Access to test strips - can you logically answer 'no' to these questions?

[Scardoc]

Here's a thought as most car drivers ie me have some kind of insurance why not ask those who indulge in their dangerous pastimes to provide themselves with same, .

We all pay NI.

 

[graj0]

Here's a thought as most car drivers ie me have some kind of insurance why not ask those who indulge in their dangerous pastimes to provide themselves with same

I have always thought that as a brilliant idea. Over the years (now 62) I've worked with many people whose sporting activities, although very laudable, have cost a fortune in time off work and hospital fees. Even my own brother in law, a keen footballer, ended up requiring expensive surgery for his shoulder, even after receiving several injuries to that shoulder (dirty opponents knew there was a weakness maybe?) he carried on until it was just too much and his shoulder needed some serious surgery.
Sorry, gone way off topic. I think at the end of the day the NHS wanted to save money, the government wants to save money. Type II diabetics just happened to be a soft target because of some research that suggested it was pointless to test, it made no difference. Unless of course you were changing diet to get the numbers down. In my case, if I was to follow the eatwell plate advise they dish out I'd be on insulin now and would need to test more regularly. As it is I take metformin but I know if I start eating the carbs again my BG WILL go up.

 

[StormyDog]

I'm concerned about those who eat to their meters considering how poor their accuracy is.
The acceptable accuracy range is +-15%. For people to eat to their readings the deltas need to be massive.

A meter could read anywhere between 6.0 & 8.0 for an actual reading of 7.0.

Being a newly diagnosed T2 I'm learning about my condition.

I do think we T2's need more than a few minutes with a DN every 3 months but I need a better regime with my testing against my BM



Sent from the Diabetes Forum App

 

[Scardoc]

I have always thought that as a brilliant idea. Over the years (now 62) I've worked with many people whose sporting activities, although very laudable, have cost a fortune in time off work and hospital fees. Even my own brother in law, a keen footballer, ended up requiring expensive surgery for his shoulder, even after receiving several injuries to that shoulder (dirty opponents knew there was a weakness maybe?) he carried on until it was just too much and his shoulder needed some serious surgery..

But where does it end? You need insurance to play football in case you break a leg.....or in case you break someone else's and get sued. It would never work, people would be too scared to participate or wouldn't want the expense and end up not exercising.........that could lead somewhere else!!

 

[Brunneria]

I'm concerned about those who eat to their meters considering how poor their accuracy is.
The acceptable accuracy range is +-15%. For people to eat to their readings the deltas need to be massive.

A meter could read anywhere between 6.0 & 8.0 for an actual reading of 7.0.

Being a newly diagnosed T2 I'm learning about my condition.

I do think we T2's need more than a few minutes with a DN every 3 months but I need a better regime with my testing against my BM



Sent from the Diabetes Forum App

It can be very frustrating, I agree.

However, what you are looking for is trends - mashed potato being a perfect example. It isn't about whether 150g of mash sends your BG up by 2.7 mmol. Instead, it's about 'oh, I've eaten mash 3 times lately, and each time my BG shot up higher than I'm comfortable. I will try a half portion next time and see what happens... Or swap it for cauli cheese. And test that, several times.'

Unfortunately, it isn't just meter accuracy that affects the results. Other factors include stress, tiredness, what you've been eating for the last few days, monthly cycle (women and werewolves only. I hope), exercise levels and what side of bed you got out of (anger levels seem to affect me more than anything else).

So it really is more of an art than a science. But you will be pleasantly surprised how quickly you adjust, and how much you can learn from systematic testing.

 

[satindoll]

We all pay NI.

If you were trying to rile me, congratulations you did, I was brought up with the ethos "Pay as you go, can't pay, don't go" so have worked hard saved and brought outright the home we live in, we owe no one anything, all bills are paid as soon as they come in, OH has always worked since leaving school at 16, never claimed dole, lived on savings when out of work, that's why it took 50 yrs to buy our own home. Yes he is still paying NI and dose so happily because it helps others, and because its the law, and hopefully he will be with me long enough to claim the pension he has worked so hard to earn and yes he does have a private pension he's been paying into, worth only a few quid granted but we are proud of what we have achieved in our lives even if at times it has been the kind of struggle no one wants especially when the girls went to uni

 

[Brunneria]

