Diabetic experts recommend not testing??

I'm afraid that a lot of us have become cynics where the majority of HCP's are concerned for good reason. There are a few shining examples in the darkness but unless you are lucky enough to come across one then its best to do your own research and be in control of this condition. As I often say - it is our diabetes to manage not the doctors.

britishpub said:

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

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Well spotted ! In correspondence with Diabetes UK I did ask if there was a T2 on the staff. Presumably not. A T1 responded:

We do continually review the evidence base – which is why our recommendations on diet have changed quite dramatically in the 21 years I’ve worked at Diabetes UK - and we certainly try to be less dogmatic about any one approach, hopefully giving people enough options that they can find a way that works for them. As an individual with Type 1 diabetes, I personally have seen the benefit in reducing overall carb intake – but certainly don’t stick to any one approach, as I enjoy potatoes too much! For me it has been about finding a balance that works for me and enables me to eat happily (and healthily) whilst maintaining excellent blood glucose control (HbA1c of 6.5%).

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He did NOT respond to my challenge:

IanD:
"I am writing further as I have now studied the results from the National Diabetes Audit.
...................
“For most adults with diabetes, the HbA1c target is below 48 mmol/mol, (6.5) since evidence shows that this can reduce the risk of developing complications, such as nerve damage, eye disease, kidney disease and heart disease.” For T1s that target is achieved by less than 9%.

Well done – you are one of the 9% T1s with a satisfactory control. You will help the other 91% by sharing your method."

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IMO that refusal is disgusting - he has the experience that gives him satisfactory control, but refuses to share it with other T1s. He declines to help the other 91% who are at risk of complications.

I found a meter and bought the strips and lancets today. I have now been able to do one test and although it might not be calibrated I got a reading of 10.4, and my diagnostic reading was 17.1 at about the same time of day. That does at least give me some idea of how the alterations I have made in my diet are working. It gives me the confidence to go on in the same way - plus I know that I will be checking so there is a constant resistance to any cheating with the sweets and chocolate my husband has in one of the fridges.

I must be lucky. Doctor diagnosed T2 in September. At first post diagnosis check up 4 weeks later he was really happy I had taken steps to control my illness - understanding, diet, exercise, testing and targets. First target being to review my HbA1c test due in January to assess whether I need to continue with Metformin and to review my cholesterol for a further discussion on statins. Targets might not be achieved but at least there's an open mind and a discussion to be had. Faced with the reception it seems many have had from the medical professions on this forum I'd certainly be thinking twice before accepting their advice.

The position taken by Diabetes UK is quite interesting and this document lists some of the arguments for and against self-monitoring of blood glucose by people with type 2:-
https://www.diabetes.org.uk/Documen...tes-UK-position-statement-SMBG-Type2-0413.pdf

slip said:

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!

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His budget will be hit significantly if you become a T2 insulin dependant, since he is then obliged to support more testing than you are asking for as a preventative measure. This is the argument I used, and eventually it worked. It helps that I am still a car driver, and also on a med that can and does lead to hypo's. The issue was discussed at the EU parlianent, but was not supported due to the expert knowledge that gets wheeled out on such occasions. That is not a Uk-only phenomenon. My MP also raised this with the then Health secretary, but she got booted out of office before she could respond.

Hi,

I happen to live in a "post code lottery" area. I also get to speak with T2s. My dad was one treated with met & yes he was issued with a meter & prescribed strips.. (Correction. "Drums" for an Accu-chek mobile.)
I asked these T2s "do you have a meter?" Yes they reply, but I never use it.. Your right.! It don't make sense...

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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Basically these "experts" have other priorities in mind. Our ability to normalize our blood glucose just isn't at the top of their list.

So if you believe it it important to you as it is to many of us...then we simply eat to the meter and become the rare "anecdoctal" T2D with normalized HbA1c and insulin levels....

Oldvatr said:

His budget will be hit significantly if you become a T2 insulin dependant, since he is then obliged to support more testing than you are asking for as a preventative measure. This is the argument I used, and eventually it worked. It helps that I am still a car driver, and also on a med that can and does lead to hypo's. The issue was discussed at the EU parlianent, but was not supported due to the expert knowledge that gets wheeled out on such occasions. That is not a Uk-only phenomenon. My MP also raised this with the then Health secretary, but she got booted out of office before she could respond.

