Just been told I should only test twice a day.

This is just the standard line adopted by individual practices and PCT's to save money. Your health apparently doesn't come into it.

As you have found, tight control of Bg levels is achieved by frequent testing until such time as you are fully aware of what the different foods/drinks do to your Bg levels.

There is an ePetition running on the No10 website at the moment which covers this and other matters. The link is available elsewhere in these posts. Do a search on 'Petition' top right and you should find it.

Ken.

I test mine between 4 and 8 times a day (average of 6 strips a day)
Testing twice a day is definitely not enough on MDI.
You need to be able to test your levels before meals to know what dose to take, at bedtime to know if you are high enough to go to bed without something to eat, before exercise and sometimes after exercise, after correcting hypos and before driving. The last is extremely important and the DVLA advice is to test before driving and every 2 hours during long journeys.(see http://www.diabetes-support.org.uk/dvla_6240.pdf)


The appropriate NICE guidance is rather vague but notice the point about personal preferences.

Self-monitoring of blood glucose control
• Advise use of self-monitoring as part of an integrated package including:
– appropriate insulin regimens
– other diabetes education. D
• Advise use of meters and strips chosen to suit individual needs (but not use of sites other
than the fingertips for self-monitoring). D
• Advise a frequency of self-monitoring depending on:
– characteristics of an individual’s blood glucose control
– insulin treatment regimen
– personal preference in using the results to achieve the desired lifestyle. D
• Teach self-monitoring skills close to time of diagnosis and initiation of insulin therapy. D
• Interpret results in the light of clinically significant life events. D
• Reassess skills, use of results and equipment used at least annually.

Click to expand...

It may be that your nurse is unused to dealing with people on insulin, let alone MDI. I would point out to her the reasons why you need to test more often. If you log results annotate them , show them to her as proof of their usefulness.

ive been told i dont need to test more than a couple of times a day while im stable but im on mdi and test b4 every meal and also if i feel off and will continue to do so

I had exactly that experience this week, being told by a pharmacist that I only need to test twice a week!!! My doctor wont prescribe more than 1 X 50 strip canister at one time.

I was diagnosed type 2 in March this year and have been testing at least 4 X a day. I am using Metformin 4 x 500mg and Humulin S and L.

As was said in a previous post how am I supposed to know how much insulin to administer if I don't know what my bg levels are?

I find it hard to believe that so many differing opinions are given over testing. Hospital diabetic nurse told me test before each meal and at bedtime, pharmacist said 2 x per week! and doctor seems to thing 50 times a month is fine.

Who is right

Download and print off the link to the DVLA about Insulin treatment and Driving that phoenix posted earlier. Show it to your GP and Nurse then tell them you will hold them resposible if you have a Hypo while driving.

You might just get all you need. :twisted:
Ken.

The usual advice for T2 not on insulin is twice weekly. I would say once a day would be enough and rotate to different times each day. It's not ideal, but works.

Twice a day is totally insufficient for Type 2s. For Type 1s IMNSHO it amounts to malpractice.

This was my Bible

http://loraldiabetes.blogspot.com/2009/ ... -test.html

as a Type 2 once I had gained sufficient control and predictability I was able to reduce the frequency but I would NOT recommend that for anyone using insulin

"Now you're on Lantus you only need to test once a week", that was in Canada.

so we are not alone

are you type 1 or 2/

I have type 1 and test before every meal, otherwise how would I know how much insulin to give (whether or not to make adjustments if my bs is high) I also test if I am about to drive anywhere. I used to test a lot more but have been advised not to test between meals. I recently did the DAFNE course and following this a letter was sent to my GP surgery to say I had done this and they should provide me with plenty of test strips. Ask at your hospital if they can speak or write to your GP.

I have just received my new 3 year licence from the DVLA and enclosed with it is the leaflet that Phoenix mentioned.

