Complaint reply from NHS

[EllieM]

Now I'm curious, do those T2s in the forum who've maintained hba1cs below 40 (or whatever the prediabetic level is) for several years still qualify for VAT exemption when they buy testing strips?

 

[EllieM]

And as for the elderly bit. my 91 year old T2 dad is pretty frail and occasionally falls. He's been medication free since adopting a low carb diet 3 years ago (ish) and IMO his GP is right to let his hba1c run in the mid 50s. His numerous health conditions (bad back, hips etc) predate his T2 and the risks from just one hypo would be significant.

There's a big difference between 91 and falling to pieces and 51 hoping to make it to 91 though.

And my dad had his diabetic checkup a couple of days ago (virtually) and was told everything is fine, but forgot to ask for his hba1c (grrr).

 

[Dave Russell]

I was diagnosed two weeks ago. They said I was prediabetic in 2015 when I had my last blood test - My MOT. I don't recall being told this.

 

[MrsA2]

I was diagnosed two weeks ago. They said I was prediabetic in 2015 when I had my last blood test - My MOT. I don't recall being told this.

I found from my online records I was prediabetic in 2006. No one ever mentioned it in 15 years!

 

[Mr_Pot]

Now I'm curious, do those T2s in the forum who've maintained hba1cs below 40 (or whatever the prediabetic level is) for several years still qualify for VAT exemption when they buy testing strips?

Although my HbA1c is below 40 I am officially "well controlled" so I still claim the VAT exemption. I don't buy a lot of strips these days so I doubt Rishi is too worried.

 

[HSSS]

Now I'm curious, do those T2s in the forum who've maintained hba1cs below 40 (or whatever the prediabetic level is) for several years still qualify for VAT exemption when they buy testing strips?

Still diabetic so why not as that is the criteria for vat exemption not medication or hba1c ? Type 2 is more than just hba1c imo. We simply use food not drugs to manage it and testing is part of that management.

 

[HSSS]

I found from my online records I was prediabetic in 2006. No one ever mentioned it in 15 years!

Mine dated back 8 yrs

 

[Mrs T 123]

Yep I still claim the exemption but it still costs a small fortune for the strips - I just ordered some more last night and I don't test a lot but I noticed I had spent over £300 in strips in possibly last year or more (I can't remember exactly), I wouldn't like to add on what it has cost me since being diagnosed not far of 5 years now ... I would much rather have spent the money on something I liked ...

 

[Mrs T 123]

Still diabetic so why not as that is the criteria for vat exemption not medication or hba1c ? Type 2 is more than just hba1c imo. We simply use food not drugs to manage it and testing is part of that management.

And an expensive medicine at that - imo the food I eat costs more than me just being able to eat anything or what is on offer at a particular time ... salmon, chicken, meat, lindtt chocolate etc and all the special keto/low carb goodies I buy to keep me sane are not cheap at all (no £1 ready meals unfortunately)

 

[Oldvatr]

I think tht if there is ever a query, then HMRC will request access to your medical records, then write to your current GP for confirmation of your status at the time in question. When I have applied for VAT exemption from a supplier such as Amazon, then I am required to make a statement at the time of purchase that I am eligible for exemption, and this is a legally binding statement. I sign as T2diabetic, since I know my records class me as Resolved, which means I am receiving treatment and ongoing reviews of my condition by an HCP. I think, but am not sure, that the new classification of In Remission does the same.. NB the the requirement for prescription exemption is that I need to be also getting regular diabetes medication, and be countersigned by GP when making the initial application at the pharmacy. Technically if the doctor signs you off as in remission but does not continue regular reviews, foot checks etc, then you may forfeit the scrip charge waiver if you are no longer on diabetes medication. The answer is to hurry up and get past 60, although Rishi is considering removing the age exemption soon.

 

[Alexandra100]

Do you have the name or link to this study. I’ve seen reference to it a couple of times lately.

https://www.nice.org.uk/guidance/ng28/chapter/Recommendations
see para. 1.6.9

 

[Goonergal]

Now I'm curious, do those T2s in the forum who've maintained hba1cs below 40 (or whatever the prediabetic level is) for several years still qualify for VAT exemption when they buy testing strips?

There is no guidance so I claim it - still qualify for eye screening and am most definitely not ‘cured’.

And apart from anything else, by bringing my numbers down without meds, I’ve saved the NHS the cost of medication and costs of possible complications, and I pay for any prescribed meds I do need for other conditions so I’d guess I’m putting in way more than I’m taking out.

 

[Oldvatr]

https://www.nice.org.uk/guidance/ng28/chapter/Recommendations
see para. 1.6.9

Section 1.3 is still the old mantra. HCLF CICO to the fore.

Interesting that they now advise sucrose based foods replacing carbohydrates but within the energy balance. How many T2D will understand this aspect, I wonder? Those that are sports / fitness inclined maybe, but Joe Average and Jane Average will not be interested in calorie counting. I for one would not. I do not even carb count.

I think the section 1.6 is a better explanation in these guidelines compared to the graphic posted earlier. Docs understand the written commands and guidance better than a vague choose something that suits between these limits. This section also avoids the elderly frail and incompetant aspects of the earlier graphic. It is more medication orientated which makes more sense.

 

[HSSS]

And an expensive medicine at that - imo the food I eat costs more than me just being able to eat anything or what is on offer at a particular time ... salmon, chicken, meat, lindtt chocolate etc and all the special keto/low carb goodies I buy to keep me sane are not cheap at all (no £1 ready meals unfortunately)

Those same £1 ready meals and cheap goodies those make/keep people sick in the long term though.

Mince and chicken thighs etc are cheaper meat. Eggs aren’t expensive. Baking massively cuts the cost of goodies compared to buying decent keto stuff ready made. Freezers and bulk cooking of special offers helps too.

and don’t get me started on people who pay £3 + for daily coffees etc then moan about the cost of decent food.

 

[HSSS]

https://www.nice.org.uk/guidance/ng28/chapter/Recommendations
see para. 1.6.9

Thanks but that’s the targets and considerations not the study being discussed a lot on various groups. It was my understanding there was a recent report/study aiming to justify higher levels in some people (elderly/frail) and I was interested in the detail and reasoning used.

 

[JohnEGreen]

My first A1c ordered by my neurologist not my GP was 51 my GP at that time said you are not diabetic end of discussion though I did remind him that that was in the diabetic range and the letter from my neurologist held no weight.

My second A1c again ordered by my neurologist not my GP was 64 my GP said you are not diabetic again end of discussion.

A year later and first appointment at my new GP's Surgery finger prick oh dear that's a bit high here is a prescription for metformin and my name put on the register of diabetics.

And " Oh dear John we seem to have missed the boat here a bit sorry" not that it was his fault.

My reply was so I am diabetic that's a bit of a kick in the teeth his rejoinder don't see why you already knew for some time and that was true but it's one thing to sort of know it despite being told otherwise and something else to have it confirmed.

Doctors like anyone else make mistakes it's not always about guidelines or definitions some times, it's not malicious it is just plain error.

 

[Dark Horse]

Interesting that they now advise sucrose based foods replacing carbohydrates but within the energy balance

There's a big difference between 'advising sucrose based food replacing carbohydrates' and 'Advise adults with type 2 diabetes that limited substitution of sucrose‑containing foods for other carbohydrate in the meal plan is allowable'. The former sounds like an instruction to replace carbohydrates with sucrose whereas the latter sounds like it is saying that it's preferable not to replace other carbohydrates with sugar but if you really want to do that, it's OK as long as it's only to a small extent.