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Your doc HAS to give you a meter, as you are on hypo inducing treatment. But I like your argument! Can some of you guys that are T2Ds who are on metformin try that tactic and report back?!

I know it is totally unscientific, but yesterday's mid afternoon reading was 10.4 and today's is 8.2 - mmol/l. I did manage to take a Metformin tablet yesterday evening. Just seeing that sort of change is so encouraging.

Received this alongside my latest HbA1c result:

Dear Mr K9,


Blood glucose test strip Review

We are writing because you are currently using a blood glucose-testing device for your Diabetes. As a practice we are reviewing all patients receiving blood glucose test strips on repeat prescription to ensure that they are fully informed about when/if they should be testing and what they should do based on the results.


Current guidelines published by the National Institute of Health and Clinical Excellence, recommend that blood glucose monitoring should be available to those patients who:

• Are prescribed insulin
• Are prescribed a class of anti diabetes medicine called sulphonylureas
• May or may not be taking medication, but the need for testing is included in their management plan

The best and most accurate method of assessing blood glucose control in patients outside of these criteria is by regular HbA1c testing, which will be carried out by the doctor or nurse in the GP Practice.


As per these guidelines, all patients who are diet controlled or prescribed oral medication, other than sulphonylureas, are being reviewed against the guidelines for self-management of blood glucose.


As a result of this review, we are writing to advise you that there is no clinical requirement for you to continue to monitor your blood glucose, and the testing strips have been removed from your list of repeat medication. You should continue to attend the regular appointments made for you by the Practice to check your overall diabetes control, including HbA1c testing.


If you have any concerns at all then please telephone the practice pharmacist,on xxxxxxx xxxxx(Mon-Thurs).


Yours sincerely


On behalf of the practice

Should your Test Strips be stopped? It is vital that you carry on testing, having a Blood Glucose Meter is an important piece of any Diabetics equipment.
Lots of people and Forum Members use the SD Codefree Meter because the Test Strips are the cheapest to buy. Even cheaper if you buy them in bulk. Here is the link check it out.
http://homehealth-uk.com/all-products/codefree-blood-glucose/monitoring
Always state you are Diabetic for VAT exemption. Here in the UK we use mmol/L
If you buy the Test Strips in bulk, below are discount codes.

5 packs - 264086. 10 packs. - 975833

I've also been T2 for 20 years and I always measure my BG. Only then can I have control. Only then did I understand the need to change my diet to low carb and exercise daily. I think doctors do not bother to heal us, but to leave us in a just reasonable quality of life.

I have an excellent Doctor who has never denied me test strips nor anything else. I am Type 2 on Insulin and my Doctor asked me "After you test do you adjust your medication in light of the test results". I replies "No". Then he said "Why do you test?" I had no answer.

So annoying isn't it . One day the medics guidelines will catch up with the lower carb / testing revolution .It will cost them money initially but will save in the long run.

I believe in the low carb / test revolution because it works for me ( nearly 4 years post diagnosis and still diet and activity controlled). For me my monitor is the best investment in my health .

I agree with you Jamrox

Tanis said:

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.

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this is exactly what my doc said too but id already brought a meter as i am like you id rather know whats going on and this is my way of doing it

I bought myself a meter soon after diagnosis and test regularly. Having read many posts on this forum I didn't bother to ask my GP.
Since September this year I have been to A&E 3 times. Even thought the doctors knew I was type 2 on Metformin they didn't seem to think there was anything wrong that I was testing.
In fact last week a neurologist asked me if I had tested when I first became unwell and what was the number.
So yes I agree that the reason why GPs don't prescribe meters and strips to type 2s on diet only or Metformin is a budget issue. False economy.

Today 7.7 mmol/l - it is so encouraging to see the numbers dropping every day. Absolutely encouraged to go on being careful about what I eat - the Christmas present of chocolate was received with thanks and passed on to the hopefully non diabetic husband of mine. It seems crazy to deny people the ability to check, but where meter and strips etc are supplied people should be followed up and asked for readings on a regular basis, or for the meter to be returned so that they can be put to good use.