Gp Madness

[MrBen]

Hey. Just feel the need to vent. I am type one - 40yrs nearly.
3 yrs ago I was told by my GP - "You should not be doing more than 4 blood tests a day." I disagreed so he referred me to a Diabetic Consultant. When I saw the consultant she congratulated on my hbA1c of 50. Agreed to write the GP a letter stating he must prescribe the correct amount of strips, and duly signed me off.
Next GP I saw yesterday for a review - I told her I did approx 8 tests per day ( I drive alot and I run regularly ). She started to say " If you are well controlled you should be doing less than this..."
Aaaaaaahhhhhh.
I asked her very bluntly " Are you a Diabetic Consultant?"
At which point I asked her to read the entry on my medical file from the Diabetic Consultant.

Please at least be honest and say to me "We cannot afford your blood test strips" - don't try and make me feel bad because I am managing my lifelong disability the best I can - which happens to be pretty good.

I need to find a new GP ASAP

 

[dbr10]

Hey. Just feel the need to vent. I am type one - 40yrs nearly.
3 yrs ago I was told by my GP - "You should not be doing more than 4 blood tests a day." I disagreed so he referred me to a Diabetic Consultant. When I saw the consultant she congratulated on my hbA1c of 50. Agreed to write the GP a letter stating he must prescribe the correct amount of strips, and duly signed me off.
Next GP I saw yesterday for a review - I told her I did approx 8 tests per day ( I drive alot and I run regularly ). She started to say " If you are well controlled you should be doing less than this..."
Aaaaaaahhhhhh.
I asked her very bluntly " Are you a Diabetic Consultant?"
At which point I asked her to read the entry on my medical file from the Diabetic Consultant.

Please at least be honest and say to me "We cannot afford your blood test strips" - don't try and make me feel bad because I am managing my lifelong disability the best I can - which happens to be pretty good.

I need to find a new GP ASAP

And it's only so well controlled because of the testing you do.

 

[Deleted Account]

Thankfully, my GP doesn't know enough about diabetes to even think about how many test strips I use.
However, if they do, I intend to direct them to the DVLA requirements to test before driving and ask them if they want to reduce my mobility?
Limiting test strips makes my blood boil (or perhaps that's just the heat wave).

If you need any assistance to address this, have you seen the advocacy service Diabetes UK offer?
https://www.diabetes.org.uk/how_we_...cks/availability-of-blood-glucose-test-strips

 

[Circuspony]

Even my consultant went on about this! Having congratulated me on scores of 48, 51 and 49 over the past 6 months (diagnosed last Aug) she was flicking through my meter saying 'You test A LOT'. Well yes, that's how I get those hba1c results.......

 

[Tony337]

In years gone by a GPs surgery would get paid more if each patients HBA1c is well controlled!
I'd almost forgot this nugget and do wonder if the criteria is still the same?

Tony

 

[dbr10]

Even my consultant went on about this! Having congratulated me on scores of 48, 51 and 49 over the past 6 months (diagnosed last Aug) she was flicking through my meter saying 'You test A LOT'. Well yes, that's how I get those hba1c results.......

It's that just dumb

 

[kev-w]

Hey. Just feel the need to vent. I am type one - 40yrs nearly.
3 yrs ago I was told by my GP - "You should not be doing more than 4 blood tests a day." I disagreed so he referred me to a Diabetic Consultant. When I saw the consultant she congratulated on my hbA1c of 50. Agreed to write the GP a letter stating he must prescribe the correct amount of strips, and duly signed me off.
Next GP I saw yesterday for a review - I told her I did approx 8 tests per day ( I drive alot and I run regularly ). She started to say " If you are well controlled you should be doing less than this..."
Aaaaaaahhhhhh.
I asked her very bluntly " Are you a Diabetic Consultant?"
At which point I asked her to read the entry on my medical file from the Diabetic Consultant.

Please at least be honest and say to me "We cannot afford your blood test strips" - don't try and make me feel bad because I am managing my lifelong disability the best I can - which happens to be pretty good.

I need to find a new GP ASAP

Point out that it's because of the number of strips you use that your hba1c is ok and make the point that if strip reduction leads to a hba1c rise then it's their a**e that'll be getting kicked, I'd say just to keep on putting the repeats in as you need them.

