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Diabetic experts recommend not testing??

W

wiredwoman

Member
Messages
9
Type of diabetes
Type 2
Hello! Newly diagnosed about 5 months ago, (although I have been here before because my husband has had Type 2 for 15 years and we’ve benefitted greatly from the advice on this forum, thank you!)

On the day of my own diagnosis I was told not only that I wouldn’t be given a meter/test strips but that the doctor didn’t want me to test at all. Instead he would be giving me a ‘miracle’ drug (Empagliflozin) that ‘you will love’ because I would lose weight.

Fast forward 5 months and I have indeed lost weight, how much is due to the wonder drug is difficult to assess because I have also completely changed my lifestyle - low carbing and daily treadmill. The doctor on seeing my weight reduction was delighted with himself and the miracle drug and I had to remind him that I’d actually put in quite a lot of work myself! My HBAIC has reduced from 10.6 to 7.3. All going in the right direction except now that my weight has plateaued I really would like to test to see what spikes me. Would I be better eating a potato or a slice of wholemeal bread? How can I possibly know how I react to different foods and exercise when I’m not allowed to test. So on this visit I politely requested to be allowed to test and the response was interesting. At first I was told I don’t need to and when I mentioned NICE guidelines/lifestyle changes he said NICE can say what they like but they don’t have to manage his budget. I asked if this was a financial decision and he said “Yes, of course.” But later he said he would prefer to prescribe the expensive wonder drug at £40 a month (he could have given me a cheaper drug (Glimepiride) but I would have gained 10kg instead of losing it!) This drug is not recommended as a first step apparently but he is prepared to ignore the guidelines if he is passionate about an issue. Finally, when I pushed him on the decision to disallow testing being purely financial he said that was part of it but that every diabetic expert, and all the conferences he attends the consensus is that testing does not lead to better control.

So that’s my question. Is it true that diabetic experts believe that patients kept in the dark do better ultimately? It seems unlikely to me, but I’m open to being proved wrong. I really feel that I need to know what’s happening to my body, not to be obsessive about it but to understand what makes a difference. If I have to fund that myself then so be it but I’m confused after the conversation with my doctor as to the real reason why I shouldn’t do it.
 
Three times i have asked for testing equipment but have been told no as i am on Metformin and not at risk of hypos. I want to test for ME! I need to know what my body is doing. I need to know my triggers. So i bought my own equipment and test 3 times a day. It helps me so much. It is my body and i will do what i want with it. If i want to test, i will! I do not believe it can do any harm and dont believe a little obsession with blood levels is a bad thing when you are dealing with a disease that can ultimately kill you. I do believe Drs. are driven by costs in this case.
 
wiredwoman said:
Finally, when I pushed him on the decision to disallow testing being purely financial he said that was part of it but that every diabetic expert, and all the conferences he attends the consensus is that testing does not lead to better control.
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They aren't engineers, I suppose they have never heard anything about control theory.

I suppose they also think that a continuous glucose control and an insulin pump is inherently bad.

If I have to fund that myself then so be it but I’m confused after the conversation with my doctor as to the real reason why I shouldn’t do it.
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It's the same reason because I, being on statins I could only test cholesterol and transaminase once a year Money .
 
wiredwoman said:
How can I possibly know how I react to different foods and exercise when I’m not allowed to test.
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You have answered your own question here and you don't need the permission of a doctor to test. It would be nice if he prescribed the equipment but if he has financial problems then I suggest you buy your own meter. My DN admitted it was finance at the root cause of the advice not to test. Eventually I got a meter from her and she stopped the strips so I buy my own.
 
Thanks Tanis, yes my thoughts exactly. I want to have as much control of this as possible and not rely on an annual HBA1c to see where I'm going wrong. I can understand, even if I'm not happy with financial constraints being the reason but I was puzzled by the 'expert' opinion.
 
Hi. Yes, it's your decision and worth the cost if you can afford. BTW Glimepiride is not the best drug to prescribe at early diagnosis and you being overweight. It's job is to create more insulin which may not be your problem unless tests show otherwise. It does not cause weight gain but having too many carbs with it does. I assume you are already on Metformin which may help a bit?
 
Squire Fulwood said:
You have answered your own question here
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Thanks for your response. Yes, as I mentioned I can fund my own testing if necessary but my question was more about whether diabetic experts, the ones who host the conferences, etc are coming up with rationales so that doctors on the front line can justify non-testing. It would make it more comfortable I'm sure to feel there is an alternative reason rather than saying we don't want to fund you. Or *conspiracy theory alert* maybe the conferences are funded by big Pharma who don't really want us to control and possibly reverse our diabetes. My doctor has said that although I have reduced my BG he is expecting that it will rise next time ("it's just human nature") and then he's going to put me on this or that drug and then 'injections' - he seemed very sure and enthusiastic!
 
