A bit of a rant...

[james1986]

I have had type 1 Diabetes for 6 years now, I was diagnosed whilst at university in Manchester where I regularly saw a consultant etc.... I have been studying abroad in italy for 2 years and recently moved back to Manchester where I have had several problems with my new GP.

When I first registered she sorted my repeat prescription etc and took bloods which I have now had back - Hba1c was 57 in new money, not sure exactly what that is in old but around 7.3 maybe? Which is ok but has been better. This is where she then informed me I couldn't have more than 100 test strips per month because my condition "was well controlled". I know that it could be better at times but the main reason it is controlled is because I DO test 6 times a day yet she gives me enough to do 3... The DVLA tells me to test every time I get in a car and my last consultant and dietician told me to definitely test before every meal and bed and if I wanted after meal times to see if correction doses have worked etc. My last gp had no problems in giving enough strips (6 times a day) for 3 months whilst I was living abroad so I don't understand the big deal. This is an ongoing issue which I am still fighting for but at the moment I am having to buy the extra strips from boots at 20 something pounds a pop or off ebay. I've recently finished uni and just starting work so money is not flowing.

I was also informed by my GP that she wouldn't refer me to the diabetes centre because my blood control was good enough.... Now I'm afraid this is where I nearly lost it with her. I am 100% sure that if I asked my consultant to write to my gp and tell to her to give me more strips it would happen. Is she playing some sort of budget game with me or this something I'm not actually entitled to??????????? I've had conversations about correction doses and she just don't understand why I change the amount of insulin I take so how I am supposed to talk to her?

I would also love to do a DAFNE course because I'm just doing things as people suggest them or reading online but how can I access a course without speaking to a DSN or dietician?

She's supposed to be retiring in the summer so should I just stick it out and pay the extra for strips hoping for a better situation when I'm passed onto someone else's list or is there actually something I can do about this?? Any help would be greatly appreciated. Sorry for the rant... James

 

[SueR]

I have been in a similar position as yourself and a letter from my diabetic nurse resulted in more test strips. I am testing 3/4 times a day and the 50 strips on my repeat were not lasting. I now get 100 per month.

My GP is given regular up-dates on my treatment and the increases in insulin. I know that when I need extra insulin it will be given. I have been discharged from the hospital and am under the care of a decent diabetic nurse, who does all she can to make my life easier.

Getting your consultant to write to your new GP is the best plan. I have been told that the consultant out ranks and can over rule any decisions your GP makes about your treatment. I'm lucky as I have a decent team of GP's looking after me - there's 5 in the practice and all of them are good, so it doesn't matter who I see when I have problems.

 

[Elc1112]

Hi James,

Seems a lot of GPs have been trying to cut back on the number of test strips they provide to diabetics. I put in a repeat prescription for strips a few months ago an got a phone call from GP's receptionist telling me I'd ordered too many that month and no more would e prescribed. I got an appointment with a doctor at the surgery, one that specialises in diabetes, and managed to get more prescribed.

Is there another doctor you can see at your local surgery? Might be worth asking if there is one that is a specialist in diabetes. Like you, my control is good because I DO test regularly. As you said, DVLA suggests testing before each journey. For me that's at least three a day!

Hope you get it sorted.

Em

 

[iHs]

I'm not sure what is really going on for us insulin dependants and bg testing but an absolute must is for those using bolus/basal is to be able to test bg levels approx 6 times a day at least or else there is no point in using the regime.

I would go back to your gp and ask her to transfer you to another regime as you are no longer happy to carry on like you are doing. Its going to cause you loads of anxiety, hypos and hypers. Say to her that you would like to use an insulin pump and that you would like to see a consultant to discuss this with. She might say that your diabetes is well controlled but you can reply back that it wont be if she restricts the test strips.

 

[noblehead]

James,

I had a similar problem myself with my gp questioning the amount of test strips I was using with a view to reducing them, during my diabetes check I told my consultant about this and he wrote to my gp insisting I get 200 per repeat.........strangely enough gp hasn't mentioned it again since!