QUOTE:
"Carry your glucose meter and blood glucose strips with you. Check blood glucose before driving (even on short journeys) If blood glucose is 5.0mmol/l or less take a break before driving"

Now lets say you do 2 x school runs, 2 x work trips & 1 shopping trip, then by the DVLA advice you will need to test 5 times a day before worrying about before or after meals.

I will be showing this leaflet (# DIABINF) to my GP and see what he says!!!!

GOOD MORNING,

MY WIFE AND I TEST MY B.S. UP TO 12-15 TIMES A DAY, OF COURSE WHEN DRIVING IT IS CHECKED WHEN STARTING OFF, THEN AT REGULAR INTERVALS, THIS IS TO ENSURE THE SAFETY OF MY FAMILY & OTHER ROAD USERS.

I HAVE 4 BLOOD METERS, 1 IN THE CAR, 1 DOWNSTAIRS, 1 IN THE BEDROOM & 1 IN THE COMPUTER ROOM, THIS IS FOR MY SAFETY & TO STOP ME HAVING PANIC ATTACKS.

I HAVE TO BE WELL STOCKED WITH BLOOD STRIPS, I HAVE A PRESCRIPTION FOR 100 STRIPS, USUALLY ONCE A WEEK, I AM WELL STOCKED.

MY DOCTOR DOES NOT HAVE A PROBLEM WITH THIS, BUT RECENTLY MY WIFE PICKED UP A PRESCRIPTION, A NOTE FROM ANOTHER DOCTOR SAID THIS MAN HAD SOME STRIPS RECENTLY, WHY DOES HE HAVE TO TEST SO OFTEN, MY REPLY WAS WHY NOT, I HAVE TO LIVE WITH THIS CONDITION YOU DO NOT, WHAT WOULD YOU DO IF YOU HAD IT, LIKE YOU SAY WHEN YOU DRIVE YOU HAVE TO BE SAFE.

IF YOU ARE CAUGHT DRIVING WITH LOW BLOOD SUGAR YOU COULD LOSE YOUR LICENCE, PLUS FACE CHARGES TOO.
IT IS IMPERATIVE YOU TEST YOUR BLOOD SUGAR AS OFTEN AS YOU NEED TO, REGARDLESS OF WHAT HEALTH OFFICALS SAY, IT IS YOUR LIFE, YOU HAVE TO LIVE WITH IT.
WHEN YOUR BLOOD SUGAR IS UP OR DOWN YOU HAVE TO CHECK ON A REGULAR BASIS.

LAST WEEK ONE DAY MY BLOOD SUGAR WAS CHECKED 3 TIMES DURING THE NIGHT THEN SEVERAL DURING THE DAY, 17 TIMES IN ALL, MY HEALTH IS THE MOST IMPORTANT NOT THE COST.

CARRY ON TASTING, GET YOURSELF STOCKED UP ON BLOOD STRIPS, DO TAKE THE GOOD ADVISE SO FAR. BE SAFE, BE HAPPY, BE CONTENT, SAFE DRIVING, TEST REGULAR, THE ANSWER IS, WHY SHOULD I NOT TEST REGULAR. BLACKBIRD.

I'm type 1 and test on average 2 or 3 times a day. Always before bed and usually at one other time during the day. I vary the time at which I test so I can get an idea of my control level.

If exercising, I always test before exercise.

Regarding correcting bg levels with your mealtime insulin, the advice I was given was this:

"It is most important to focus on getting the correct insulin dose with the meal you are eating."

I was discouraged from correcting at meal times - unless it is an extreme result. If you are applying a corrective dose with the mealtime insulin, how will you know whether the insulin you injected for your meal was correct. By focusing on getting the mealtime dose correct, the levels you get 3-4 hours after will sort themselves out.

It is possible to control your bg levels effectively with 2 tests a day as long as you learn from those test results and use them to forward-plan and not just use them for an instant corrective measure.

Having said that, if you apply the principles I've talked about to more frequent testing, you'll accelerate the learning and be able to dose the carb portions more effectively, and sooner.

