Insulin level test (U.K.) without the NHS

[HSSS]

Anyone know of places I can access an insulin/c-peptide test (and maybe even antibodies too) in the U.K. without an NHS endo request? And likely costs? Is it an in person only test? in which case location matters too.

Any advice which specific test to go for and under what conditions (fasted or not for example)?

 

[Mrs HJG]

@HSSS you should not have to pay - why should you - ask, insist and be annoying to your doctors, your HbA1c has gone up, they do not need to know that you have hit a bump in the road, imagine what it would be on the Eatwell Plate! Say you want to try Metformin, it's number 1 on the NICE treatment list, they cannot refuse, (as I said before, whether you take it is your choice), but get on the prescription exceptions list and make them work for their money. Being proactive will save them money in the long run, if that's at the forefront of their treatment/diagnosis.

All tests seem to go to Exeter university for analysis, and mine were authorised by the hospital team/nurses, I've never spoken to the Endo there, but it didn't seem to be a big deal at the time. Maybe a long time ago it was expensive and exclusive, but I think that may have changed but GPs are unaware and live in fear of the wrath of the Practice Manager or the hospital team.

I really wish you luck, you have been nothing but helpful and knowledgeable on this site, and I value your responses, but time for you to think of number one and get your doctors to understand you are not mucking about.

 

[HSSS]

@HSSS you should not have to pay - why should you - ask, insist and be annoying to your doctors,

Say you want to try Metformin,

Being proactive will save them money in the long run, if that's at the forefront of their treatment/diagnosis.

All tests seem to go to Exeter university for analysis, and mine were authorised by the hospital team/nurses, I've never spoken to the Endo there, but it didn't seem to be a big deal at the time. .

To answer your points.

It seems I do need to pay because they have no reason, under their guidelines, to see a reason to test. I’m still within the well controlled level of 58mmol. They have no grounds to suspect LADA/type 1. They firstly don’t see my problem. After all type 2 is a progressive condition and I’m progressing. Nothing to see here. Additionally they say I need to make more dietary efforts. (Which just might be true). Or have failed with medications before they will escalate investigations. I’m well versed in being persistent with drs but it doesn’t always work.

I’m not so sure I do want to take metformin yet. I need to examine my reasoning there again perhaps.

So much in the nhs would be more cost effective in the long term. That doesn’t seem to be a strong motivating factor in the policies.

Your type is questioned and you have had dealings with the hospital as a result it seems, even if not an endo appointment. Most straight forward unquestioned type 2 do not get this.

I have another appointment later this month with the nurse. I’ll try again but then I need to have a private option ready to go. Who knows, maybe I can get a compromise of a private referral through the gp’s and the tests taken there. If you don’t ask…..

 

[Mrs HJG]

@HSSS I wouldn't recommend booting your HbA1c to 129, but I am learning this is a bit of a door opener

Oh my nurse loves a private referral. and blatantly said she won't refer me for any NHS diet/education courses or anything until after my private appointment - excuse me lady, that means you are more than happy for me to bumble on for 12months+ without any 'help' (albeit I will no doubt ignore now I have seen the low carb light), but as I am (indirectly) paying, she is happy to use the outcome, cheek!

NHS gatekeepers are a riddle wrapped in a mystery inside an enigma; badly misquoting Churchill!

I googled as no doubt you have too, and only spotted Medichecks in London, but seeing the variation in prices charged for HbA1c tests, seems to be a licence to print money. Care to join me on Dragon's Den?

{Mod edit.]

 

[ZoeinKent]

@HSSS, so sorry to read about your frustration (on your other thread). It's something I share, as despite eating low carb my last HbA1c was 41 (I know that may not sound too bad, but initially I had more success).

Regarding the blood tests, I've been looking at this website:
https://privatebloodtests.co.uk/

It seems a GAD antibodies test is about £130 and c-peptide £238 (ouch!). They do the tests in person at Spire healthcare settings. No idea how good they are, but I'm planning on going for the GAD test at some point.

Best of luck.

 

[AndBreathe]

Medichecks does an insulin resistance test:

https://medichecks.com/products/insulin-resistance-blood-test

Blue Horizon do C Peptide:

https://bluehorizonbloodtests.co.uk/search?q=c+peptide

and it looks like Zoe has located a GAD antibody test.