If you were trying to rile me, congratulations you did, I was brought up with the ethos "Pay as you go, can't pay, don't go" so have worked hard saved and brought outright the home we live in, we owe no one anything, all bills are paid as soon as they come in, OH has always worked since leaving school at 16, never claimed dole, lived on savings when out of work, that's why it took 50 yrs to buy our own home. Yes he is still paying NI and dose so happily because it helps others, and because its the law, and hopefully he will be with me long enough to claim the pension he has worked so hard to earn and yes he does have a private pension he's been paying into, worth only a few quid granted but we are proud of what we have achieved in our lives even if at times it has been the kind of struggle no one wants especially when the girls went to uni

But we all make lifestyle choices that have knock on effects which may require state, medical or emergency service intervention.

Some people exercise or play sport, because they think it is good for them, and get injuries.
I do not exercise much (to avoid injury due to hyper-mobile joints), so I get the negatives of a sedentary(ish) lifestyle.
And (this is not intended as a personal attack!!!) if I remember correctly, I have seen you mention that you have 8? children and, er... Was it over 20 grand kids? ( which is incredible, by the way).

But how much have those three sets of lifestyle cost the NHS?
Injury from fitness/sports
Sedentary lifestyle
Multiple midwives, health visitors, docs, nurses, surrounding childbirth.

Again, I am NOT criticising people's life choices - including my own. I am just saying that all our decisions have consequences, and there is always a personal and financial cost - which we often do not acknowledge - and the NHS often picks up the bill.

 

[graj0]

We all pay NI.

Which sadly isn't enough for what we expect out of the system, especially when you consider that it's meant to cover pensions, unemployment and sickness benefit as well as the NHS and the NHS alone seems to be expected to pay for more and more procedures.

 

[satindoll]

Yes It was my personal choice to have my 6 kids but I worked to keep them fed and clothed, besides I personally don't believe in abortion for me and have great humility and admiration for those who have to chose it for whatever reason, I lost one son at six weeks old due to viral pneumonia , so when they told me my daughter had been affected by rubella it was by choice I continued the pregnancy, she was not that badly affected and has achieved a second degree in Human Microbiology and Nucliar Medicine at Brunell, she is reacerching into creating an artificial liver and there have been great steps forward though more research needed, she and her spouse/partner also managed to find a way of tagging genes with regard to transplant rejection, so I think she has paid back her costs, my other children have paid their dues through the work they do and until my thyroid played up a familial problem I hadn't had any health problems per say, my OH three sons who I class as my own are a delight, and yes between us we have 22 grandchildren 6 of whom are mine, the great granddaughter is also mine.
I too have limited mobility due to rheumatoid arthritis in my hips and a plated ankle joint due to falling in the bath and breaking it on both sides. If I could find a job of work I would happily do so and buy all my own gear, I hope in the years I did work I payed my dues, and no I do not claim any pension regardless of right as I believe as I get my scripts for free its as good as getting one.

 

[Brunneria]

It is great that your family are well, productive and happy.
But there is no need to justify your life choices - just as I do not have to justify mine.
Nor does anyone else.
And at the same time, we will all have to live with the consequences (expected and not expected).

Thank heavens that the NHS will do its best to pick up the pieces, if necessary.

 

[PatsyB]

These strips seem to cost a lot wouldn't you think they would make a cheaper one...

 

[satindoll]

It is great that your family are well, productive and happy.
But there is no need to justify your life choices - just as I do not have to justify mine.
Nor does anyone else.
And at the same time, we will all have to live with the consequences (expected and not expected).

Thank heavens that the NHS will do its best to pick up the pieces, if necessary.

Maybe it was unintentional but you did make me feel that I had to justify my choices, or maybe I'm just feeling a bit touchy today

 

[satindoll]

These strips seem to cost a lot wouldn't you think they would make a cheaper one...

Wot and give up their Rolls Royces not a chance

 

[graj0]

Which sadly isn't enough for what we expect out of the system, especially when you consider that it's meant to cover pensions, unemployment and sickness benefit as well as the NHS and the NHS alone seems to be expected to pay for more and more procedures.

My comments are not directed at anyone in particular, but as a generalisation we all expect our tax and NI to go an awful long way.

