Blood sugar monitoring

[jennings103]

I was diagnosed just over two years ago. I had a blackout while driving and the tests they put me through diagnosed type two diabetes. My big complaint is that my GP will not allow me to monitor my blood sugar level, unless of course I pay for all the strips, lancets etc. How widespread is this? I have been led to believe it is quite widespread. The problem as I see it is , how am I to look after my diabetes if I cannnot test? After all, I am the main part of the group maintaining my disease. I would be grateful to know if anybody else has had this problem and how if at all they managed to overcome it.

M J Jennings

 

[Dennis]

Hi Michael and welcome to the forum.

You are absolutely right that without being able to test your blood sugar levels then you are not able to exercise any control over them. The NICE guidelines are completely clear that doctors should encourage patients to take responsibility for management of their condition, which includes prescripotions for test strips. But unfortunately what you have found is very common.

By refusing to prescribe them, your GP is in breach of the NICE guidelines, but is almost certainly only reiterating what his PCT have told him - don't prescribe test strips because we can't afford it!

Its difficult to know what line to take with your GP - asking him straight why he chooses to ignore the NICE guidelines for Type 2 diabetics will most likely alienate him.

 

[nannab]

I also have the same problem. One GP in my practice won't prescribe strips, but another one has prescribed just one box, not on repeat prescription, just a one off. I totally agree with you, how can you manage your own health without the equipment to do so. I still buy my strips and lancets off the internet (a lot cheaper than Chemists), so that I am able to monitor what foods, exercise, stress etc. do to my bg readings.

Unfortunately, it appears to be extremely common.

NannaB

 

[Silvercat]

I have just managed to persuade my hospital diabetic nurse that I need to monitor and she has persuaded my doc to prescribe...I have yet to go see my doc but will be interested as to how many strips I get prescribed per month.

 

[bluebird]

Hi

How frustrating it is to have to keep asking the doctor for test strips and being told 'we don't believe in it. You are controlling your diabetes well'.

I've been type2 for three years and up to now not on medication. My results as of yesterday were HBA1c 7.1. When I said to the doctor that if I could have tests strips for just one month to monitor how different foods affected my blood sugar the reply was as above.

It's as if they don't want to help control your levels just wait until it gets worse and prescribe pills.

Bah humbug

Regards Val

 

[peachypooscat]

I have never had problems like this. My GP has also put mine on repeat and always 2 boxes of everything. AND I dont have to pay.

I must be lucky

Regards

Peachypooscat

 

[saffy]

Hi ....im the same...my GP cant give me enough strips ....if i go without my own readouts i get told off...why are some gps so tight on this...may be a bit more assertiveness wouldnt go amiss...i have learnt this through personal experience...i go in my drs as an equal...i used to be...yes dr...no dr...three bags full dr...not any more...im an ordinary 61 yr old woman..but as good as them...as long as your not rude or insulting..but assertive...it seems to work..no harm in trying it...good luck ...Saffy

 

[ash]

The whole situation sucks. Postcode NHS lottery strikes again.

My PCT is in breach of the guidelines, and the yare just calling our bluff. If you don't ask, you don't get, and they are playing on ignorance to avoid funding them.

HBa1C 6.3 T2

 

[Whitevanman]

This comes from our Labour Goverment, it saves money, Yea.
I`m told i can have enough strips to test twice a week, how the hell do I know what i`m doing testing twice a week, as a delivery driver how do i know what is haperning to my mmol.

The only way i know and have been able to control my type 2 is having to buy another machine and all what goes with it myself.

Although i must say Accu-chek are being realy helpfull, Free record books, free hardwere to transfer data from machine to computer, free program disc, free battires for life and free test solution.

 

<blockquote id="quote"><font size="1" face="Verdana, Arial, Helvetica" id="quote">quote:<hr height="1" noshade id="quote"><i>Originally posted by Whitevanman</i>
<br />This comes from our Labour Goverment, it saves money, Yea.
I`m told i can have enough strips to test twice a week, how the hell do I know what i`m doing testing twice a week, as a delivery driver how do i know what is haperning to my mmol.

