Health to provide you appropriate resource to manage your own condition. If your doctor refuses this then you have the right of appeal. If you make it absolutely clear that you will pursue this as far as you need to in order to obtain what you require they may back down in the first instance. If they do not then you need to continue to pursue the matter. I have no doubt that they may try to fob you off with limp excuses.at every stage. You do not have to accept this. Let's face facts it is completely wrong of them to do so. They are meant to be looking after us.

 

[Oldvatr]

I'm seeing my GP on Thursday and hoping against hope to persuade her to prescribe me some glucose testing strips. However, I don't imagine she could prescribe strips that work with my TEE2. As the strips are so dear, I would be willing to buy a new machine in order to get free strips. (I believe there is no hope that the NHS will give me a machine, as my recent HbA1c was only 41.) IF she agrees to prescribe me strips and IF there is a choice of machine to which they are tied, WHICH should I ask for? I presume there are certain machines that the NHS supplies? My criteria for a machine are that it should need the minimum size of blood sample and that it should be at least as accurate as the TEE2. Advice and info. would be welcome.

I use the Dual from the same people, and that is being supplied by my GP, Most GP's are now restricted to meters that use test strips that cost less than £10 per 50 (ex VAT). Note that the price charged to the NHS is much less than that paid by us for over the counter or even over the Net. We do not have to pay VAT on strips, so make sure you get exemption when you buy privately.

Note The SD Codefree is NOT one of the approved meters. The Spirit Dual is, and I find it quite good. It can also accept ketone test strips. and has bluetooth for use with phone apps.

 

[Bluetit1802]

We do not have to pay VAT on strips, so make sure you get exemption when you buy privately.

That only applies to diagnosed diabetics.

 

[Oldvatr]

That only applies to diagnosed diabetics.

Good point there, But not sure if being on Metformin counts as being registered even if pre-diabetic or gestational?

 

[Bluetit1802]

Good point there, But not sure if being on Metformin counts as being registered even if pre-diabetic or gestational?

I have no idea, although Metformin is prescribed for other conditions such as PCOS.

 

[Oldvatr]

I have no idea, although Metformin is prescribed for other conditions such as PCOS.

The VAT exemption is claimable by anyone with a chronic condition, of which diabetes is only one. I suspect pre-diabetes is not and that gestational diabetes is not since they are not in their own way a chronic condition,

https://www.gov.uk/government/publi...017-vat-reliefs-for-disabled-and-older-people

 

[Alexandra100]

The VAT exemption is claimable by anyone with a chronic condition, of which diabetes is only one. I suspect pre-diabetes is not and that gestational diabetes is not since they are not in their own way a chronic condition,

https://www.gov.uk/government/publi...017-vat-reliefs-for-disabled-and-older-people

Surely pre-diabetes is a chronic condition in its way, often expected to lead on to the chronic condition diabetes. Even though we know it can also regress to "normality", those "normal" glucose readings are usually only to be had at the price of constant testing / vigilance. So, still a chronic condition, being managed by diet, exercise if possible and testing.

 

[Oldvatr]

Surely pre-diabetes is a chronic condition in its way, often expected to lead on to the chronic condition diabetes. Even though we know it can also regress to "normality", those "normal" glucose readings are usually only to be had at the price of constant testing / vigilance. So, still a chronic condition, being managed by diet, exercise if possible and testing.

I think you are confusing Chronic with Inevitable. It may indeed lead to a full diagnosis of diabetes, but a lawyer would argue that it is not proven, and hence should not qualify. Bit I did raise the question for discussion, The anecdotal evidence is that it is a recoverable condition given a following wind (Metformin again!!!!)

If NICE and DUK got off their backsides and addressed the question of diet properly, then maybe T2D could cease to be a chronic condition.

 

[Butterfly1960]

Awwwwwwww shucks Madam Butterfly you make me blush. I think the thing is that test strips are there or at least should be there to enable us all type 1's and type 2's to better manage our blood sugars in the hope of a better long term outcome. The possible complications associated with poor management are just as relevant for type 2 diabetics as the type 1 condition. There is a quite wrong suggestion that testing is only there for hypo prevention or correction. We are all diabetic and should be treated fairly and with parity. The way some tyoe 2 diabetics achieve excellent control without insulin makes me quite envious. They have far better self control than I could ever dream of having. The thing is though the medical profession spank them on the backside like naughty children and deny them the stuff that they need. Type 2 does not and should not mean 2nd class

Yes, that's true regardless of the type of diabetes we have been dealt, we all need a chance to help ourselves thru our conditions in the best way poss NHS seem to be fighting anyone with any sense who wants to live as healthily as poss
but I seem to be in a minority with my care team on my side and so helpful . I found out today that my DN is on hols for 2 weeks!! She deserves a break, poor woman is run off her feet as the only diabetes nurse in the practice, and no locum for a DN either!! The next available appointment is in November as a non-urgent visit but I have a good supply of lancets and testing strips from Amazon.... should be ok til next appointment.... which might coincide with my birthday.... nice free stuff maybe gift from NHS?!?