I 've tolerated arthritic knees for 12 years, due in part to playing rugby, cricket, hockey and later on jogging, badmington and squash, all bad for knees, especially mine. So for the last 7 years with bone on bone because of no cartilage I have been repeatedly told that I am too young for replacements, the money isn't there to pay for the type of replacement knee, made by Smith and Nephew, that is warranted for 30 years and the NHS small/medium/large variety only last 10, maybe 15 years.

So I've got used to the fact that the NHS doesn't have the money, we don't pay enough into it. I suppose I should be pleased that they think I'll last another 15 years.

Sorry, just noted that the comments were in reference to another message.

 

[satindoll]

My comments are not directed at anyone in particular, but as a generalisation we all expect our tax and NI to go an awful long way.

I 've tolerated arthritic knees for 12 years, due in part to playing rugby, cricket, hockey and later on jogging, badmington and squash, all bad for knees, especially mine. So for the last 7 years with bone on bone because of no cartilage I have been repeatedly told that I am too young for replacements, the money isn't there to pay for the type of replacement knee, made by Smith and Nephew, that is warranted for 30 years and the NHS small/medium/large variety only last 10, maybe 15 years.

So I've got used to the fact that the NHS doesn't have the money, we don't pay enough into it. I suppose I should be pleased that they think I'll last another 15 years.

Sorry, just noted that the comments were in reference to another message.

No problem, as I said on another post I am sure they are hoping we will join the hosts of the heavenly choir first, I expect nothing therefore I am not disappointed when nothing comes

 

[mcdonagh47]

Nice one @Dillinger

3a (or maybe an alternative to 6) - HbA1c tests do not help in determining short-term variation, especially high amplitude spikes. The mitigation of these spikes is also essential to good control.

well let's see about the rest...

1. No. The HBA1C does not measure average blood sugar levels , it measures something else entirely ( glycation of haemoglobin). Its partly because of that difference that the method of reporting was changed a couple of years ago from %s - 6.5 % A1C was too confusingly like an average bg of 6.5 mmol. But they weren't related.

2.Debateable. The UKPDS study on which much of the talk about risks of Complications rests found that "good" A1cs lowered the occurrence of laser eye treatment for diabetics by 82% but had negligible effects on the three other main complications. The total reduction for all 4 complications was 88%. So they divided that figure by 4 and came up with the statement that good control of A1cs led to a 22% reduction in complications. Aggregating results like that to produce a false positive is what Ben Goldacre defines as "bad science" in his famous book of the same name.

3. No. we do not need to reduce bgs "over time" to lower HbA1cs we need to reduce bgs pronto ! The A1c although including some blood cells that are upto 3 months old is heavily skewed towards the last 10 days. That's why some dmers try to cheat by fasting and low carbing in the ten days before an A1c.

4. yes.

5. No. Carbohydrates are the major contributor to bg levels.

6. Yes.

7. The statement doesn't make sense . Should it say "our" ?

8. Not really - if you are allergic to a particular food for example you will soon know about it by blotches or rashes or anaphylactic shock without having to test your blood sugar levels. Diabetes should have been specifically mentioned in this statement instead of the sweeping generalisation.

 

[poshtotty]

Well done @Dillinger . Excellent and intelligent debate.

I'm T2 and one of the lucky ones who has test strips on prescription - but only 100 per month. When I purchased one lot (£22.70) over the counter at a late night chemist, the pharmacist was reluctant to take my money, saying I shouldn't have to pay for them.

More recently, I was chastised by my local chemist for asking for an emergency set of strips having run out again, which I blamed on the hot weather and my BS fluctuating more and needing to test more often. I was told to get my script amended to 200 per month but my DN refused, saying I was becoming obsessive about testing.

I now haven't tested for 4 days as I've run out of strips and am waiting for my next lot to arrive from ebay

The fact is that since going LCHF I have weaned myself off all my strong drugs for RA, including a nasty weekly injection of methatrexate with unpleasant side effects, including liver damage (also used as an anti-cancer drug). My health has improved, BS reduced and general health, including RA, that I see this new lifestyle choice as being the answer not only to my diabetes, but RA too.

Imagine the savings to my local health authority since giving up 4 strong RA medications? I have also declined corrective surgery on my joints because although painful, I am seeing slight improvement which is tolerable. More savings for the NHS. I was supposed to attend the hospital at 08.30 this morning for a second pre-op assessment - 2 hours - but phoned and cancelled. Hopefully my place has gone to someone else and might help reduce the waiting list.

