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Diabetes patients denied vital prescriptions

Vital prescriptions for diabetes patients to manage their blood glucose are being refused by GPs, according to Diabetes UK.
The Diabetes UK survey and prescription debates
In a poll of 1,300 patients, researchers found that nearly half of those surveyed had been refused blood-testing strips, 39 per cent of which were type 1 patients.
The issue of NHS resource management is divisive and difficult: the Department of Health has requested that GPs not restrict access to these prescriptions, citing clinical importance. Doctors insist that NHS resources need to be used as efficiently as possible.
Type 1 diabetes patients need to take blood glucose readings in order to inject an appropriate amount of insulin in order to maintain good blood glucose control.
While dietary control is an important part of managing type 2 diabetes, structured testing improves HbA1c levels, blood glucose control, and diabetes understanding, reducing the chances of long-term diabetic complications.
The risks of poor blood glucose management
Poor blood glucose management can, in the long term, lead to a number of serious complications. These include blindness, stroke, and amputation.
Of course, the survey does not represent the entire diabetes population, but it does highlight some of the more problematic questions surrounding diabetes treatment.
Implications for the NHS
Barbara Young, Chief Executive of Diabetes UK, explained that the restrictions were motivated by a desire to save money: “But any short-term savings from doing this will be tiny compared to the long-term cost to the NHS of treating these complications.
“We need to send an urgent message to NHS England that GPs restricting access to strips on cost grounds is wrong-headed, short-sighted, and unfair. It has to stop.”
Previous studies have demonstrated that when test strips are prescribed without accompanying education, HbA1c levels among people with type 2 diabetes have not improved. Because of this, some people are concerned that test strips are over-prescribed, but the issue is one of education: When test strips, along with an appropriate level of education, are provided to people who are actively testing, there have been significant positive changes.
The Diabetes.co.uk survey
In 2013, a Diabetes.co.uk survey of 20,000 people revealed that 48 per cent of respondents felt “some anxiety” or “strong anxiety” regarding the restriction of their test strips.
There are a number of risks associated with restricted blood glucose testing. Type 1 patients may be:
Unable to identify highs and lows adequately (increasing the risk of hyperglycemia and hypoglycemia)
Worried about needing to ration test strips to last the month
Unable to analyse results as well as they should
Increased risk of hospital admissions due to high or low blood sugars, including diabetic comas
While type 2 patients run the risk of:
Being unable to understand which foods are appropriate for them
Being unable to test for hypos, for patients on sulphonylureas, glinides, or insulin
Diabetes.co.uk is firmly in favour of blood glucose testing, which is important for people with both types of diabetes.
The patient autonomy required to manage diabetes makes test strip restrictions unworkable. There is no ‘one size fits all’ approach to blood testing: the individual needs of every patient must be taken into account.

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