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Argument for test strips

B

brianb

Well-Known Member
Messages
151
Location
Hebburn, Tyne and Wear
Type of diabetes
Type 2
Treatment type
Insulin
Ok im now trying to put a letter togeather to try and get test strips on prescription .

Bearing in mind my last HBA1c was 6.0 ;) and that i am only on diet/exercise for the diabetes. Candersartan for raised BP and the usual asprin. Simvastatin on hold at the moment.

Dignosed in March this year so may not be classed as newly diagnosed.

Now im reading the Nice guidlines under the reccomendations section for self testing in type 2s it says

RECOMMENDATIONS
R22 Offer 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. Discuss its purpose and agree how
it should be interpreted and acted upon.
R23 Self-monitoring of plasma glucose should be available:
 to those on insulin treatment
 to those on oral glucose lowering medications to provide information on hypoglycaemia
 to assess changes in glucose control resulting from medications and lifestyle changes
 to monitor changes during intercurrent illness
 to ensure safety during activities, including driving[/b].

I dont seem to come under any of these catagories so do i have an argument.

As far as i can see other than using it to avoid foods etc that raise BG and in doing so give myself piece of mind(and not the anxiety that they claim in the report)and as part of my requirement to test before scuba diving i don't really have a good argument do I?

OR

am I missing someting in the guidelines?

Im **** at arguments, there should be course to help people like me :-/

Thanks yet again for any advice.

Brian
 
You can try to argue the point about driving (if you drive a car?) as that is a common undertaking of many people - state that you won't know if you're hypo without a test first? If you drive to and from work, then that has to be at least 2 a day they must allow you?

Whether you are newly diagnosed or not you need to be in control of your diabetes and the best way to do that is to have access to all the information --- and the best way to do THAT (see a trend here haha) would be to understand your own body's reactions and fluctuations throughout the day ...

Good luck and if all else fails threaten to turn up with an hba1c of 11 next time if it means you'll get testing scrips!

x
 
Hi
Thanks for the reply, I like were u r coming from but not on any diabetic meds so not likely to have any hypo's so my first argument is trashed straight away. What else can I try?

Thanks
Brian
 
It's true enough that if you are on medication for diabetes (injectable or otherwise) you are more likely to suffer bouts of hypoglycaemia, HOWEVER badly controlled diabetes without medication can still result in hypos that are enough to stop you driving to an adequate safety standard.

You could point out some symptoms *cough* not suggesting you invent anything ... but you might like to recall some times when you ahve felt strange and don't know why ... maybe if you were able to immediately test your BG you could have a better understanding of what's going on ...

Good luck (if it goes TU then you could try crying, they'd be so shocked they might just give you a scrip!)

:)
 
Hia Brian,

I'm also a newly diagnosed type 2 and was worried there was a chance my dr would refuse testing strips especially after my DN refused me saying we would talk about it at my 4th app.

I already had a Ascencia Contour machine so i bought my first lot of strips ( £22.40 ) tested in the mornings - before meals - 2 hours after meals and before bed. Kept a food diary of everything i had eaten and test results which showed quite clearly showed me what spiked me.

I took this with me to my Dr and when i asked for strips he began the usual type 2's don't need to test blah blah - So i pulled out my diary and showed him my argument against his and why i needed to test as a newly diagnosed - That i wanted to be in control - That i believed with regular testing i could get in control - That by keeping a record i could adjust my lifestlye and how else could i do that without regular testing in these early days.

He wrote me out a script for one testing box and that i now on repeat with a review in 6 months.

I now how a good idea of what does spike me - Carbs! so i am lowing carbs - losing weight - and keeping good numbers. I test now once a day after tea and occassionally when i get up.

Testing has helped me feel more in control of diabetes than anything - I was anxious - irritable and feeling down right low before i was testing.

Good luck and let us know how you get on.

Carol xx
 
Not knowing how long you've been diagnosed, the main part of recommendation 22
Offer 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. Discuss its purpose and agree how
it should be interpreted and acted upon.
Click to expand...
Should help.

The important part of the first sentence is self-management education. NICE guidelines stress that self-monitoring programmes do benefit, both the patient and the NHS.

A response from the under-secretary for health can be found here.
Any PCT which is automatically discouraging the prescription of blood glucose testing strips is not acting in according with NICE's advice that self-monitoring may prove useful to people in their overall approach to self-care
Click to expand...
.

I'm still waiting for a response to an FOI request for details behind the advice given to both PCTs and GPs by Sue Roberts, then National Clinical Director for Diabetes, unfortunately the diabetes NSF team appear to be taking their time.

Regards, Tubs.
 
I wonder if the arguements listed would help me get them?

I'm newly diagnosed, and spend up to 15 hours a day five days out of seven in a 44 ton articulated truck! I occasionally drive a coach as a part time job. (I hold HGV & PSV licences) The advice I was given was to eat small amounts regularly all day, which I normally do. I also have sleep apneao and cataracts on both eyes. DVLA are fully aware of the conditions. Do you think this would make a good arguement?
 
Also recently diagnosed Brian, had pretty much teh same conversation with the diabetes nurse in hospital that she COULD supply me with a monitor and a few strips to see me through a few days, but my own doc would be hesitant to prescribe the strips as they are "just soooooooooo expensive"

Said - do I need to self test - reply: well not really as you are type 2 and we will be able to control it for you etc etc etc etc

Went to aforementioned doc on an unrelated matter, and he said: I assume your doing your own tests every morning ? What's your readings been like ?
Told him about the convo with DN and he went white, then red, then purple - started spluttering about something or other and said wait there while i go get you a machine. Unfortunately there was none in the surgery or the PCT clinic so he said if I bought my own, let him know what one it is and he would write me out a script, on repeat, for whatever machine I had.
He also rang me two days after seeing him, at work as well, to enquire how was I coping with doing my self tests and what the readings were.