I don't think it's a conspiracy as such - just the inevitable result of telling people to continue to follow the Eatwell plate and not give them instructions on ways to tailor their diet to their BG meter readings. If they did that, they'd have to abandon the underpinnings of their whole dietary advice and no way is that going to happen any time soon. Fat phobia has a lot to answer for.
 
I personally think its mostly about control ... If the Dr tells you to test and lets you have a meter.. then you can see how inadequate the gov guide to eating is .. but most of all it keeps the control of your body with the Drs... Also the Drs do have to follow the guide lines regards testing .. and are told not to advise testing for T2 that are not on insulin.

If you get your own meter and test you are taking back your control .. You can manage your T2 in most cases without the need for fancy drugs. I test and do not involve my Drs or DSN in the management of my T2 now.
 
If they really believe it, then it is complete claptrap. Buy an SD codefree meter. Test before and 2 hours after meals. Eliminate those carb foods which cause the greatest spikes. I believe I am right in saying that, if you reduce carbs, there is the possibility of becoming over medicated, so you need to be careful.
Empagliflozen is an SGLT2 drug which causes you to pass glucose out of the body in the urine. The doctor may be right that it is a better treatment than standard Metformin. It is recommended by Jason Fung, but may lead to greater risk of UTIs.
 
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If you want to test - buy a meter and test.
Your doctor sounds a real charmer.. maybe look around for another.. I think that the "studies" that allegedly show that testing doesn't lead to better control do not include educating people on how to interpret their results. Because the Low Carb High Fat diet is currently outside the advice given by HCP's then most will not advocate. So if you test, take meds and don't change your diet you are almost doomed to failure from the start. Therefore in that scenario testing is indeed a waste of time and resources. If however you test, eat to your meter i.e. modify your diet to take account of your readings, then you can make major changes to your condition. That's what I have found anyway, in my limited experience.
Hope that helps..
By the way one of the most cost effective meters/strip is the SD Codefree which is available here
https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/
Regards
Mark
 
It is highly likely that the Diabetes "Experts" don't actually suffer from the issue themselves.

Why anyone would consider somebody without first hand experience of something an "expert" on a subject is beyond me
 
britishpub said:
don't actually suffer from the issue themselves.

Why anyone would consider somebody without first hand experience of something an "expert" on a subject is beyond me
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It's like the courses for the newlyleds that are done by nuns... :-0
 
If someone gives a meter and test strips to a new T2 and tells them they MUST eat carbs, then the readings are going to scare the living daylights out of them, and the whole experience will be depressing and frightening.

If someone gives a meter and test strips to a new T2 and says 'test before and 2 hours after food, and if your bg rises by more than 2mmol/l then you need to reduce the carbs in the meal until your bg stays in range', then the experience will be empowering and result in greater health and fewer long term complications.

But doctors are not trained/educated/open to the idea that dietary control is possible for the fat, lazy, greedy, slothful T2s.
After all, they ate their way to this condition, so they haven't got the self control to change... (and no, I don't agree with this thinking)

It also goes against NHS dietary guidance to tell people to reduce carbs.
 
Definition of an expert
Ex is a has-been
(S)pert - a little drip under pressure

To re-code @Brunneria post

If you test you will find out that my dietary advice is bu11sh...
 
I guess his budget won't be hit when you have to go into hospital for treatment of a complication bought on by high blood sugars!
 
Having been told not to test, as I wouldn't understand the results, I bought my own supplies and got on with testing. Some time later, following a change of GP, due to a retirement, I had quite a "robust" conversation about this with my new GP. She was quite honest in saying budget couldn't deal with it, bearing in mind the numbers of T2s these days.

My feedback was that I, and so many others would feel better about things if an honest reason was given rather than a patronising, insulting "you won't understand the results" fib, without not even understanding anything about the patient's background. She agreed. We moved on.

As you know, interpreting test results is a little learning curve to begin with, but once upi have a grip of the basics, it's not rocket science.

I found testing was the single biggest breakthrough in understanding how my body works, and therefore learning what foods I could eat with extreme gusto, and which I really had to leave off, for some time at least.

Good luck with it all moving forward.
 
What I could see is that if you don't give the "cultural" tools to make a reasonable choice you are getting bad results anyway. I've watched the transmission on ITV when the people that followed the dieting indications has lost weight when the one that "had" to eat the birthday cake not, was enlightening.

After having understood what are the dietary problem and the consequence of bad diet we could talk of self control. That is one has to be taught on how to deal on problems of diet slipping, holidays, relatives, and so on....

By the way nobody told me that I was at risk of diabetes, they gave me statins. They've fooled me once, They don't fool me twice.
 
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