Testing

[raineuk]

Just been told by the receptionist at my local GPs that I am using too many test strips. So they have reduced my testing to 1 strip per day. Okay I thought. I'll leave it and see my GP and he said yep thats right. Now the question is, when do I test. Morning to adjust my insulin or at bed time to stop me from having hypo's through the night. I favour night time as I live by myself.
Brian.
P.S. I've managed to get my levemir down to 46 units from a 100. I guess thats going to go to pot.

 

[iHs]

That is really worrying :cry: :evil:

You need to contact yr PCT and MP and ask them to send you a copy of their letter to yr GP giving their advice regarding bg testing. You will find I'm sure that they urge GPs to use their discretion regarding prescribing of teststrips. Yr GP is not using his/hers very well and is failing to adhere to their duty of care towards you, so depending on what your PCT has written in their letter, a phonecall of complaint to your PCT needs to be made. PCT will then contact yr GP to put them straight.

Doesn't matter what type diabetic you are, if you need to use insulin, then you need to test yr bg about 4-6 times at least.

 

[badmedisin]

Your gp is totally irresponsible. Make a formal complaint, write to the PCT and youp MP and maybe get a new gp. Make a nuisance of yourself until they have to give in just to make you go away!

 

[kentishman]

I test once a day but always before I go to bed because a Hypo in the middle of the night is quite unpleasant. I've woken up once or twice sweating and confused and had to get some sugar inside me.

 

[mcmoby69]

your doctor obviously got his qualification off a cornflake packet!
get rid of him. to comply with DVLA requirements you need to test before you drive to see if you are fit enough to do so, then every 2hrs on long journeys.
how does he expect you to set your basal insulins ?and titrate your bolus injections if you dont know what levels you are at before meals etc?, plus you wont be able to test the impact of meals on your bg after eating either.

make sure you dont run after any buses and never catch a bug or cold ever again! you might have to go to two strips a day! also ask your doctor how many strips a day he/she would want if they were diabetic.

 

[ANDYCAP]

Hi, Im new to this site so please handle me gently!!

I have been reading various postings which have made me sit up and think.

I was diagnosed Type 1 3 months ago, and have been told by my GP that at the start, yes he did say 4/5 times a day, but that can be reduced to a couple of times now. My levels range from 6/7 first thing in the morning and 12/14 last thing at night. I have been to see him and says that is OK.

I just noticed your comments re testing before driving and every 2 hours thereafter. I drive regularly from Kent to Lancashire and at worst and it can take 10 hours. Does that mean I have to stop 5 times at worst during my journey?

I do stop off for a drink of tea once, but on that basis, stopping every 2 hours would increase my journey time.

Sorry if the question is off the wall, but I am still learning to deal with this on top of all of my other medical problems.

 

[badmedisin]

You do need to stop and test every couple of hours as you could easily go hypo during that time. If you get caught having a hypo while driving or even at the wheel and parked, you'll lose your licence.
Going up to 14 by the end of the day is well out of range, not convinced by your doctor if he thinks that's ok. Do you see a proper specialist? Have they taught you anything about carb counting and adjusting insulin? May be worth getting them to put you on a dafne course. I learnt more on that than I learnt from doctors in 22 years!

 

[noblehead]

Hi, Im new to this site so please handle me gently!!

I have been reading various postings which have made me sit up and think.

I was diagnosed Type 1 3 months ago, and have been told by my GP that at the start, yes he did say 4/5 times a day, but that can be reduced to a couple of times now. My levels range from 6/7 first thing in the morning and 12/14 last thing at night. I have been to see him and says that is OK.

I just noticed your comments re testing before driving and every 2 hours thereafter. I drive regularly from Kent to Lancashire and at worst and it can take 10 hours. Does that mean I have to stop 5 times at worst during my journey?

I do stop off for a drink of tea once, but on that basis, stopping every 2 hours would increase my journey time.

Since you are type 1 using insulin, then the answer to your question is yes. I test before driving and always make sure I am above 5.5, prefer to be above 6 should it be a long journey, then stop and test every hour until I reach my destination. No matter how well a type 1 is controlled, hypo's can come on unexpectedly and catch you out, so the only way to prevent this happening is by testing regularly. In the event that your bg does start to drop, you should pull in and eat fast acting glucose followed by a small snack, and don't continue to drive until levels are above 6.

Always better to be safe than sorry, so my advice is to increase your journey time and allow for regular stops to test.

