Strips/prescription advice

[Aaron1977]

Hello, new to the forum - did a search and found lots of info and points on this, but nothing concrete.

My partner has been type 1 since she was 13 and is now 31 (and 8 weeks pregnant!) with excellent control over blood sugar levels. She recently changed her testing machine so had to change the prescription for the type of strips she gets.

Anyway, long story short, they wouldn't give her the usual 4 boxes of strips (4x50). Apparently, according to the receptionist, that's just too many. She queried this saying that A, what does she know and B: she has got this many strips for 10 years plus!

So the receptionist duly went to the doctor, who said that she could have 3 boxes "this time" but after this month it would go down to 1 box. If she needs more than that she "obviously doesn't have good BS control" - which is completely idiotic in my opinion. It's the strips that help her have grade A control in the first place.

What annoyed me more than anything was this one size fits all approach - like if you don't do A or B then you must be terrible...surely everyone manages things differently? My partner likes to test her blood when she gets up, before the drive to work, maybe once in the day, maybe once in the evening and then once before bed. That's at least 5 times a day, which is 35 strips a week which is at least 3 boxes a month!

So my questions are, is this common? Doesn't the NHS have a duty to provide a level of care and isn't the availability of strips promoting self management? Does the GP in some way have a budget for things like this - is it in their interest to not prescribe testing strips?

I read something about a NICE report - is there anything in this regarding the provision of strips and testing equipment?

If, when she sees the doctor, he refuses to give her the right amount of strips - is there anything she can do other than change doctor?

Sorry for the questions - I did ring the NHS helpline but they didn't really know anything and told me to ring the primary care trust. My experience with them isn't great so I thought I would ask this community first.

Many thanks!

Aaron

PS: it's our first baby too so I have more questions floating around in my head

 

[Stuboy]

Hi,

Im not sure about the NICE guidelines, but as she is Type 1 then she should be getting all the test strips that she needs to stay in good control, esp. with a baby on the way!!!!

The only reason she HAS excellent control is because she is testing regularly and know's what's going on. It's the only way to stay in control. Knowledge is power afterall!

I would argue the point with the DR and ask her exactly how she expects your wife to stay in good control (take blood results and proove the good control) emphasis the importance of staying in good control while she's pregnant.

I've never had an issue with this so far. Look up the NICE guidelines on this and read them, if you find that they state a type 1 should have as many strips as they need... print it out, highlight it and take it to the dr, litterally throw the book at her! lol

That's what i'd do

Good luck and keep us updated!

 

[LittleSue]

Hi Aaron

Stuboy is absolutely right. Your wife's testing appropriately. Unfortunately PCTs/practice managers see test strips as a way to cut costs, especially after a study said effectively type 2 diabetics don't benefit from testing (was a very poor study). They just remember "diabetics don't need to test" and conveniently forget about patient needs, safety and the costs arising from poor control (hospital care doesn't come from their budget!).

Seems no logic to PCT/surgery mindset other than cutting costs and claiming payments. A hospital consultant told me GPs ask for original printouts of hospital test or scan results (instead of a letter with results and recommendations), then claim they initiated the test and acted on it, when really it was the hospital specialist who decided the appropriate test, interpreted the results and used his specialist knowledge to advise.

Strip trouble often starts with changing meter, because the default prescription is one pack. I had a similar problem, took in a letter from the DAFNE team saying I needed "increased monitoring supplies" following DAFNE training but they reduced me from 100 to 50 strips. The receptionist lied, saying the letter didn't mention increased supplies. (Standard, open letter given to us all, I knew precisely what it said.) Had to make an appointment to sort it out, took my diary to show I could justify every test and the resulting changes. Explained following regime change I was having night hypos whilst adjusting the dose (history of sleeping through hypos) so needed to test at 3am. Suggested I could save 7 strips/week if I phoned doctor at home at 3am each night for him to diagnose whether I was hypo. He gave me 150 strips/month, could've got more.

Maybe your wife could arrange an appointment with the senior doctor in the practice or the manager (or both), and make it clear she's type 1, driving (if she does) and pregnant. She could get her diabetes consultant to write to the GP although from experience even consultant's advice doesn't always work. Incredibly they aren't compelled to follow NICE guidelines either.

 

[Trinkwasser]

[A] get her to see an endo promptly, this should be possible due to the pregnancy

ask your pharmacist if any other doctors in your area are more inclined to prescribe adequate supplies of strips (this may not work as it is almost certainly a PCT money-saving ploy)

 

[hanadr]

You say she's pregnant, has she transferreed her helthcare to the maternity services yet?? As a diabetic, she'll end up on the consultan's list I expect and he/she will be more interested in maternal and baby health. That should ensure she gets enough strips.

 

[Aaron1977]

Thanks for all the advice people!

She had her first diabetic clinic since the news yesterday and they have said they will write to the doctor informing him that she needs at least 3 +boxes per week. The diabetic consultant said this was becoming more and more common and that really the diabetic themselves should be able to self test wherever possible and as often as they feel comfortable... he didn't mention the nice guidelines but he did think it was just common sense.

Hopefully this will get sorted!

Aaron