Maybe i'm the lucky one in the pack - but i'd certainly be downloading a copy of teh NICE guidelines and waving them under the doc's or pratcise nurse' nose for sure - can't really hurt trying


Jim
 
we will be able to control it for you etc etc etc etc
Click to expand...

That is so wrong, on so many levels. Primarily because the diabetes NSF acknowledges that the patient needs to 'own' the condition. The only person who can control BG levels is the patient. In order to do that, we need access to the right tools. In this instance strips, lancets and a meter.

Regards, Tubs.
 
tubolard said:
we will be able to control it for you etc etc etc etc
Click to expand...

That is so wrong, on so many levels. Primarily because the diabetes NSF acknowledges that the patient needs to 'own' the condition. The only person who can control BG levels is the patient. In order to do that, we need access to the right tools. In this instance strips, lancets and a meter.

Regards, Tubs.
Click to expand...


exactly tubs - which is why my doc went ballistic and said he would prescrbe strips and lancets for me. I think my doc will soon have a better understanding of diabetes when i've finished with him - thats when i've understood it myself of course.

Jim
 
I'd always been lucky with my strips until very recently I went to order some more and noticed that they had been removed off the repeat section!

Had to visit my GP who explained that too many Type 2 were testing unecessarily and worrying themselves over the results! Becasue of this the PCT had removed all repeat request of strips and lancets from every type 2 diabetic!

I explained that I had just had an appt at the diabetic clinic, had my medication changed to Byetta and thus would now have to inject twice a day and they suggested testing at least twice a day for the next month, more if I was driving around.

My GP reluctantly gave me a one off prescription for 150 strips and said when I've run out I will have to go back and see her and she'll do another one off prescription, she wasn't allowed to put it back on repeat for me even though I now inject! She did happily say I can put your needles on repeat prescription!!!
 
It's worth looking up your local PCT's diabetes policy. That will tell you if you stand a chance. Trouble is that NICE protocols are GUIDELINES and not compulsory.
 
If your GP will not prescribe the strips, or a tester for that matter, is there any way you can buy them yourself?
 
You sure can buy them VBee, most chemists carry a range of machines and will supply most strips to go with them ... the machines are supplied cheaply and the strips are expensive. Try to find out which are the cheapest strips in your local pharmacy and buy a machine to match as it ends up costing less that way :)

Both machines and test strips are very easy to find online, both via eBay and online chemists shops - again, research the cheapest strips and find a machine to use 'em!

Problem is that 50 strips costs from £14.00 to £25.00 (give or take) depending on where you buy them, so even if you're only testing a few times a day it still adds up ... so the "theory" is that to control your diabetes effectively, you need to (at least to begin with) understand how your body reacts to certains foods, illnesses and activities SOOOOO the NHS would save a shedload of money if they stumped up the cash for the strips now, instead of giving us amputations and sugeries and medication until we die ... does that make sense?

Have a lovely afternoon ... J/xxx
 
Makes sense to me. :) Just storing that bit of info for when/if my GP gives me a pack of tablets and tells me to shuffle out of her office in a 5 minute window - again without saying the D word... :roll:
 
caroluk said:
Hia Brian,

I'm also a newly diagnosed type 2 and was worried there was a chance my dr would refuse testing strips especially after my DN refused me saying we would talk about it at my 4th app.

I already had a Ascencia Contour machine so i bought my first lot of strips ( £22.40 ) tested in the mornings - before meals - 2 hours after meals and before bed. Kept a food diary of everything i had eaten and test results which showed quite clearly showed me what spiked me.

I took this with me to my Dr and when i asked for strips he began the usual type 2's don't need to test blah blah - So i pulled out my diary and showed him my argument against his and why i needed to test as a newly diagnosed - That i wanted to be in control - That i believed with regular testing i could get in control - That by keeping a record i could adjust my lifestlye and how else could i do that without regular testing in these early days.

He wrote me out a script for one testing box and that i now on repeat with a review in 6 months.

I now how a good idea of what does spike me - Carbs! so i am lowing carbs - losing weight - and keeping good numbers. I test now once a day after tea and occassionally when i get up.

Testing has helped me feel more in control of diabetes than anything - I was anxious - irritable and feeling down right low before i was testing.

Good luck and let us know how you get on.

Carol xx
Click to expand...

This is pretty much what I did. However although the results have impressed the hell out of my GP she is still "not permitted" to prescribe me any strips. She and her colleagues are none of them very happy with the restrictions placed on them by our PCT, not just on this issue.

This is curently "the Bible"

http://www.bmj.com/cgi/content/abstract/335/7611/132

have a look at the rapid responses and you may recognise a few names

 to assess changes in glucose control resulting from medications and lifestyle changes
Click to expand...

hmmm well "lifestyle changes" covers a lot

Went to aforementioned doc on an unrelated matter, and he said: I assume your doing your own tests every morning ? What's your readings been like ?
Told him about the convo with DN and he went white, then red, then purple - started spluttering about something or other and said wait there while i go get you a machine. Unfortunately there was none in the surgery or the PCT clinic so he said if I bought my own, let him know what one it is and he would write me out a script, on repeat, for whatever machine I had.
He also rang me two days after seeing him, at work as well, to enquire how was I coping with doing my self tests and what the readings were.
Click to expand...

YOU have an excellent doctor!

If Kaiser Permanente thinks testing is cost effective then it MUST be

http://care.diabetesjournals.org/cgi/co ... /29/8/1757

Andrew Carter, Mary Vernon and many others are pro-testing
 
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