Nigel

 

[badmedisin]

If you have to stop and treat a hypo, make sure you take the keys out of the ignition and move out of the driving seat, as these would still count you as being 'in control of the vehicle', which you must not be when you're hypo. Also bear in mind that it can take 45 minutes to properly get over your hypo and start thinking clearly again.

You should always carry something like lucozade or full sugar drinks to treat a hypo. You need about 15g fast acting carbs (mini cans if pop are perfect for that, no measuring and they don't go bad) and 10-15g slower acting carbs afterwards to stop you dropping back down. I think individually wrapped snack packs of crackers or biscuits are most convenient to store in strategic places.

I know it's a pain in the wotsits but stopping every so often won't slow you down as much as crashing or being arrested!

 

[ANDYCAP]

You do need to stop and test every couple of hours as you could easily go hypo during that time. If you get caught having a hypo while driving or even at the wheel and parked, you'll lose your licence.
Going up to 14 by the end of the day is well out of range, not convinced by your doctor if he thinks that's ok. Do you see a proper specialist? Have they taught you anything about carb counting and adjusting insulin? May be worth getting them to put you on a dafne course. I learnt more on that than I learnt from doctors in 22 years!

Thanks for the reply. I never knew that I could lose my licence over that! It's bad enough trying to cope with watching the amount of Morphine I take daily - up to 100mgs every 12 hours. I have to time my driving so that it is in the middle of the two doses.

No I don't see anyone, just the GP and had one chat with the GP's nurse who gave me a load of booklets and told me to read them. I didn't know there was anybody else I needed to see. In fact in the 3 months I have seen the GP twice including the first time when he gave me the kit and a prescription for the pens, needles, box etc. The consultation took all of 10 mins and learned how to inject etc from the instructions in the free kit.
Carb Counting???? All I have read in the booklets given to me is that I should avoid anything that has more than 15 of sugar per 100gm??
Apart from that, just been told to live a normal life.
Insulin - nope just told to take the authorised does of Levimir once a day more or less at the same time and that's it.
What on earth is a DAFNE course?? Sorry I must come over totally stupid.

 

[catherinecherub]

Hi Andy,
Dafne website, this explains the principles for you.

http://www.dafne.uk.com/

 

[HLW]

Oh wow your GP is an idiot. Once a day testing with insulin omg. Not safe at all especially with driving like others have said.

Andy as others have also said 14 is not ok, too high.

 

[badmedisin]

Sorry to bring bad news, but your gp is kinda slack!
Diabetes is pretty complex and you need to be under the care of someone who has in depth knowledge. Most gps aren't equipped to deal with it. Get him to refer you to the diabetes specialist at your local hospital. It's your right, and it's his duty to sort it.
There's a lot to learn unfortunately. Your blood sugar shouldn't go above around 8 generally, and anything under 4 is a hypo. The best way to control it is to count the carbs in every meal, test your blood sugar before you eat (and always test if you feel ill or weird), then adjust your dose of fast acting insulin to cover each meal. DAFNE (dose adjustment for normal eating) is a 5 day course which will teach you how to do that properly, and more. It's totally invaluable. I had ****** control for 22 years, thanks to never getting adequate education, until I did the dafne course in January. Now I have a decent (not brilliant, but decent) HbA1c for the first time ever, and feel like I'm in control of the diabetes, rather than the other way around. So I would strongly recommend it.
As for carbs, you need to count the total carbohydrate in foods, not just the sugar. Sugary food within moderation is ok as long as you inject enough to cover what you eat.
Testing once a day is absolutely not going to work. You need to test before you eat, some people test 2 hours after to find out which foods cause a spike, you also need to do it before exercise, before bed, if you feel unwell, and before driving.
I hope your gp can get you referred quickly, as he has some fairly huge gaps in his knowledge. Good luck!

 

[badmedisin]

Sorry, I forgot to say, have you told the dvla that you have diabetes? As you're on insulin it's a legal requirement. They'll want to contact your doctor for medical assessment and your licence will have to be reviewed every 3 years. Do they know about the morphine? I'm amazed you don't just sleep all day on that dose! I'm sorry you're in so much pain and I guess all the added stress of diabetes isn't helping. I really hope you get medical peeps who can actually help you learn all this stuff soon. But I would recommend reading through this site, there's some real experts on here who can offer fantastic advice. I'd be lost without it! And always feel free to ask about anything you're not sure if -there's no such thing as a stupid question! (well, generally )