 

[therower]

@MrBen . Welcome to the forum.
Strange as it may seem I had a totally opposite response from my GP a few years ago.
I said I was testing 5/6 times a day but felt guilty using to many strips.
His response/ lecture as always stuck with me.
Basically his reply was that he was happy to provide as many strips as required if it kept my HbA1C at a satisfactory level.
He went on to tell me that the cost of an hospital stay, amputation, after care, mobility aids and even more medication was far greater than test strips.
He did all this in a rather lecturing manner and made it blatantly obvious that he valued my control more than his NHS allowance.
Different GP's , different times maybe. Worth using it as part of your argument for test strips.
Good luck.

 

[ann34+]

@MrBen . Welcome to the forum.
Strange as it may seem I had a totally opposite response from my GP a few years ago.
I said I was testing 5/6 times a day but felt guilty using to many strips.
His response/ lecture as always stuck with me.
Basically his reply was that he was happy to provide as many strips as required if it kept my HbA1C at a satisfactory level.
He went on to tell me that the cost of an hospital stay, amputation, after care, mobility aids and even more medication was far greater than test strips.
He did all this in a rather lecturing manner and made it blatantly obvious that he valued my control more than his NHS allowance.
Different GP's , different times maybe. Worth using it as part of your argument for test strips.
Good luck.

Hi, this WAS the case, i recall a few years ago when the finance manager at my surgery queried my strip use, the consultant answer agreed with my GP - it was like you say, using more strips cost less money for the NHS in the long run, reduces laser treatment, cost of one laser treatment to NHS = thousands etc etc.

BUT something to think about - in my opinion doctors are changing, and may be forced to have different motivations, which seem perverse only to our NHS mindset. Suppose - and i read today that the new health secretary has accepted funds from a group which wants american style health care in uk - we did have that style here, where payment is received through treatment of , say, eyes needing laser treatment or any other diabetic complication, Logically doctors, even consultants, are not going to want you to be complication free. If you think i could be wrong, i hope so - but i am worried - just look at the level of diabetic complications in the usa. Maybe soon GPs may not want us complication free, or maybe they will be paid to refer us on, needing laser treatment to the local private provider, and if healthy what income can we generate for the GP or hospital? - it is very concerning.

 

[EllieM]

just look at the level of diabetic complications in the usa.

Yes, but T1s in the USA have the problem that they have to pay for insulin, let alone test strips, (plus the fact that the price of insulin has tripled recently, hello, price gouging), so it's not surprising that they have more complications when some of them can't even afford regular supplies of insulin.
I'm so thankful to have always lived in countries with universal health care.

 

[ickihun]

This thread reminds me of one A&E Dr asked me how often I tested. I told him 6-8 depends on exercise. He was in awe of my hba1c of 48 and how good my kidneys were.
I credited it to Metformin. A great med to protect the body from diabetes complications.

 

[Derbysocks]

Does your GP know you are required by the DVLA to test your bg every 2 hours while driving. This alone can cause the use of more than 4 test strips a day.

 

[teasytux]

In years gone by a GPs surgery would get paid more if each patients HBA1c is well controlled!
I'd almost forgot this nugget and do wonder if the criteria is still the same?

Tony

Hey Tony337,

Yes, my GP gets paid for every Diabetic Patient with blood sugar control under 7.4!

I just saw my GP diabetes nurse & I suggested that they give a % of the payment they receive as an incentive to those patients who keep under the limit & in turn help out those who are above the 7.4 limit.

She looked at me, shaking her head & just laughed! Well, nice to dream, eh!

Regards, Tux

 

[JC Durant]

I’d change doctor . I have been T1 for the same period . I used to use 15 strips a day. I Drive , go for long runs etc. Now I am on Libre . I test 50 times a day and my blood sugar HBA1c is now 5.7. My consult says it is low but that is untrue in my view if you test a lot and throughout the night if you have the right tools in my view. I would have no life or no food on 6 tests a day.

 

[clanders]

I'm so sorry to hear that your GP is not facilitating your frequent testing. I have brittle diabetes and am asymptomatic to hypos. My diabetic senior registrar told me I should be testing up to 6 times a day. Fortunately my GP gives as many Caresens strips as I need, at least 4 and sometimes 6 tubs. I now have a sensor and glucose monitor. We've been told we can have 50 test strips a day and that we have to check blood sugars when the monitor shows hypo levels or low reading. I have up to 6 hypos a day! I also have a fabulous GP and am confident I will be able to get more as I need them and use them! Politics have no place in care

 

[EllieM]

