TYpe 2 and Test Strips

Kleinian2

Member
Messages
7
I have been using test strips for some while but, suddenly, my GP refuses to prescribe them! He says that HbA1C is quite sufficient done every two or three months. I am not understanding this! Certainly the test strips are very expensive and maybe if they were cheaper they would get prescribed?

I have found them useful and testing allows me to keep an eye on what is going on with my glucose levels. I have some problems with diabetic retinopathy and I have been warned that hyperglycaemia could leave me going blind!
 

daisy1

Legend
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26,457
Type of diabetes
Type 2
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Hi Kleinian and welcome to the forum :) Obtaining a prescription for test strips is a problem for a lot of us. Here is some basic information written by Sue and Ken, the former monitors, since you are a new member even if you have had diabetes for some time, and this includes a link to "Tips for Strips" which gives you some arguments you can try and use to persuade them to give you some strips. Failing that, EBay or Abbott are what a lot of members end up using.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.
 

kjt57

Well-Known Member
Messages
48
I am the same, could not get test strips on prescription. I get mine from Ebay, you can get some good deals, last lot were £11 for 50 Breeze 2 from America. Its not ideal but if you have to pay its better than the prices at a chemist.
 

ebony321

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Kleinian2 said:
I have been using test strips for some while but, suddenly, my GP refuses to prescribe them! He says that HbA1C is quite sufficient done every two or three months. I am not understanding this! Certainly the test strips are very expensive and maybe if they were cheaper they would get prescribed?

I have found them useful and testing allows me to keep an eye on what is going on with my glucose levels. I have some problems with diabetic retinopathy and I have been warned that hyperglycaemia could leave me going blind!

I hope you will challenge this decision before resorting to buying your own.

by your profile it says you are on oral medication, if this medication can induce hypo's then i believe you are entitled to strips on prescription.

If you drive you need to frequently test during long trips and EVERY time before you drive.

Ask your doctor if this is the case as i'm sure he/she would not want to be held responsible for you not testing and something happening!

Tell your doctor you want to be pro-active in your OWN treatment, that in your eyes a hba1c every 3-6 months is not suitable as any changes that may need to be made could have been made months earlier and a hba1c would show these changes too late for you to put things into action straight away.

Say that you want to use diet and exercise alongside medication to keep your diabetes controlled, that you want to test to see what the affects of food and exercise have on your readings which will not be shown by just a hba1c.

That you have had retinopathy and want to keep this problem limited by testing and adjusting factors around you where possible.

Unfortunately it's a story that is told far too often, that more and more people are being encouraged to rely on one blood test, that people could be doing very well by testing then suddenly it's taken away and their diabetes control can start to slip because of it.

It's worrying people are being told not to test and i hope your Dr will see that it's an essential tool in your diabetes.

All the best.
 

Kleinian2

Member
Messages
7
My thanks for the replies and the help and advice. I will confront my GP if I have to do so about test strips. If he is adamant in his refusal anyone know the way forward? GP's should not be able to get away with dictatorial behaviour and a lot of them try it. In my practice one GP makes it quite clear that you will get a few seconds on the NHS BUT if you book an expensive private appointment then you will get his time.

One needs a few weapons to launch and I think the argument that Metformin could trigger 'hypos' is one such.

The more I see of GP surgeries the more I get worried about them. It is no longer possible for a GP to be knowledgeable about all things and Consultant referral is the answer. W hen I was originally diagnosed with type 2 my GP point blank refused to prescribe Metformin and said that the answer was 'diet and exercise'. I insisted on a Consultant opinion and the Consultant was amazed and wrote to my GP and then I got Metformin. It is worrying.
 
Messages
2
I only use test strips if I feel unwell, to see if my glucose is high or low, I can't tell the difference between high and low I seem to get the same symptons, last year my levels started rising to I had Saxagliptin added to my metformin, I was also given glucose as I was told Saxagliptin can cause low sugar, I was told not to take the glucose until I had checked to see if my sugar level was low,
now I have had my presciption for test strips stopped, I havn't had a presciption for a year,that's how few I use, now if I feel sweaty and shaky I don't know what to do, if I take the glucose and it's not low I could end up in A&E, if it's low and I don't take it I could end up in A&E, which cost more a tub of test strips or a visit to hospital or call out the GP,they have also altered my visit to the practice nurse from every 6 months to once a year, that means if any thing is wrong it could be 11 months till it's picked up, the six monthly checkups left a lot to be desired every time I went one of the questions was do you get deppressed the answer was always yes it was a tick in the box and that was it
it was just peace of mind knowing I could test if I wanted now it's a constant worry
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
Hi Tony and welcome to the forum :) I'm afraid a lot of members have the same problem as you. What they do is to buy their own kits themselves. It is possible to get free meters from the manufacturers by phoning them and saying you are going to test a lot - that way you will be buying their strips as that is what they want, and they will send you a free meter (and a few strips with it). There are also ads for free meters on this forum. As for strips, most members who have problems getting a prescription for them use either e-bay or Abbott to get them as you will have seen earlier in this thread. You can't carry on putting your health at risk by not knowing what your BGs are.

