We're too expensive. Type 2's.

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catherinecherub

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http://www.bbc.co.uk/news/health-10740224 Diabetes drugs costs for Type 2's are spiralling out of control.
So who is to blame?
Uneducated patients?
Uneducated Dr's?
Lack of Diabetes Specialist Nurses?
Lack of Dietitians?
PCT's attitude towards Type 2 Diabetes?

Unmanaged Type 2's face all the possible complications that Type 1's do.
 

IanD

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Type of diabetes
Type 2
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Carbohydrates
I was told on the X-PERT course that Hounslow spend more on test strips than drugs - so I asked if good control was keeping the drug cost down ..... it is for me.

Drs prescribe, while dietitians advise a high starchy carb diet as a healthy diet for everybody, especially diabetics. Eat the carbs, & control the resultant high BG with the drugs prescribed.

On the occasions when discussion arises, the conversation goes:
Me: Are you as an HP diabetic yourself?
Them: No!
Me: Is your advice based on successful control of diabetics, or on what you have learned?
Them: Research reports.
Me: Your research finds that T2 is progressive, so that we go from diet, to oral medication, to insulin, with complications setting in along the way.
Them: Agreed.
Me: I've been there, done that. I followed the starchy carb diet, until the complications set in. I was becoming crippled with neuropathy, & had the beginning of diabetic retinopathy.
Me: I began a low carb diet, & within 3 months, my mobility was fully restored. Two years on, my retinopathy is clear.
Them: If it works for you, fine, but we have to recommend the findings of research.
Me: I learned from diabetics with good control (on this forum.) You HPs should learn from us, NOT from other people's research. Their research confirms the idea that diabetes is progressive. Our experience shows that low carb can give long term good control, & reverse complications.
Them: but you NEED carbs for energy, for brain function, etc.
Me: I'm 71; I play tennis at club standard & hold my own against younger players without bananas & energy drinks. While playing, I drink water. My BG is maintained at 6-7, whereas if I rest, it will drop to 5-6. The BG I need is generated by my body. As for brain function, I read, do complex puzzles (thanks Daily Mail) & study the Bible & prepare sermons.
Them: If it works for you, fine, but we have to recommend the findings of research. In any case the long term effects of low carb are questionable.
Me: I'm a research/development scientist, working in industry. My research had to work, or I would have been out of a job. I trusted your research for 8 years, until I was becoming crippled. 2 1/2 years on, my results are all good. Your "long term" research results on low carb are inconclusive & are related to sustainability, NOT effect. (Ally might update us, but we are still waiting.) I am afraid to abandon low carb. I've too much good health to lose.
Them: If it works for you, fine, but we have to recommend the findings of research.
 

mobrien

Active Member
Messages
31
Sounds like talking to a robot "if it works for you"
I am glad you have your life sorted it is an inspiration for others to take hope and don't let this thing beat us. Thank you for sharing :D
 

Alanem

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One thing that certainly made me think is how Contour strips are getting on Ebay. Are some people stocking them up instead of using them? How many other non drug accessories are also sold like this. Too much trouble and not enough people to check it out I suppose.
 

hanadr

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Ian
Have you ever got them to cite the research they are "quoting"? I keep asking and HAVE NEVER got an answer. So WHERE IS THIS RESEARCH???
Hana
 

IanD

Well-Known Member
Messages
2,429
Type of diabetes
Type 2
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Tablets (oral)
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hanadr said:
Ian
Have you ever got them to cite the research they are "quoting"? I keep asking and HAVE NEVER got an answer. So WHERE IS THIS RESEARCH???
Hana
There are two answers, Hana:
1. The anon technical person at DUK promises to let me have it (with both barrels?)
2. It's "received wisdom"

We're still waiting for Ally to report the Exeter study, but I get the impresion from what she has said that perseverence is the problem. We might eventually find, as it seems with saturated fats, that it would be "unethical" to do a low carb study, as it goes against received wisdom.

My Dr (married to an Indian) said he can't get his diabetic relatives to cut down on rice, chapattis, etc.

