NICE guidelines & HbA1c testing

A

Atad heavy

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Good morning everyone,
My apologies if this post has already been discussed at length, I have tried searching for existing threads but found none.
I was really disappointed to be put on yearly HbA1c tests as I had only been diagnosed as type 2 in October 2018. Now I know why - it’s down to NICE guidelines, this applies to diabetics whether they are on meds or not and the only exception is if your Dr orders a test. This is just sheer stupidity to my mind & a very poor decision. We are warned about the complications of diabetes but I for one, do not have a medical degree so would not necessarily associate new symptoms with possible complications. A year between testing is a long time & it’s very sad that they don’t recognise the importance of this test. For the people who are making lifestyle/diet changes these results can be good motivation to continue & improve.
 
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Prem51

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I agree. If we control our condition we often only get an annual HbA1c test. If we don't take action ourselves and the diabetes progresses we would get more regular testing.
The only thing we can do is to self test with bg meters - which hcps often discourage for T2s. Its all down to cutting expenditure, which I suppose is inevitable with Government austerity restraints.
 
A

Atad heavy

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Jim Lahey said:
Never mind HbA1c. If you want a lesson in real stupidity then consider the advice handed to most T2s that they should not monitor their own glucose. Preposterous!
Click to expand...
I got that telling off at my annual review which was done just over 2 months from diagnosis
 
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Rachox

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A

Atad heavy

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Rachox said:
Whichever way I search it comes up with 6 monthly HbA1cs, this page says the same:
https://pathways.nice.org.uk/pathways/type-2-diabetes-in-adults#path=view:/pathways/type-2-diabetes-in-adults/managing-blood-glucose-in-adults-with-type-2-diabetes.xml&content=view-node:nodes-hba1c-measurement
Show your GP!
Click to expand...
I have just read the paragraph about HbA1c targets which was very interesting. It even says patients should be encouraged to maintain their levels - that alone begs the question how can you maintain without more frequent testing. I self test against the advice given by my DN, I use the Accu-Chek monitor but the HbA1c prediction has been low compared to the lab test.
 
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Daibell

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Atad heavy said:
They must have changed those guidelines because my surgery were adamant that that is how often it is done now. I am going to discuss this with my Dr as I feel it’s so important.
Click to expand...
Your surgery is wrong. Many of us have had 3, 6 or 12 monthly reviews depending on the last HBA1C. I'm on 3 months between my last and next review as my HBa1C went up quite a bit due to my beta cells still failing and my bad insulin control. I'm expecting it to go back to 6 months and possibly 12 months again if control is improved.
 
ert

ert

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Atad heavy said:
Good morning everyone,
My apologies if this post has already been discussed at length, I have tried searching for existing threads but found none.
I was really disappointed to be put on yearly HbA1c tests as I had only been diagnosed as type 2 in October 2018. Now I know why - it’s down to NICE guidelines, this applies to diabetics whether they are on meds or not and the only exception is if your Dr orders a test. This is just sheer stupidity to my mind & a very poor decision. We are warned about the complications of diabetes but I for one, do not have a medical degree so would not necessarily associate new symptoms with possible complications. A year between testing is a long time & it’s very sad that they don’t recognise the importance of this test. For the people who are making lifestyle/diet changes, these results can be good motivation to continue & improve.
Click to expand...
Wow, there appears to be a lot of discrepancy between surgeries.
 
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ringi

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I think there is a quality of care target that require at least one A1c each each for all pr on the diabetes register that feeds into how much a GP partner is paid. NICE clearly recommended every 6 months when stable and at least every 3 months if not stable or recent changes to drugs or lifestyle.

I am on 6 monthly tests.
 
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Prem51

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I only get one HbA1c test annually. I did question this but my gp said I have good control so don't need 6 monthly tests.
I contacted the Quality Care Commission about this but haven't heard anything.
 
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Atad heavy

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Prem51 said:
I only get one HbA1c test annually. I did question this but my gp said I have good control so don't need 6 monthly tests.
I contacted the Quality Care Commission about this but haven't heard anything.
Click to expand...
I just don’t think it’s right to limit testing to yearly especially when I have only just been diagnosed as type 2. It’s a cost cutting exercise but how much will it save in the long term?
 
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Listlad

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The last words on the lips of my GP was 3 months. I will be putting those words to the test at my next appointment with him. Maybe he made a mistake. But that is certainly what he said. The actual words were “every 3 months”.
 
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Member496333

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To be fair to the opening post, it does say annual unless the doctor specifically orders a test. I don’t know the veracity of this statement but if true then it could explain anomalies in testing frequencies.

Just saying :pompous:
 
Listlad

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Jim Lahey said:
To be fair to the opening post, it does say annual unless the doctor specifically orders a test. I don’t know the veracity of this statement but if true then it could explain anomalies in testing frequencies.

Just saying :pompous:
Click to expand...
This kind of explains my situation as I visited the reception desk about a month ago and asked about this and they said annually. So I said but I have been told every 3 months by my GP. So they said I would need to see him about that. So....hence the next appointment which will entail asking him to instruct the front desk to fix me up with an HbA1c test. It remains to be seen what happens next.
 
A

Atad heavy

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Messages
405
Type of diabetes
Type 2
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Diet only
Jim Lahey said:
To be fair to the opening post, it does say annual unless the doctor specifically orders a test. I don’t know the veracity of this statement but if true then it could explain anomalies in testing frequencies.

Just saying :pompous:
Click to expand...
I was at the surgery for other blood tests & asked nurse if she would do HbA1c as well, she said no because of the NICE guidelines stating yearly so I have to wait until next January and what’s absolutely priceless is that I get told off for self testing.
 
A

Atad heavy

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Messages
405
Type of diabetes
Type 2
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Diet only
Listlad said:
This kind of explains my situation as I visited the reception desk about a month ago and asked about this and they said annually. So I said but I have been told every 3 months by my GP. So they said I would need to see him about that. So....hence the next appointment which will entail asking him to instruct the front desk to fix me up with an HbA1c test. It remains to be seen what happens next.
Click to expand...
It’s not just me having this issue then !!
 
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