Yet I am still limited to 100 testing strips per month.

I shall be taking @Dillinger's questions to my DN at my next review. Thank you for raising the subject for the well reasoned argument.

 

[kyrani99]

Hi, my response to your:
2. The lower our HbA1c levels are the lower our risk from complications are.

Is no! This is only trends and the doctors making the opinions have conflicts of interest. Trends are about correlation, not causation. From what I have read there is more evidence that high blood pressure and high cholesterol are the cause of the problems, not high blood sugars, unless they are above 9 or 10% over a long time.

5. Food is the major contributing factor to raised blood sugar levels.

is No. It is stress that is the problematic factor because this is what causes the liver dumps of glucose that keep fasting glucose levels higher and create problems in glucose being absorbed more readily after meals.

For your numbers..
"6. Some foods have different effects on our blood sugar than others.
7. We cannot accurately tell what are blood sugars are at any given time.
8. In order to monitor what the effects of different foods are we need to test our blood sugars."

I would say that if a person becomes anxious about what they have eaten then that will raise their blood sugar levels more than the food that is eaten. All of the absorbed nutrient goes directly to the liver from the small intestine. It does not go past the pancreas.

The liver decides what will be put into the main blood circulation. Some glucose may be converted to triglycerides first so the glucose load is smaller BUT it might be that some triglycerides are converted to glucose so the glucose load is greater. I have yet to find a doctor to give me an answer. I would say the liver's action is not the result of what you ate but how stressed you feel.

So testing all the time may be a cause of high blood glucose.
So there may be a case that justifies doctors who tell their patients of Type 2 diabetics that they shouldn't test.

However by testing all the time and not only the times my doctor instructed me, I discovered that my stress was the cause of my problems so I would say, provided you don't get stressed about testing, it is better to test than not to test. It helps you get a clear picture. And there are things you can do but most people want to rely on drugs.

 

[poshtotty]

@kyrani99 I read your comment with interest and will throw this into the melting pot for what it is worth.

I have had an extremely stressful 2+ years since my mother died suddenly and unexepectedly. Unknown to me, she had appointed me as one of 3 executors, the other two being my brother and sister. Not only did I have to cope with bereavement and shock, but I suddenly found myself unprepared for the time-consuming and financially draining task of being an executor and warring with my siblings over the execution of my Mother's estate. Two years on, my legal team advise me I have a good case to apply to the courts to have my siblings removed as executors, citing their incompetence, leaving me to administer the estate alone. There is no light at the end of the tunnel and I am still in a very stressful family situation, while trying to avoid going to court. Coupled with this, I run my own business full-time at this very busy time of the year, in an industry where I work directly with very stressed clients and I need to be the calming influence.

My stressful situations haven't improve, yet my health and blood sugar levels have considerably improved.

My diet has changed dramatically and I intend to eat this way for life but today I relaxed my eating and had Sunday lunch with a friend. I had roast beef, Yorkshire pudding, roast potatoes, roast parsnips and other vegetables, plus a Pimms Eaton Mess afterwards, followed by a floater coffee. I expected my bs to be through the roof, but one hour after the meal I was 8.3, and 2 hours after eating 7.1. I anticpate being back in my usual range of 5-6 by tea time.

So, despite extreme stress, my BS are coping and my liver function is returning to normal. I'm unsure how this can be explained, given your interesting theory.

 

[kyrani99]

What is my interesting theory? I was only stating what I've read about diabetes. The main problem from what I've read is the liver dumping too much sugar into the bloodstream. If you take drugs that counter this, like Metformin then the liver is prevented from carrying out this function as much as it would normally. So the amount of sugar dumped is greatly reduced.

As far as stress is concerned, it is not just a matter of stressful situations. I am in far more extreme stressful situations than you. It is a matter of how you handle those situations. That is to say do you get stressed by them or not.

From what you have said you seem to be relatively unaffected by them otherwise your blood glucose would have been spiked each time and you say that is not the case. It is possible to be angry and worried etc., and still not be stressed. A lot of what stress is about is a person feeling it is all too much for them or telling themselves they can't cope or buying into other people's suggestions that may be adverse. It is a question of perception and reaction.