Are you back on the low carb diabetes forum?
 

Patch

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Ian - save me a space at the wall. I've been banging my head against my own wall and it's getting lonely... :wink:
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
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Pump
In answer to Catherines question, All of the above!
Before I got diabetes , I thought that type 2 was a very mild form and that type 1 was the serious ailment. A 10 minute consultation at the doctors is hardly likely to change peoples perceptions.
More education, more practical education. More individualised advice. Expensive but will save money in the future (but of course that's someone elses budget)



What evidence? If they won't say why don't you try to find out yourselves?
The methodology/evidence and evaluation of evidence for the NICE dietary guidelines is in section 6:1 here
http://www.nice.org.uk/nicemedia/pdf/CG66diabetesfullguideline.pdf

The European document
Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus
Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study
of Diabetes (EASD)

is more detailed and gives a huge amount of evidence complete with references; 261 of them.Looking all those up would take a very long time.
Perhaps that is why you don't get a simple answer to a not so simple question.
http://www.dnsg-easd.org/info/general/Document/get/5/documentId/guida.pdf
 

IanD

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Thanks, Phoenix, I've read a lot of it. So, a low carb diet could reduce my HbA1c slightly, to around 9, provided I am sufficiently obese to start with. I can't imagine the non-specialist GP giving it more than a cursory glance. Or a specialist GP drawing significant conclusions from it.

If that is the quality of research, & presentation of results, it's not going to change our HPs' understanding or recommendations.

We on our own, folks - become your own expert on your condition.
 

Alanem

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This topic was meant to create comment about the announcement that the cost of treating diabetics is out of control but it seems to have fallen on stony ground. If the powers that be decide to make cuts it could affect a hell of a lot of people including the vast majority of people on this forum,
 
C

catherinecherub

Guest
Alanem said:
This topic was meant to create comment about the announcement that the cost of treating diabetics is out of control but it seems to have fallen on stony ground. If the powers that be decide to make cuts it could affect a hell of a lot of people including the vast majority of people on this forum,

It didn't take long for this topic to get hijacked.
I really thought, silly me, that low carbing would not be included. :roll: :roll:
 

sugarless sue

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="catherinecherub"]http://www.bbc.co.uk/news/health-10740224

Diabetes drugs costs for Type 2's are spiralling out of control.

So who is to blame?

Uneducated patients?

Patients who are first diagnosed put trust in their HCP's to show them what is wrong with them.Too many GP's and nurses only look at drug treatment and not lifestyle/holistic treatment.

Uneducated Dr's?

Our first encounter is with the GP's usually. Many are told to 'not eat sugar' for 3 months and come back. They then go back, still uncontrolled and are put on Metformin.
If they had proper dietary advice then many would be able to take control by diet at first. Most GP's are not experts on Diabetes, they should be referred to an expert such as an Endocrynologist.


Lack of Diabetes Specialist Nurses?
Lack of Dietitians?

We have a chronic lack of specialist nurses and dieticians not because they are not there but because the NHS cannot afford to employ them.

PCT's attitude towards Type 2 Diabetes?

A lot of PCT's think Type 2 is not as serious as Type 1 .The PCT's are restricted by budgets, the NHS is struggling to cope with an ever growing population and ever increasing costs of drugs so they cut back on what they see as the soft option to save money.

Unmanaged Type 2's face all the possible complications that Type 1's do.

It's a sad fact that many type2's fulfill the 'progressive' prediction through no fault of their own but because HCP's genuinly believe this to be true. On this forum we know that good control can be maintained by lifestyle changes and not by relying totally on the drugs doing the work
 

graham64

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catherinecherub said:
It didn't take long for this topic to get hijacked.
I really thought, silly me, that low carbing would not be included. :roll: :roll:

So just why would you want to exclude Low Carbing :? :? :? , I would have thought it affected all T2s regardless of dietary regimes. If your referring to IanDs contribution the fact that he was pointing out the flawed dietary guidelines which lead to greater expense is a valid point.

Back on topic :roll: :roll: :roll:
My estimated diabetes related prescription cost is £12.50 per month, the approximate price to the NHS of 50 test strips.