The only way i know and have been able to control my type 2 is having to buy another machine and all what goes with it myself.

Although i must say Accu-chek are being realy helpfull, Free record books, free hardwere to transfer data from machine to computer, free program disc, free battires for life and free test solution.


<hr height="1" noshade id="quote"></font id="quote"></blockquote id="quote">

I get everything on prescription, but have 2 spend £7 on batteries every few weeks! its not much more than that for a new meter with batteries included!

 

[sugarless sue]

You must do a lot of testing!!I've had mine nearly a year and not had to change batteries!

Knowledge is the key to control

 

[jennings103]

Thanks to everybody for all the info. For anybody who does not know, the NICE guidelines state that for a type 2 diabetic being controlled by diet and exercise (+/-) Metformin, a 3-6 monthly HbA1c may be sufficient. Urine or blood testing may be chosen by the patient to enhance glucose control through lifestyle and dietary changes. If a patient chooses to test, education is required regarding when to test (e.g. pre and post-exercise or post-prandial) and what to do with the results. They also state that the type of monitoring is the patients choice. So armed with that information, we should all go to our GP and confront them with it so they hopefully will have no choice but to offer us the relative test supplies. Unfortunately, it seems we have to buy the test metre. However, when I asked a GP (who was not my regular one), he offered me a metre but would not give me the supplies to go with it. That was before I had the knowledge about the NICE guidelines.

M J Jennings

 

[Dennis]

Michael,

Here is the exact wording of the new NICE guidelines for HBA1C and self testing by Type 2 diabetics.

<b>1.3 Glucose control levels</b>

1.3.1.1 People with type 2 diabetes should be:
• involved in decisions as to their individual HbA1c target level, which may be above or below that set for the general population of people with type 2 diabetes
• offered therapy (lifestyle and medication) to assist in achieving and maintaining their HbA1c target
• encouraged to maintain HbA1c below 6.5% unless the resulting side effects or their efforts to achieving this impair their quality of life
• informed that any reduction in HbA1c towards the agreed target is advantageous to future health.

1.3.1.2 Measure HbA1c levels at:
• 2–6 monthly intervals (tailored to individual needs) until blood glucose control is stable on unchanging therapy. Use a measurement made at an interval of less than 3 months as a useful indicator of direction of change, rather than a new steady state
• 6-monthly intervals once the blood glucose level and blood glucose lowering therapy are stable.

1.3.1.3 Measure HbA1c by high precision methods and report results in DCCT (Diabetes Control and Complications Trial) aligned units.

1.3.1.4 In people in whom HbA1c monitoring is invalid (due to disturbed erythrocyte turnover or abnormal haemoglobin type) estimate trends in blood glucose control by:
• fructosamine estimation, or
• reliance on quality-controlled plasma glucose profiles, or
• total glycated haemoglobin estimation (if abnormal haemoglobins).

1.3.1.5 Unexplained discrepancies between HbA1c and other glucose measurements should be investigated. Seek advice from a team with specialist expertise in diabetes or clinical biochemistry.

<b>1.4 Self-monitoring of plasma glucose</b>

1.4.1.1 Self-monitoring of plasma glucose should be offered to newly diagnosed people with type 2 diabetes as an integral part of self-management education. The purpose of SMPG should be discussed and agreed.

1.4.1.2 Self-monitoring of plasma glucose should be available to:
• those on insulin treatment
• those on oral glucose-lowering medications to provide information on hypoglycaemia
• assess changes in glucose control due to medications and lifestyle changes
• monitor changes during intercurrent illness
• ensure safety during activities including driving.

1.4.1.3 Assess at least annually in a structured format self-monitoring skills, the quality and frequency of testing, the use made of the results obtained, impact on quality of life, and the equipment used.

1.4.1.4 Discuss the use of urine glucose monitoring where plasma monitoring has been found unacceptable to the individual.

 

[sugarless sue]

I just wish in 1.4 1.2 that it specifically stated 'on diet only control' as well .It still leaves an abiguity that some PCT's will try to slide round.