Bit of a mish-mash, but as you control when the blood draws are done with any of these, you can manage the process to suit you.

 

[oldgreymare]

I so empathise with your frustration. Unfortunately current UK NHS NICE guidelines do not routinely recommend Antibodies and c-peptide tests. Referral for these will be based primarily on clinical signs to first differentiate possible Type 1s (under 10% of the total diabetic population) versus 90% of diabetics, almost all Type 2 (insulin resistant).

Re private tests, I personally prefer going to a clinic for blood draws - no way can I get more than a very few drops from my fingertips, so almost all "home" sampling ruled out. But costs for in clinic tests include technician time for blood draw plus possibly their labs interpretation (as opposed to just test result & reference range). So you may be able to get a cheaper rate by ordering as many tests together. Antibodies tests are most useful for initial diagnosis - so not sure that is still relevant for you.

Possibly c-peptide may be the most informative for you, but make sure you are on a moderate carb diet (100g +) when you take it - might help best to distinguish if you are insulin deficient (LADA/T1) or insulin resistant (T2).

 

[HSSS]

Antibodies tests are most useful for initial diagnosis - so not sure that is still relevant for you.

Possibly c-peptide may be the most informative for you, but make sure you are on a moderate carb diet (100g +) when you take it - might help best to distinguish if you are insulin deficient (LADA/T1) or insulin resistant (T2).

yeah I realise a negative antibody isn’t conclusive either because they were never there or haven’t lasted, whereas a positive result is a lot more so. Yes ultimately I want to know if my problem is resistance or lack.

Can you explain the reasoning behind moderate carb when testing ? I’m assuming if you aren’t demanding any insulin how can it be measured. How does fasted/not fasted figure in that if I’m right though?

 

[Daibell]

In my experience GP referrals for the two tests vary greatly area by area. The tests need to be sanctioned by the local diabetes clinic and not the surgery. My clinic endo was fairly dismissive when the C-peptide test was 'lost' and the clinic nurse said as my GAD was negative there was no need for a further C-Peptide (ignorant). I complained and now have a good relationship with the endo who accepts I am T1 in behaviour but the tests don't quite prove it. My excellent DN did refer me for the tests at my request despite my GP being dismissive. So, it all depends on your local service

 

[HSSS]

Just checked those test links. Oddly the privatebloodtests one seems to be run by blue horizon but offers different tests at different prices and locations. So now I have a £236 cost for c peptide and glucose at a convienient location including the cost of the draw and report as a baseline to search against. Thanks all.

 

[AndBreathe]

I so empathise with your frustration. Unfortunately current UK NHS NICE guidelines do not routinely recommend Antibodies and c-peptide tests. Referral for these will be based primarily on clinical signs to first differentiate possible Type 1s (under 10% of the total diabetic population) versus 90% of diabetics, almost all Type 2 (insulin resistant).

Re private tests, I personally prefer going to a clinic for blood draws - no way can I get more than a very few drops from my fingertips, so almost all "home" sampling ruled out. But costs for in clinic tests include technician time for blood draw plus possibly their labs interpretation (as opposed to just test result & reference range). So you may be able to get a cheaper rate by ordering as many tests together. Antibodies tests are most useful for initial diagnosis - so not sure that is still relevant for you.

Possibly c-peptide may be the most informative for you, but make sure you are on a moderate carb diet (100g +) when you take it - might help best to distinguish if you are insulin deficient (LADA/T1) or insulin resistant (T2).

I live in a village, so not some mega metropolis, but we have a private phlebotomist around these parts. During lockdown her business exploded. She will draw bloods for private and NHS. If the tests are NHS, she will also take the vials with her to an appropriate drop off point.

He charge for a blood draw is £15. If the test is fasting, and therefore before 08:30 there is a £5 surcharge.

During lockdown both my OH and myself had private blood draws and I also had an NHS panel to be dne, in readiness for a consultant (telephone) appointment. Our total bill was £20, with my NHS bloods dropped off for me.

I think I found our lady by googling something like "phlebotomists near me".

@HSSS - Just tagging you in in case there was anything of interest.