Quote from my doctor on T2's and glucose self monitoring

[pavlosn]

Been to see my doctor yesterday.

On the subject of T2's and self testing he had the following to say.

"As long as the patient understands what he or she is doing, then self monitoring through testing is the best way to control one's blood glucose levels"

Regards

Pavlos

 

[cugila]

That's good Pavlos. What did he have to say about FREQUENCY of testing ?

 

[Jimbo1973]

All I got othat subject was a letter last december stating that he would no longer prescribe testing strips for my meter as it was painful and, therefore,"un-neccesary" for T2's to self test. Recent guidelines had suggested this to be the case. Despite me arguing the toss with him, he plainly refused to prescribe them to me (not even the 4 packs a year I was supposed to be entitled to)

I suppose this was plainly down to cost control measures. I swapped doctors about 2 months ago and had a full medical. When the doc and practise nurse eventually got my notes from my prevous doctor they were amazed at how I had been treated. As a result, I was immediately prescribed self testing strips, more lancets and was told to test on a very frequent basis for 3 months to get a reasonably accurate picture of what is happening. I now test up to 10 times a day, which means a box lasts me 5 days or so. My new doc has no issues with this whilst they battle to control my spiralling blood sugars.

So my advice is to battle on and demand that you need these to maintain good control of your diabetes

Jimbo

 

[hanadr]

My doctor also says I don't need to test, but I Need to. How does anybody keep control without?
My PCT is the refuser on grounds of cost. So I buy my own from Abbott.
Hana

 

[kegstore]

It's interesting that it appears different doctors within the same PCT will give such remarkably different care and advice? I suppose some are braver than others, prepared to incur the wrath of some anonymous bean counter...

 

[hanadr]

Kegstore
My PCT has made sure that no-one in its area gets strips unless an insulin user. I believe Oxfordshire, which is next-door to the North of us is the same.
What price preventive medicine????? :lol:
Hana

 

[Janieb]

My diabetic nurse seems to think T2s dont need to test, however my doc when I talked to her about flu yesterday seemed to think we do. I asked her for a testing machine and strips and she said that she couldnt provide due to budget - guess I'm supposed to die then,.

 

[iHs]

It's not just type 2's diet controlled that are being restricted, many insulin users are too.
In fact, with the way diabetes is going many insulin users will also be asked to cut back on their insulin usage due its cost. So no it's not good ......... :evil:

 

[wallycorker]

........"As long as the patient understands what he or she is doing, then self monitoring through testing is the best way to control one's blood glucose levels".........

Good to hear that Pavlos. Did he suggest how diabetics ever get to the stage where they "understand what he or she is doing" without testing in the first place?

John

 

[Soundgen]

NICE say

RECOMMENDATIONS
R22 Offer self-monitoring of plasma glucose to a person newly diagnosed with Type 2 diabetes only
as an integral part of his or her self-management education. Discuss its purpose and agree how
it should be interpreted and acted upon.
R23 Self-monitoring of plasma glucose should be available:
 to those on insulin treatment
 to those on oral glucose lowering medications to provide information on hypoglycaemia
 to assess changes in glucose control resulting from medications and lifestyle changes
 to monitor changes during intercurrent illness
 to ensure safety during activities, including driving.
R24 Assess at least annually and in a structured way:
 self-monitoring skills
 the quality and appropriate frequency of testing
 the use made of the results obtained
 the impact on quality of life
 the continued benefit
 the equipment used.
R25 If self-monitoring is appropriate but blood glucose monitoring is unacceptable to the
individual, discuss the use of urine glucose monitoring.
51

http://www.nice.org.uk/nicemedia/pdf/CG66FullGuideline0509.pdf

So how can a GP not prescribe strips ?

Offer self-monitoring of plasma glucose to a person newly diagnosed with Type 2 diabetes only
as an integral part of his or her self-management education. Discuss its purpose and agree how
it should be interpreted and acted upon.

None of this was discussed with me when I was diagnosed , I asked for and was given a tesing meter at my first vist to the diabtic clinic no one said anything about what , where , when and why to test , or what to make of the readings .

 

[cugila]

Soundgen.

We have argued about this with all sorts of people.

The killer thing is that these are "GUIDELINES" , not rules and are open to interpretation, usually NOT in the Patient's favour. The 'beancounters' rule unfortunately. All we can do is keep arguing the point and hope somebody uses a bit of common sense ?

Somehow, I don't think I will hold my breath.

 

[haptagud]

- the quality and appropriate frequency of testing
- the use made of the results obtained
- the impact on quality of life
- the continued benefit

Appropriate frequency, continued benefit etc, as cugila says are VERY open to interpretation and if the PCT needs to save money...

 

[greyposter]

When I was diagnosed on June 11th 2012,exercise and diet was advised.On July 19th I was put on Metformin 1x500 for a week.2x 500 second week and now on 3x 500 per day.Testing at my expense,I've found my blood sugar rising and tonight it was 9.5 at bedtime.I've stuck to a low carb diet,so I think my Type 2 is getting worse.I do feel worse..

 

[Squire Fulwood]

My nurse was quite open about the reason she asked me to reduce my testing to one test a day. She said that there had been £50,000 taken off the budget of the practice.

To confirm what I was hearing I said, "So the restriction is purely for budgetary reasons then?" and she said, "yes".

You can't get clearer than that.