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Letter from GP

Tubs
Thanks for all that. I now have a rather large headache and I think I am going to lie down !!
Ken

Catherine: You betcha !!
 
Sorry mate :) treatment of diabetes needs to be consistent across the three territories, its knowing where and how to start. My feeling is that NICE recommendations are broad enough it just that locally we need to ensure PCTs are meeting the needs of their diabetic community.

I do think that the interpretation of NDST guidelines are insufficient for newly diagnosed type 2s but these are things that can be individually negotiated between patient and GP especially if we can demonstrate how to use SMBG.

Regards, Tubs.
 
My negotiations with my GP go something like this:
I want ............
He gives.........
I'm happy........
Then again, I am much bigger than him !

I've still got that headache and it's getting worse :roll:
 
You obviously declined the obligatory aspirin prescription then :)

Regards, Tubs.
 
So far I've been luck with getting strips on prescription but I'm now using about 8 a day while I find out what I can eat foodwise.
When I mentioned this to the DN on Monday her reactions was "Oh - do you really want to test that many times a day ?"

Well actually no I don't WANT to test that many times a day - however I do NEED to test that many times a day

how do you get through to them ?
 
Do what I did, explain how you're using the results and demonstrate the benefits of your interpretation.

Regards, Tubs.
 
Showed her the nice graph I printed out with resluts from the my lifestyle tab on this site

She smiled and nodded

( I think they're getting wise to us ) :lol:
 
Dear Tubs I just went online to the "Treatment Prescription" thread, To be honest it isnt anything more than a printout of the familiar dogma with a liberal sprinkling of links. I dont really think it will appeal to anyone who isnt likely to look after their condition in the first place or indeed those who might not like to question the system. Being cynical that just leaves the "Troublemakers" and life is just tooo short.


Dave P
 
Dave,

An important part of the information prescription is a description of what treatment to expect from the NHS - if we don't know what to expect, we won't know when we're getting poor treatment.

You and I will just have to disagree on how attempts are made to improve the treatment we receive from the NHS. You're quite right, there are those who won't question the system but can I recount an anecdote?

Well I'm going to:

I met a midwife from Bedfordshire recently, who spent some time in the same hospital that my daughter was born in, she was telling me about the difference in expectations between patients in Dragonette's birthplace and of those in her current hospital. In the former, patients were often relieved to get any service at all and made very few demands, whereas in the latter her patients had higher expectations and made possibly more excessive demands - which patients are right?

I return to an earlier point, treatment of people with diabetes has to be consistent across PCTs, this is what the Diabetes NSF is attempting to do, the National Framework for treating diabetes demonstrates the establishment acknowledge how important that tenet is. Unfortunately five years in and there doesn't appear to have been much improvement - patients need to be able to expect and make use of the highest level of treatment. Now, we can sit on our rear ends and moan that the NHS is failing and is a waste of tax payers money or we can do something about it. Me? I prefer to try and do something about it.


Regards, Tubs.
 
Dear tubs, might i suggest that the ones you need to convert already know how to use the system to their advantage.

Cynical from experience
Dave P
 
I have no problem getting strips at the moment but I totally agree with whats being said. They should be available to anyone who needs them. I think the general public education about diabetes is rubbish, its like we need to make them be diabetic for a day to understand that if we don't test, how do we know what our blood sugar levels are?!? I think we should form our own 'diabetic union' where we, as patients, argue for what we need to manage our condition effectively. Maybe we should point out nice and loudly that if we don't effetivley manage our condition now, when we all get old and our feet fall off they will be spending a hell of a lot more money in treatment to look after us. We all pay national insurance and tax, shouldn't we get value for money?

Also i think it may be worth aproaching someone who will be willing to research/ review the effects of the NHS prescribed diet for diabetics, to see if that is really the best form of treatment. I think that there are enough people on here that can demonstrate the benefit of low carbing, especially for type 2s. The only way things change is if a 'new discovery'/'new report' is brought out and we need to get the people on the board who advises the goverment on health related matters, on our side.

Count me in for campaigning for diabetics rights!!
in fact i have an idea... how about informing local MPs or even higher up healthcare ppl, about the issue, and then inviting them to an event where they have to become diabetic for a day and have to do lots of different activities where each time they need to test their blood sugar or something. that way they might understand the importance of the strips.

i can't say they'd actually turn up though....
lol

Nomi x
 
I am an insulin dependent type 2 diabetic. I have no problem getting test strips at the moment but am aware of the volatility of NHS attitude to spending.
As I am in the first 2months into the first 3 months of a basal bolus insulin regime I am testing anything up to 10 times a day and occasionally more if I am driving.
If I could not get the test strips :-
How could I adjust my pre meal injection? Need to know pre-meal BG level and carb count to calculate units.
How could I drive safely? DVLA say test every 2 hours when driving.
Prior to the new regime I was on Novomix 30 twice daily, testing 2 or 3 times a day and my BG readings were up and down like a roller coaster varying from 4.5 to 20.
At the same time as I went on the new regime I switched to a low carb diet and the results are brilliant. My Basal injection has been reduced by 25%, my average Bolus injection has reduced by 20%, I have lost 1 stone in weight and my BG control is brilliant my fasting BG is averaging 6.02 compared with 8.3 prior to the new regime and low carbing.

I would like to thank all the contributors to this forum as I have learned so much about my condition from this site and am gradually finding lo carb replacements for hi carb foods.

I am baking Fergus's bread all the time using his recipe with the addition of 0.5 teaspoonful of bicarbonate of soda which I find makes for a lighter loaf.

I get lo carb tagliatelle from http://www.lowcarbmegastore.com/ and am baking biscuits from recipes on
http://www.lowcarbiseasy.com/

Once again Thanks all

Phil
 
Even when you get strips you may be dissuaded from using them properly

− avoid pursuing highly intensive management to levels of less than 6.5%.

that line is now in all the NICE documentation I read recently, I'm pretty sure it wasn't there a while back. ACCORD is to blame of course.
 
Trink,

NDST protocol is to "monitor for deterioration" if an HbA1c is < 6.5% as quoted in their summary of guidelines published in Oct 2008.

Regards, Tubs.

Edited to point to source document on NDST website
 
I cant make up my mind whether that is depressing or not!!!.

Given the constant bombardment of " Growing Epidemic" which would indicate a deteriorating situation, and the many many references to T2 Being denied test strips which should indicate a stable situation. Or it could be a bit of Ancel Keys type analysis.
For myself i havnt been stopped but i did take graphs in at my last to blood tests and asked loads of questions ....which of course you dont know enough to ask early on.

Its silly oclock and i really must get a life
Dave P
 
tubolard said:
Trink,

NDST protocol is to "monitor for deterioration" if an HbA1c is < 6.5% as quoted in their summary of guidelines published in Oct 2008.

Regards, Tubs.

Edited to point to source document on NDST website
Click to expand...

So what they are basically saying is, don't try to do better than 6.5% although we know you will get worse . . .
 
Trink,

I'm not sure...the way I read the NDST summary is "yeah, OK, NICE recommendations are..., but you need to set a target with your patient" which is what I did with my GP. And this is what we should be arguing for - a position where the patient is involved in their own target setting rather than having one foisted upon them by well meaning clinicians.

Regards, Tubs.
 
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