Sam.

The practice nurse told me that, as a type 2 on low dose Metformin (she always makes this point - low dose) of 1 x 500 mg after breakfast, and after the evening meal, I will not go too low but this untrue. I have been as low as 2.9 mmol. mid morning when I have done extra activity and quite a few times down to 3.6 mmol. She says that even she goes as low as 3.6 mmol but as far as I know she is not diabetic. I get hypo symptoms, like my legs go to jelly and I shake when as low as 3.6 so I would not like to be driving when this happens. If I ate something carbohydrate without testing I may not be low and then will probably find out that the bg level is too high to have lunch but then without a meter wouldn't know that. Because I did have use of a meter before (as the doctor at the surgery who is not there now told me to get one and the surgery did provide strips until a year ago) I do know how easy it is to be too high a couple of hours after eating) so I buy my own test strips and lancets and therefore cannot be dictated to how often I test except by my pocket which does not allow me to use my glucose meter as often as I would like. I make sure I take glucose tablets when out and about. I find gardening such as digging and hoeing better to do in the afternoon as I don't have a tablet after lunch and my lunch lasts me until the evening meal.

Hi
Your profile says you are type 1 if this is the case you will need to test more often. I test before every meal so I can dose adjust as per my DAFNE course intructions- before bed and then before / during exercise and during hypos etc.

My repeat currently has 200 (4 x 50) strips but I am hoping to get this increased at my next review as I seem to be always at the chemist! If any doctor complains I will say that I am only following the course instructions and that if they didn't want me to do so then my local area should not run the course (see I am already for the fight!)

Louise

Dear all.

I am new to this forum but I have experienced a similar issue. I race at a senior level in large cycling races and train as much as poss hence I test 7-8 times a day.

My doc suggested to me I was addicted to testing and on digging the PCT had seen fit to red flag my use and they wanted to reduce my strip allocation to one box of 50 a time as I always got 4 each perscription and renewed when the last box was opened.

I have an avg BS reading from my Hospital visits of 6.1 - 5.9 and 6.0 i.e. perfect and like everyone else think its a nonsense a bean counter is unilaterally deciding to cut my use.

A quick call to Hope Hospital's diabetic clinic sorted it as they wrote to my doctor explaining the long term consequences/cost of me not controlling my BS far outway the cost of a few strips and all is once again rosy.

Also, the DVLA point is valid and hence the defence rests.

Good health to all!

three1ne said:

Ive only ever had 1 lot of blood strips on prescription at one time. 50 in a tub. Lasts around 1 week. What I would do to have that increased..! But considering I started this thread because ive been told I use too many.. I doubt it.

Click to expand...

That is amazing :shock: , I wouldn't have been surprised if you were type 2 and they always have trouble but a type 1 is expected to test, how else do you ensure you are taking the correct amount of insulin?

With each prescription I get at least 200 strips. I test all the time and especially on days like today when I am quite ill.

I think it's ridiculous to suggest that anything less than 3 times a day is sufficient.
I'm on insulin and I need to know what my BG's are before I can calculate my dose.

I went to the chemist the other day to try and buy some strips as I had run out at work and I was told they cost £25!! So i can see where the health service are coming from in terms of cost but they are vital part of a diabetics life.

Hi DUNNOCK

I think its really impressive that you test that many times. I try to test 6 - 8 times a day but I think if I ever get a car or have my own family I'd have to adopt something similar to what you do.

Thing is, don't your fingers get sore? Or do you test on the arm too?

I'm type 1 and my GP will only prescribe 1 x 50 strips per month. Yet again-the Welsh don't pay for their prescriptions which is great-but those that need do need to look after themselves on a permanent long term basis get shafted.
Last GP in England would prescribe as many as I needed, and would encourage me to do at least 3 blood tests a day, but did warn me that the PCT may write to me as he was prescribing too many strips. I never heard anything from the PCT.