I'm so sorry to hear that your GP is not facilitating your frequent testing. I have brittle diabetes and am asymptomatic to hypos. My diabetic senior registrar told me I should be testing up to 6 times a day. Fortunately my GP gives as many Caresens strips as I need, at least 4 and sometimes 6 tubs. I now have a sensor and glucose monitor. We've been told we can have 50 test strips a day and that we have to check blood sugars when the monitor shows hypo levels or low reading. I have up to 6 hypos a day! I also have a fabulous GP and am confident I will be able to get more as I need them and use them! Politics have no place in care

I am so lucky that though I lose hypo awareness if keep my blood sugars too low (ie at normal levels) I regain it once I keep them higher for a while. Having said all that, I believe you can get aftermarket gear to make the libre have an alarm, so presumably you could set things up so that it alarms whenever you go below 4.5 (or whatever level you choose). Presumably this would mean that you could avoid hypos altogether? Or am I being naive? I'd be trying this if the libre worked for me (unfortunately it is hopelessly inaccurate in my case) but am considering self financing a dexcom and doing the same thing. I'm wondering if I would keep my hypo awareness if I set alarms so I kept my blood sugar above 5.....(Though I guess I wouldn't know because I wouldn't get the hypos, then.)

 

[ickihun]

But the OP is type 1 so probably not on Metformin.

I test as many times as needed, always over 7 per day for the best control possible even if that means more than desired by doctors or health care professionals would like. Everyone is different and will require different amounts of strips to help maintain control and should receive as many needed to help maintain their control.

Some type1s are like me, insulin and metformin.

 

[TerriH]

It seems now that finance is the priority and many diabetics are left to self manage as best they can. I have not seen my GP for over a year and have never had a diabetic team just a staff nurse at the surgery who knows next to nothing about diabetes but still has to carry out my annual review. After 52+ years of type 1 I must be doing something right but this is in spite of rather than because of the medical profession. You must stand up for your rights Mr Ben and tell your GP that in order to live you have to do your blood glucose tests and because the strips cannot be used more than once, you must have the quantity you are using. Ask him/her how they would cope if they were told that something which enables them to live as normal a life as possible with this awful health condition is restricted because of their budget!! I wish you the very best of luck and hope you can get a more enlightened GP.

 

[clanders]

I am so lucky that though I lose hypo awareness if keep my blood sugars too low (ie at normal levels) I regain it once I keep them higher for a while. Having said all that, I believe you can get aftermarket gear to make the libre have an alarm, so presumably you could set things up so that it alarms whenever you go below 4.5 (or whatever level you choose). Presumably this would mean that you could avoid hypos altogether? Or am I being naive? I'd be trying this if the libre worked for me (unfortunately it is hopelessly inaccurate in my case) but am considering self financing a dexcom and doing the same thing. I'm wondering if I would keep my hypo awareness if I set alarms so I kept my blood sugar above 5.....(Though I guess I wouldn't know because I wouldn't get the hypos, then.)

It's an interesting and quite challenging disease to live with. I meant in my earlier reply that I can get between 4 to 6 tubs of test strips a month. The CCG in Northampton have recently adhered to the NICE guidelines and now provide Freestyle Libre meters and sensors for diabetics who struggle with control or have high sugars. The Abbott device is okay, it's lovely to not have to stab my fingers innumerate times a day. The sensors fall out after day 9 and you have to wait 5 days for a replacement. There is a Continuous Glucose Monitor available from Abbott that can alert your own or other peoples phones when the blood sugars hit an agreed 'risk' level. I am now upgrading to this model and hopefully will be able to avoid my daily paramedic parties into the future. Good luck with your GP. Could you change practice to a more diabetic aware/sympathetic GP? It seems ridiculous that someone who works as hard as you do to manage your condition is then penalised for using the tools you need to do this. I think diabetic spending is concentrated on type 2 as this is pandemic .

 

[LooperCat]

I am so lucky that though I lose hypo awareness if keep my blood sugars too low (ie at normal levels) I regain it once I keep them higher for a while. Having said all that, I believe you can get aftermarket gear to make the libre have an alarm, so presumably you could set things up so that it alarms whenever you go below 4.5 (or whatever level you choose). Presumably this would mean that you could avoid hypos altogether? Or am I being naive? I'd be trying this if the libre worked for me (unfortunately it is hopelessly inaccurate in my case) but am considering self financing a dexcom and doing the same thing. I'm wondering if I would keep my hypo awareness if I set alarms so I kept my blood sugar above 5.....(Though I guess I wouldn't know because I wouldn't get the hypos, then.)

I’ve got the MiaoMiao transmitter on mine, and have alarms set for highs and lows. You can set different alarm thresholds for different times, so in theory yes, you could avoid night hypos.