Knowledge is the key to control

 

[RoseLin]

I have had this problem too, and find it utterly frustrating! :evil:

Although diagnosed a year ago, I have been in denial about it all until very recently. I just couldnt get my head around the fact that I should take this thing seriously when I couldnt see or feel any effects from it, and made almost no effort at all to control it. :roll:

My latest HbA1c was 8.6, not good at all says the doctor... even though I dont eat biscuits, cakes, sweets, chocolate etc (well.. hmm.. sometimes chocolate!) or have any sweetened drinks.

So I decided to do some intensive testing to find out the effects of different types of food on my blood sugar, to get some feedback and educate myself a bit better, and learn what I was doing wrong! This is my last chance NOT to be on drugs

I NEEDED to know the effects of fatty foods on my bg... and my regular multivitamin drink... and what high protein meals do... and any effects of caffeine on bg... and whether slow walking helps much (I cant move around enough to do gym type exercise).. and whether bg reduces faster after a meal if I am sleeping or awake.. just SO many facts I needed to learn about my body if I was to gain control and stay off the drugs.

But I was told that strips etc could ONLY be diagnosed if I was ALREADY on medication!!! ugh! (I wonder just HOW much money is being wasted in people taking medication who maybe could have regulated their bg satisfactorily if they had better knowledge?)

Anyway.. I immediately suggested that she prescribe medication for me.. and also the strips.. and that I simply throw the drugs away! She was horrified.. but knowing I would do exactly that, she reluctantly gave me just one box of 50 strips, but no repeat prescription.

I am now putting these to good use, testing at one or two hourly intervals, day and night for a week, plotting the resultant curves on a graph, along with notes about the food being tested and any activity done, and sleep patterns..... and its FASCINATING!!!

I am testing for the curves produced from protein, fats, and carbs each in isolation, then in pairs, and then all combined. ( 7 tests total))

I am testing the different curves produced by black tea, black coffee, milk, water, and 100% fruit juice on an empty stomach.

I am testing to see whether sleeping or being awake makes any difference to the rate of change of bg after a meal.

I am testing to see how much time it takes to bring my fasting bg down by one mmol by walking slowly, (thats enough to make me puff!), compared with just sitting... and also pottering slowly in the garden...

Now I can SEE what is actually happening inside of me and know exactly what is causing that effect, and to what degree, and I feel so motivated and challenged to get my blood glucose down.. it has become a visible enemy to do battle with.. a new sport to keep improving my 'personal best'.. and I am taking this **** thing seriously at last! :lol:

Has anybody else tried this intensive educational testing and would be interested in comparing and sharing results? Do you know if, or where, graphs of these different curves have been published on the web before? EVERY diabetic person needs this detailed info, in my opinion, but it just doesn't seem to be available..

So, in conclusion.. if you are being refused strips for personal educational testing, feel free to quote some of my ideas from above, threaten your doctor with disposing of medication to get strips if necessary, and make them realise quite how CRAZY it is to deny us this self-knowledge!

Rose

 

[sugarless sue]

Good for you,Rose,I hope one we will see all your research data on here.

 

[MARCUS47]

wow on reading some of these i seem to be quite lucky with my doctor.

i was diagnosed with type 2 at Christmas this year and my doctor advised me of the testing monitor to get and gave me a repeat prescription for all the strips and lancets

 

[sugarless sue]

Welcome to the forum,Marcus.Lucky you!Sounds like you've got a clued up doctor,keep a hold of him.Hope you enjoy browsing and taking part in the discussions here.

 

[padulica]

I am not actually diagnosed as diabetic..I think I have pre diabetes, I was diabeteic in pregnancy so have a more than definite risk of progressing to type 2.
My HbA1c was 5.8 I felt this was high plus the fact my fasting BG had been 6.4..... I excercise x3 times a week, walk the dog every day and have an active job. I forced my GP to do a GGT, my starving was 6.3 and my 2 hr was 6.6...my GP confirmed the results as abnormal but no action to be taken. I WAS GIVEN NO ADVICE....I have since started on a low carb diet and eating no carbs after 6pm...my BS are now less than 5.6 in a morning. I am able to access my BG through the job that I do si have had no help from my GP.
They don't seem to have any interest in preventative action...... just treating it when you have it!!!!!
Padulica