can anybody help

greenp3

Member
Messages
15
hi iam new to this site can anybody help? today i was told that i no longer could have any more testing strips etc.. as the nurse would now test me annually when i go for my checkup. i am type 2 and am now very confused as what to do. do i need to test myself or not? can anybody tell me anything about this or is this just my doctors surgery doing this?
 

sugarless sue

Master
Messages
10,098
Dislikes
Rude people! Not being able to do the things I want to do.
So you are only going to get an annual test,presumably Hba1c and no testing all year!! :evil: :evil: That is just criminal!Can you tell us what your last test results were BTW?
 

greenp3

Member
Messages
15
sugarless sue said:
So you are only going to get an annual test,presumably Hba1c and no testing all year!! :evil: :evil: That is just criminal!Can you tell us what your last test results were BTW?
i hope you dont think im thick or ignorant but what does BTW MEAN
 

sugarless sue

Master
Messages
10,098
Dislikes
Rude people! Not being able to do the things I want to do.
Well both would be good.Your Hba1c from your doctor and your own daily readings.
 

greenp3

Member
Messages
15
sugarless sue said:
Well both would be good.Your Hba1c from your doctor and your own daily readings.
my doctors last reading a couple of months ago was i think 7.1 and my reading yesterday morning was 6.3
 

sugarless sue

Master
Messages
10,098
Dislikes
Rude people! Not being able to do the things I want to do.
If the reading from your doctor is your Hba1c then at 7.1 it is quite high.
I copied this from Tubolards post in a another thread this is the NICE guidelines about test strips etc.I suggest you read through the link as well ,print off the relevant bits and take to doctor and ask why he is not following them!!

In my opinion home BG testing is a vital tool in the management of diabetes – it allows me to check what my BG levels there and then and allows me to make the changes necessary to bring them to more acceptable levels. NICE guidelines (http://www.nice.org.uk/nicemedia/pdf/CG ... deline.pdf) for home BG testing are:

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.
 

greenp3

Member
Messages
15
sugarless sue said:
If the reading from your doctor is your Hba1c then at 7.1 it is quite high.
I copied this from Tubolards post in a another thread this is the NICE guidelines about test strips etc.I suggest you read through the link as well ,print off the relevant bits and take to doctor and ask why he is not following them!!

In my opinion home BG testing is a vital tool in the management of diabetes – it allows me to check what my BG levels there and then and allows me to make the changes necessary to bring them to more acceptable levels. NICE guidelines (http://www.nice.org.uk/nicemedia/pdf/CG ... deline.pdf) for home BG testing are:

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.
hi i contacted a pharmacist today to ask if he had heard of this before and he had he said that he had and agrees that type 2 bloods should be checked at home as he was a diabetic also and said all that he could suggest was that i went to see my doctor and discuss this with him but i dont feel comfortable about this so he suggested getting intouch with my area practitioner(i think thats what he called them), and discuss it with them so i might try that tomoz.
 

greenp3

Member
Messages
15
greenp3 said:
sugarless sue said:
If the reading from your doctor is your Hba1c then at 7.1 it is quite high.
I copied this from Tubolards post in a another thread this is the NICE guidelines about test strips etc.I suggest you read through the link as well ,print off the relevant bits and take to doctor and ask why he is not following them!!

In my opinion home BG testing is a vital tool in the management of diabetes – it allows me to check what my BG levels there and then and allows me to make the changes necessary to bring them to more acceptable levels. NICE guidelines (http://www.nice.org.uk/nicemedia/pdf/CG ... deline.pdf) for home BG testing are:

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.
hi i contacted a pharmacist today to ask if he had heard of this before and he had he said that he had and agrees that type 2 bloods should be checked at home as he was a diabetic also and said all that he could suggest was that i went to see my doctor and discuss this with him but i dont feel comfortable about this so he suggested getting intouch with my area practitioner(i think thats what he called them), and discuss it with them so i might try that tomoz.
BTW thanks for the info you have given me is is very much appreciated i wish i had found this forum years ago i would be a lot more knowledeable THANKS.
 

jopar

Well-Known Member
Messages
2,222
The reason behind prescription of BG strips for T2 diabetics is due to research!

A study was compiled to see if T2's who carried out home moitoring faired any better or suffered less complication to T2's who carried none and relied on the yearly review/blood test carried out by the doctor....

The out come of the study showed that carrying out home monitoring provided no advantages or lessened complication! It was summerised that unlike T1 who can be pro-active and adjust there insulin needs to results the T2's can't do this....