Just in case you think it's worth trying, here are some ideas of arguments to use to try to persuade them to prescribe you some strips:

viewtopic.php?f=20&t=19002#p173253
 

Danny-Random

Well-Known Member
Messages
47
Doctors are trying all over the place to not give these strips out I have a rather rude doctor who has a nigg chip on his shoulder I don't leave wothout my strips,, just because hba1c was moderate doesn't always mean a thing, it took for my cousin to go into a coma after being told he was anorexic because his tests always showed good till he was in a coma then diagnosed type 1. Odd but true without testing yourself you could end up in a bad way I'd imagine I am not very clued up at all with diabetes being the reason I am on here BUT I will say to you dont let your doctor get away with it. make sure you get them test strips!!!! :wink:
 

ailz

Well-Known Member
Messages
165
Type of diabetes
Type 2
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people that make me panic. Racism - in fact most 'isms'
Danny-Random - what's a nigg chip?

Ailz
 

IanD

Well-Known Member
Messages
2,429
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Carbohydrates
Our Dr's practice has no problem with test strip prescription - but then we've been at the practice longer than any of the Drs.

The trouble is the Drs only take notice of their own measurements, i.e. HbA1c, & as they "know" the diabetes is progressive, their interest is in what to prescribe as you get worse, both for the diabetes & the complications. Sadly the progression is true IF you follow the DUK diet of starchy carbs with every meal. I proved that after 7-8 years on their diet, & complications set in. Then I found this forum & cut the carbs & reversed the complications.

Try to become well-informed, both the diabetes & with your own condition & response to foods. Try to get on a diabetes education course. You can work through the XPERT course on this thread.

The absolute minimum for testing is daily, overnight, & good control should be below 6. You will be able to see any trend. Tests at other times - 1 & 2 hours after meals & at bedtime, before driving, etc, would be helpful so you know your condition better.
 

viviennem

Well-Known Member
Messages
3,140
Type of diabetes
Type 2
Treatment type
Other
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Not acceptable, Tony.

Though diagnosed in April 2010, I was only registered Type 2 last November (in denial :roll: ) though I went straight on to my low-carb way of eating in April. I asked for Metformin after reading round, to help with weight loss, and was immediately rumbled by the diabetic specialist and had to admit my condition!

When I gave in, I was immediately given a meter and strips on prescription (though told to go easy with them! but I get at least 50 every month). I have full blood tests (liver, kidney, thyroid etc) every year, HbA1c and lipid profile every 3 months.

Our practice nurse does the foot tests for neuropathy etc; I have also had a retinal scan and seen the podiatrist; also the dietitian (we agreed to differ). I haven't been to a hospital clinic or seen the diabetic nurse (who covers a number of practices) yet.

I think my care level is what a newly diagnosed Type 2 should expect. If I continue with levels as stable as mine are now, I shan't mind if they do an HbA1c every 6 months, once I've got through the first year. Having a meter, if anything changes I shall know to go back before then if necessary.

Just my opinion! But I think this is good practice. They work with me, not against me.

Viv 8)
 

ebony321

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Very well said viv, that's the treatment you should expect to receive.

Also it's my understanding that HBA1c's should be given every 3 months until good control is acheived then moved to every 6 months at LEAST.

For example if your HBA1c came out in january at 5.5% great! ..but then by march time it's slowly creeping up and up, til your next one the following january comes out at 10.5% oh dear! then you've missed out on well over 6 months worth of chance to prevent this from happening!

one hba1c every year is nowhere near good enough to monitor control, whether you use medication or not!

when testing daily you can spot if you are diet controlled if your diet isn't quite enabling you to get the control you want then you can tweak this yourself, if your using medication you can see if this also needs to be tweaked. If your using Hypo inducing meds or insulin it expecially needs to be monitored incase you slip into hypo land!

Testing is so so so important to anyone with diabetes, what ever type and whatever method of control is used!!
 

