Level of care and prescriptions

[Jackinthebox]

I was diagnosed with Type 2 diabetes at the end of November 2012 and have not been able to get my blood sugar levels down below about 17 and it fluctuates between 17 and around 27 despite changes to medication. I am pretty inexperienced in the ways of the medical system having only seen a doctor twice in about 30 years. So I don't have much to compare to.

This week on my weekly trip to have my Glucose levels taken by the health care assistant I was asked if I would take a prescription for a box of the strips that go into the home testing kit but instead of keeping them for my own use bring them back to the surgery for their use. I presume they otherwise have to pay for them. Anyone else been asked to do this ? Is it a common practice that just accepted ? I think I will conveniently forget to take them with me next time.

Since my diagnose about 7 weeks ago, I have not had any consultation with a doctor, any explanation of what Diabetes is, how is happens and how it can be treated (I have of course done my own research now) I even had to ask the Doctor if it was Type 1 or Type 2. They have given no advice on diet. My only contact with the Doctor has been when the blood sugar levels are not dropping the health care assistant will go and ask him if he wants to change my medication (This is usually a discussion that takes place in the corridor/waiting area in front of other patients) He then comes into her room makes little or no acknowledgement that I am even there and types the changes into the PC prints a new prescription and hands it to me with some verbal instruction of how many I should take.

I have now been advised that as a GP he can do no more and my case is being referred to the local hospital as I may need to go down the Insulin injection route. I was shown the letter sent to the hospital and even that had an error in what medication I have been taking so I was advised just to tell them when I go. Not had a date for my first visit and the letter was sent on 15th Jan. Once again is this par for the course or really poor level of service/care?

 

[sallylondon]

Wow Jackinthebox, you having a hard time!

Your doctor sounds like he needs a personality transplant, and more training. The strip scam sounds decidedly dodgy in my opinion! I bet you can not wait to get to the hospital to get some questions answered. Given the recent weather problems I would think you will have to wait for a while to get your appointment sent through. Is it worth ringing the hospital to see when they think the appointment will be sent out?

I hope that Daisy will come along and post some information that many of us have found really helpful in bringing our levels down. Changing my eating a bit and cutting down on potatoes, rice, pasta and especially bread made a real difference to me.

I wish you luck and keep us posted about your progress.
Sally

 

[Daibell]

Hi. You treatment sounds typical of a broken NHS. I think you may be much better off as and when you attend the clinic. How old are you and what meds are you on? They should have given you diet advice but at least you can get that here and low-carbing to the meter is essential. To ask you to get strips for 'their' use is outrageous and no doubt against NHS rules. You sugar levels are far too high. Have you had an HBa1C blood test yet? If you are quite young and not overweight there is always the possibility of Late Onset T1 so let us know. If older and overweight then you are most likely an insulin resistant T2; there are of course shades in between. If your sugar levels rise even with low-carbing then be prepared to go to A&E for attention

 

[happycat]

Unfortunately your experience is typical of the level of care in some areas. It is really good that you are going to get to see someone with more knowledge at the hospital. As others have said try to push for your appointment, maybe being prepared to accept a cancellation. I was diagnosed in September and have not had a great deal of help except for the offer of metformin and statins. I am trying to eat less carbs and no sugar. It seems to be working for me although my original sugar levels were lower than yours are. It is disgraceful that you were asked to get them some strips for testing. I was refused them and so I buy my own. I also bought a meter because it is the only way that I know what is happening. I do hope that things will work out for you, good luck and try to stay positive. All the best and sending you a hug

 

[Jackinthebox]

Thanks guys for all the comments and good advice, still trying to understand more about carbs and getting really annoyed that all the books & diets assume you must be overweight when I am only 5.5 stone (35kg). Tried to chase up hospital today but was distracted by garden centre and they were closed when I called, silly me thinking they would keep office hours ! :clap:

 

[Daibell]

Hi. Thanks for the weight and age info. Your weight is quite low and so is your age. I think it's possible your T2 diagnosis might really turn out to be a late onset T1 as the pills aren't helping and it's less likely you are insulin resistant. Hopefully the hospital will take the right action but you might want to hint that a GAD test and c-peptide test might help confirm the right diagnosis? Your meds appear to be a sensible start but if they don't bring your sugars down then I guess you realise that insulin may be needed.

 

[daisy1]

Hi Jack and welcome to the forum

Here is the information we give to new members and I hope you will find it helpful. Ask all the questions you need to and someone will be able to answer.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• 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

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Squire Fulwood]

This week on my weekly trip to have my Glucose levels taken by the health care assistant I was asked if I would take a prescription for a box of the strips that go into the home testing kit but instead of keeping them for my own use bring them back to the surgery for their use. I presume they otherwise have to pay for them. Anyone else been asked to do this ? Is it a common practice that just accepted ? I think I will conveniently forget to take them with me next time.

I have been trying to think why a HCP would ask you to do this and I don't know. Maybe they could prescribe them for you to do a home test but since they are doing the testing it is just an accounting thing whereby these strips could be allocated to your record.

I suppose that if your surgery does not have a built in pharmacy (mine has) then this is just a way of getting the strips to the surgery. The pharmacist will have to do the paperwork.

I have never heard of this before and it is intriguing.

 

[twinkle1980]

This week on my weekly trip to have my Glucose levels taken by the health care assistant I was asked if I would take a prescription for a box of the strips that go into the home testing kit but instead of keeping them for my own use bring them back to the surgery for their use. I presume they otherwise have to pay for them. Anyone else been asked to do this ? Is it a common practice that just accepted ? I think I will conveniently forget to take them with me next time.

I have been trying to think why a HCP would ask you to do this and I don't know. Maybe they could prescribe them for you to do a home test but since they are doing the testing it is just an accounting thing whereby these strips could be allocated to your record.

I suppose that if your surgery does not have a built in pharmacy (mine has) then this is just a way of getting the strips to the surgery. The pharmacist will have to do the paperwork.

I have never heard of this before and it is intriguing.

As the daughter of an NHS counter fraud specialist... The whole thing smells fishy to me. Personally I would report it to your pct.counter fraud team who can and will look into it.

 

[Jackinthebox]

Squire Fulwood - I do my own testing at home and was supplied the monitor and get my own strips on prescription free of charge. The GPs surgery are just trying to get the strips FOC so they dont have to come out of their budget. Very dodgy I think. I go once a week and they take a reading and record it on my record.

Oh and when I called the hospital today they have no record of the referral letter from the GP allegedly sent on 15th Jan. Called the GPs they say it was sent on 15th which is fine but the fact is the hospital dont have it but apparently the admin lady is not in so they cant do anything but she did say the letter is sent electronically and that can take a bit longer ! What utter nonsense !

 

[donnellysdogs]

Jackinthebox
I know you having a **** time and dreadful treatment.. However, to try and get your bg levels a tad lower in the interim .. What foods do you eat? Have you always been of lighter weight or has this come about due to diabetes?

It also would be worthwhile preparing a lust of questions for the consultant when you do see him/her..i think you will be better off than under gp care.