I know that before meters were availble or common place (my first meter cost me well over £100 with out VAT) that the old BM blood sticks money could be saved by cuting them either in half or thirds if you had a steady hand and good eyesight... But with the meters there is no way of cutting the cost, it a whole strip or nothing! Prehaps some of you T2's might be able to convince your doctor to prescribe these as a cheaper alternitive (with a promise that you will cut then down)? I know that not using them in a meter and ensuring that you write all your results down and having to wait for two minutes to get a result is a complete pain and yes unfair... But if it means that you can continual to monitor with out shedding loads of money for bio-metric strips!!!!

It seems on both sides T2 and T1 are getting there strips restricted... I use a insulin pump, which means that I have to test frequently during the day... the mimium is 4 times, but in reality it is more like 10 times a day as I do drive and need to test before driving... Change my infusion set, tube set or even a new cartridge means that I have to test before I change and then one about another hour later to ensure that everything is working and insulin is being delivered!
 

hanadr

Expert
Messages
8,157
Dislikes
soaps on telly and people talking about the characters as if they were real.
Firstly
the Irish Study was done with newly diagnosed T2 patients, half of whom who were asked to test, but not given any ideas on what to do with their results. It's the PCTs who are blocking the test strips. NICE has specifically told them not to do a blanket ban. My PCT West Berks actually admits it's not following NICE guidelines on this. It's a money saving policy.
Secondly, with an HbA1c of over 7, you are outside the protocol range and should be doing your own testing at the Very least until you get thet down to below 7. You're not likely to have much luck with the PCT. I've been at them for months and they've given up replying to me. I get strips by begging my doctor, who is allowed to prescribe them and if I get desperate, I buy them from the suppliers. It's half the price of the local pharmacy!
several people on this forum Always supply theirs themselves. I'm a pensioner, so I don't have that much income
I know the PCTs are storing up trouble with patients developing complications and needing VERY expensive treatments, which they cannot deny them, but when a single kidney cancer patient needs medication that costs £ 45,000 per year and scans, inpatient stays and lab tests on top, you can see that if they can save £200 - £300 pounds per year on a number of diabetics, many of whom are elderly and don't have time to develop costly complications, they will try to get away with it. And they do, just by refusing to discuss the matter.
 

jopar

Well-Known Member
Messages
2,222
hanadra

I'm not saying that the PCT's are right, nor am I', quailifying the merit behind the study... But what the PCT has based there dission on..
 

hanadr

Expert
Messages
8,157
Dislikes
soaps on telly and people talking about the characters as if they were real.
Jopar,
I wasn't critisizing what you wrote, just clarifying for an newbie
 

jenrose

Well-Known Member
Messages
290
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
very cold and very hot weather
I had been getting prescriptions for strips and lancets until my last diabetes review in June when the nurse told me she didn't think I needed strips. My HbA1c was 6, 9 months before it was 6.9 and when I was diagnosed 9 months before then it was 16. Two months later the doctor prescribed Metformin 500 mg twice a day which I have been taking. The nurse says you don't go too low on that but I have been as low 2.9 mmol/L when I have walked further than usual. Without a meter I wouldn't of been able to know what my bg was. At first I used to get symptoms like a hyp at 5.0 mmol/L but now it goes lower. She said to see a dietician. Anyway I read in the Diabetes Uk magazine that they wanted to know if anyone had difficulty getting strips on prescription so I emailed them that I did and they said to write to my MP amd PCT. I followed their advice and haven't had a reply back from the PCT but my MP said he would write to Ann Keen MP Department of Health. When he received the letter from her he forwarded a copy to me. In the letter, Ann Keen MP, wrote that the NICE guidelines stress that there are benefits from self-monitoring and that Sue Roberts, the National Clinical Director for Diabetes, has produced a factsheet for Strategic Health Authorities on home blood glucose monitoring. The factsheet suggests that 'PCTs may wish to link their strategy on self-monitoring to that on patient education'.

The letter also reveals that NICE is currently reviewong it guidelines on Type 2 diabetes. The progress of the reviewed guidelines can me monitored on NICE's website. It was pointed out that 'Any PCT which is automatically discouraging the prescription of blood glucose testing strips is not acting in accordance with NICE's advice that self-monitoring may prove useful to people in their overall approach to self-care'.

I am hoping that PCT's will change their minds about saving money this way. I feel it is short-term gain and long term loss for the NHS. My nurse did changed my review to 6 monthly which is better than every 9 months and I think to wait a year until you know how what your HbA1c (which tells you your average bg level over 2 -3 months) when you are going 'blind' is not good enough.