Kleinian2

Member
Messages
7
My GP practice will not even go by the NICE guidelines! I managed to get some test strips because the GP who refused them didn't tell the computer he had done so and the pharmacy got the prescription.

I have now changed my GP clinic and it was very easy to do. I just asked Google and all the info was there. I simply went to the new clinic and completed a form and then they do everything and I have no need to contact my old clinic again. All very painless.

The behaviour of some GP's is very worrying and they seem to be clueless about diabetes.
 

old485

Newbie
Messages
3
Hi. I have been in the same position as yourself, in fact I am now seeing another GP in my practice, who specialises in Diabetes. I had a most constructive discussion with her yesterday, and the gist of what was said goes like this:
'Type Two Diabetes is best monitored by two-three monthly checks to get a better picture of what is happening. A routine test regime done at home does not give an accurate overall picture of what is going on. Therefore we do not issue prescriptions for test strips unless you are Type One Diabetic.'
This seesmed reasonable, provided you keep to a proper dietary plan. Deviating in any way may cause problems you are not going to be aware of for some time.
The Doctor described Type Two as; 'A snake in the grass.' It lies there quietly, and then suddenly gets up and bites you. This, I am informed is why Metformin is so frequently prescribed. It is believed by the medical profession that any risks are generally outweighed by the benefits.
Having said this, I've refused medication at the moment for a number of other medical reasons and complications, but as far as I can see, keeping your dietary regime strict is the best possible way of avoiding unexpected issues, when you are not conducting regular monitoring yourself.
Best Regards.
 

viviennem

Well-Known Member
Messages
3,140
Type of diabetes
Type 2
Treatment type
Other
Dislikes
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What diet has she recommended, old485? Have you had enough test strips to be able to find out which foods affect your blood glucose levels and which don't?

I'm sure that people who have been managing their diabetes well for a good while could probably manage with minimal self-testing; but I would certainly not have been able to cope over the last 6 months without testing, or the advice of this forum.

We are all different! There are some people on here who can eat foods that make my bgs spike quite badly. For me, testing has been a valuable educational tool.

Viv 8)
 

Kleinian2

Member
Messages
7
old485 - I'm afraid there is a lot of confusion about test strips not helped by clueless GP's. HbA1C is useful but it is NOT a substitute for self monitoring. The NICE guide lines are quite clear and should be followed by all GP's. The feedback from HbA1C is too slow for changes to be made that might be beneficial and you need warning of any hypos you might have. I sometimes get a BG of 3.2 and that is a hypo (less than 4!) maybe caused by Metformin.

Doing blood tests is not difficult - I can do one in maybe 10 seconds - but you need to be taught how to do it perhaps by a practice nurse. I use only the first joints of my first two left fingers and I have no problems after a great many 'pricks'.

You need to know if you are having hyperglycaemic peaks because these are the things to avoid especially if you have any retinopathy. You could go blind! I'm afraid the NHS is only concerned with saving money and test strips are not cheap but I bet the Queen would get them!
 

Kleinian2

Member
Messages
7
Viv - I don't need to monitor my BG as much as I used to do but in the early stages of Type 2 people need the feedback from self monitoring that allows them to gain a knowledge of what they can eat and what they can't eat. I discovered that a glass of pure orange juice is an absolute no-no but I can drink tomato juice. I would not have been able to get this info from HbA1C.
 

galgal

Active Member
Messages
31
I feel bad about your post. The text strips are very expensive. Luckily for people in Ireland, once diagnosed with diabetes we are provided with a "long term illness book". Our GP writes in everything we need in relation to diabetes, - glucose monitor, test strips, pills, etc. Once written into the book we can go to any chemist and get these item free of charge. I don't know how I would be able to cope otherwise - I think 50 test strips here is about 40 - 50 Euro. I would have to re-mortgage the house.
 

viviennem

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Messages
3,140
Type of diabetes
Type 2
Treatment type
Other
Dislikes
Football. Bad manners.
I use 2 meters - the Freestyle Lite I was given by my GP, with test strips on prescription. I use this one most. Once you've registered your meter with Abbott, the manufacturer, you get a free replacement should anything go wrong, and the strips are £14.50 per box of 50, direct from Abbott. I sometimes buy some strips from Abbott so as not to draw attention to how often I ask for them on prescription!

In my handbag I carry a Bayer Contour which I was given free by the company. This is my out-and-about and emergencies meter. I don't need to use it very often, and I buy the strips on ebay.

The Freestyle measures plasma blood glucose reading, and is comparable to the fasting bg test done at the GP.

The Bayer Contour measures whole blood, and the readings are a little lower than plasma readings.

Viv 8)