Get your diabetes clinic to intervene as you should not have to buy them being insulin dependent.

 

[james1986]

Hi guys, thanks for all the comments... I probably should have made it clearer but I don't have a consultant at the mo because I moved away to Italy and she won't refer me again because she says that my condition is well controlled. I would love to get a letter from a consultant to say that to her but at the mo I simply can't. Is she allowed to not refer me or can I approach them directly?

 

[CarbsRok]

Hi James,
write a letter to your GP, copies to the practice manager as well as the PCT.
Explain that you drive so need to test to keep your self safe as well as other road users.
You do dose adjustment for insulin dosages, no test strips or lack of means that you are limited to how many times a day you can eat as no test means no insulin which equals no food.
Or the other alternative is you eat but stay indoors as can not drive due to no test strips.(Which means unable to work)
Also point out you have every right to be refered to a consultant. You are not happy with the lack of understanding or care provided by her (your Dr) as she has failed to grasp basic care or needs of a person with type 1 diabetes.
Also ask who put the restriction of test strips in place for type 1 diabetics as you would like to have the information on file for any future claims for compensation due to the onset of complications :evil:

 

[iHs]

Some diabetes clinics have walk in sessions where people can just turn up although they appreciate a phone call first. There should be an on duty dsn there who will be able to advise you on the test strip problem.

There are quite a few gp practices now that are re stricting teststrips and IMO it makes the basal/bolus regime and even biphasic insulin, dangerous to use, so people need to put their foot down and remind the gps that if something happens to you because you have not been able to test, then the gp will be guilty of failing to adhere to their duty of care!!

I agree with everything CarbsRok has said as well :thumbup:

 

[Snodger]

I have nothing more to add beyond what CarbsRok has said - totally spot on 100% endorse it; beautifully put. But I just wanted to say, please come back and let us know what happens and what you decide to do.

 

[xyzzy]

Don't take her c**p.

Unfortunately you don't have a right to force her to get a second opinion.

You can ask your GP to arrange a second opinion either from a specialist or another GP. However, the GP does not have to do this if they do not think it necessary. You have no right to a second opinion.
You do have the right to see a GP competent to deal with your particular case. If a GP refers you for a second opinion, you cannot insist on seeing a particular practitioner. However, you should not be referred to someone you do not wish to see.
If the GP refuses to arrange a second opinion, you may wish to change your GP (see under the heading Changing a GP).
If a GP is unsure about a diagnosis, they could be found negligent if they failed to refer you to a specialist and you suffered as a result of this. If you have not been referred for a second opinion and have suffered as a consequence, you may wish to complain.

However I would attack this from the competent GP angle. Tell her the first time you Hypo because you haven't been able to test you will bring a claim of negligence against her because she has caused you to suffer. Put it in a letter to her or the practice manager so that they can't deny you ever said it to them.

Good luck!

 

[noblehead]

James,

Do as CarbsRok suggests and get those letter fired-off asap, let's know how you get on.

 

[davey b]

Bottom line is that you have a RIGHT to be referred to a consultant and/or diabetic clinic regardless of whether you have good control of your blood sugar levels or not. It is in black & white in the Dept of Health's Diabetes National Service Framework. Whilst being in good control of your levels may be beneficial. it is no guarantee that there won't be complications at some point - and it is for this reason that you need to be 'in' the system for regular checks.

I'd point this out to your doctor via letter - with a copy to the Practice Manager and either the Chairman of your Primary Care Trust or the Customer Service Manager.

 

[sugar2]

I am not sure I agree 100%, as many GPs are able to provide an excellent service to their diabetic patients, and there is no ned to go to a consultanat.

Doesn't sound like your GP os one of these those!!!!!!

Personally, I would nag her..mentioning the DVLA requirements over and over again.

I have GP care in the past, although back with teh consultant now...and that was triggered by moving to another GPs practice with a different policy. When talking prescriptions though, my best friend is the nurse at the surgery, who can and does write prescriptions for strips. She also got me onto a DAFNE (well equivalent ish) course as well) I would suggest, unless your GPs surgery is a one woman band, try making an appointment with another GP?