There's more details here on the cost effectiveness of drugs etc. and other statistics :

http://bookshop.rcplondon.ac.uk/content ... 663ded.pdf

Graham
 

Ardbeg

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IanD said:
Thanks, Phoenix, I've read a lot of it. So, a low carb diet could reduce my HbA1c slightly, to around 9, provided I am sufficiently obese to start with. I can't imagine the non-specialist GP giving it more than a cursory glance. Or a specialist GP drawing significant conclusions from it.

If that is the quality of research, & presentation of results, it's not going to change our HPs' understanding or recommendations.

We on our own, folks - become your own expert on your condition.

Hi Ian;

I agree with you entirely that you need to become an expert on your own condition.

Having said that, I have to say that, to date, both the DN and various GP's I've seen have been excellent. Not necessarily in their diagnosis/treatment for me, mainly their attitude. My previous experience with doctors wasn't good - they didn't like being questioned or challenged. No longer the case where I live. I've discussed my condition at length, suggested tests and treatments and they have been courteous, attentive and helpful.

I guess it's a bit like when you go abroad and try and speak their language, rather than just not bother and speak English. I've found that both the DN and the doctors seem to appreciate the fact that I'm tackling T2 in a very positive and proactive manner.
 
C

catherinecherub

Guest
If the excellent advice given on this forum by Sue and Ken was printed off and placed in Dr's surgeries for diabetics then there would not be so much confusion about an appropriate diet for Type 2's.
I am sure that this research conducted will have a bearing on medications that will be prescribed in the future. Spiralling costs have to be addressed. Let us hope that there is not a blanket ban on test strips for Type 2's, not on hypo inducing meds, to keep the budget under control. If we have to rely on HBA1c's then we may need some Divine intervention.
Will this mean that people who react badly to Metformin will not be given the more expensive SR one? It affects some people's day to day living as has been posted here. Frequent trips to the loo, abdominal pains are difficult to cope with day in day out.
Byetta and Victoza are expensive and already rationed so will these be used less? Will cheaper versions of all medicines be the only ones available? We know from experience here that some of them do not work as well.

As to the low carb debate, there are people here who low carb and still have to take medication and it is not about that. Some people do not have a choice when it comes to using medication as their diabetes may not have been diagnosed early enough, they are taking meds for other conditions that affect their blood sugars, they are less ambulant because of other health problems. Some members have posted that they became ill using a low carb diet. People's responses to different foods are individual and there is no one size fits all. I know that some members find this difficult to understand but it is true. None of us can be sure of good results following other people's eating plans.
Of course we have to manage this condition ourselves as the HCP's cannot be with us 24/7. We are on our own and only see the professionals for checkups or problems that occur. I am sure that Adberg is right in that if we ask questions, put forward our own well thought out strategies and question everything that we do not agree with then our HCP's see us in a different light and respect us. The generation of accepting everything that HCP's say is right has long gone and we need to be proactive. This is a self managing chronic disease.

As to the progression issue, who know the answer to that. We are proactive here and are doing the best we can. Will that stave off complications? We do not know and all of our stories about control maybe totally different 5-10 years from now.
 

daisy1

Legend
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Type of diabetes
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In Switzerland we are allowed 400 test strips per year. Methinks not enough for a Type 1.
Sufficient for me (type 2) - I don't use anywhere near 400 a year. Don't know about the
lancets as I don't change them frequently but I know they pay for a certain amount without
problem. They only pay for generic medication - not the full price ones unless a generic
doesn't exist.
 

IanD

Well-Known Member
Messages
2,429
Type of diabetes
Type 2
Treatment type
Tablets (oral)
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Carbohydrates
ally5555 said:
Ian - I havent heard anything more about Exeter so nothing to report.
Thanks Ally, Is the study continuing, or has it fizzled out? Or are they waiting years for long term results?

I had positive results on my BG almost immediately, & health benefits within weeks. After 3 months, I was fully active. Well over two years on low carb, & there is no adverse effect.