Money saving or being bloody minded?

[Mervyn]

Hi,
I had an appt yesterday with the nurse for diabetic foot clinic at the GP. I asked the nurse why I am no longer having my yearly
GP diabetic clinic with associated blood tests.

She told me that it was really now down to my DNS. As I told her that I have only seen the DNS once face to face, and the other times I have to ring her twice a week on her mobile,the nurse booked me in for this Monday for HBA1C and other bloods.
She then goes on to tell me why I did not automatically get blood tests.

Apart from the fact that is should now be down to my DNS, the GP surgery has been informed by the Dr in charge of Diabetic services in our area, that NO diabetics need to have fasting blood tests!!! Although I have had very high Cholesterol and extremely high triglycerides for years, and on the maximum dose of Lipitor and other medications, I am no longer to have regular (yearly :crazy: ) fasting bloods due to this decree.

Now is this to save money or the head of Diabetic services just being bloody minded?

 

[the east man]

Probably a bit of both. It also explains why diabetes is so out of control. The NHS has no one to blame but themselves for this epidemic.

 

[Mervyn]

Yes and with the stoppage of test strips for most type 2 sufferers ,I get them as I am on Insulin, I suspect that as they keep banging on about obesity and the diabetic epidemic, they will eventually stop the free prescriptions for Diabetics on medication!

 

[hanadr]

Every diabetic should be getting a battery of 15 tests annually.[Check DUK website for the list] Even once a year isn't really enough. I arrange a set of tests through my DSN each 6 months. I never have a problem with that. I just ring and ask for the request sheet for the path lab. My vet brother has said that he monitored his canine and feline patients at least once each 3 months. {he's retired now]
Hana
PS if you are being denied your annual review, complain to your PCT via the local PALS[Patient Liaison Service] group. Number on-line They have rules about how long it takes to answer you.

 

[LittleGreyCat]

Is the issue a fasting blood test?
AFAIK these are used in the early months of diagnosis, but after that the main blood test is for HbA1c to measure long term BG control.
Are you being denied all blood tests, or just the fasting one/

 

[Mervyn]

hana I will speak to the DNS today if she returns my call!! I have been having a Fasting Blood test at least once a year for years as my Trigs should be 1.7 and have been absolutely way,way above that and my cholesterol is very high and indeed I have cardiovascular disease and have had some small strokes in the past.

But the surgery nurse tells me that the chief in charge of Diabetic Services has decreed that no Diabetic needs a fasting blood test!!!! absolutely amazing and unbelievable but that is what they are saying!! maybe they have given up on me!!!

 

[hanadr]

Mervyn
I'd strongly recommend a low carb diet. I too have had a stroke. Just one, but it was a fairly biggie. I've worked had to overcome the effects. Despite common beliefs, the best way to lower cholesterol is low Carb not low fat. I know medics don't believe this is good for you, but they know their dietary advice doesn't work, but keep repeating it. Probably in the hopes that the next time things might change. They haven't grasped that EVERY time you drop something, it falls. Perhaps next time it will float upwards.
Hana

 

[Mervyn]

Hi Hana,
I am trying to cut my carbs (I find it very hard) but I am getting there bit by bit!! I am going to try soya and linseed bread this weekend as the wife is going to buy some. I will get there eventually though. :?

 

[IanD]

Professional negligence - a new concept in patient care.

Mervyn - I am appalled by your "treatment." Don't be afraid to talk to talk to other people - especially your local pharmacy. Is there a local patient support group?

I endorse what Hana says about low carb. It transformed my life.

 

[Mervyn]

Hi Ian,
Thanks for your reply...the only Diabetic group that I know about is the one run by the NHS at our local hospital!! My GP has been very good for the last 30yrs but it seems that Diabetic services are now run from a small community hospital quite a few miles away. My GP cannot even prescribe Insulin. I had to see a DNS and that has been the only time I have seen her!

I get the impression that the GP and nurses at my surgery are quite upset about this. I just hope that they are not using us diabetics as pawns in some sort of political game!! :thumbdown: Maybe that when you reach pensionable age they think it is not worth the effort!!!

Mervyn

 

[phoenix]

or crossed wires?
Most of the annual checks for people with diabetes don't need to be fasting tests . There are some people whose doctors insist that even for an HbA1c people should fast when there is no reason for it to be, some doctors also prescribe regular fasting glucose tests, rather a waste of money after diagnosis. Maybe the this is what he meant when he wrote that people with diabetes don't need to have fasting checks.
Just googling I found this on a docs website

Once a year you should request an annual non fasting blood test (full blood count, kidney function,
HbA1C, thyroid function, lipids). Please bring an early morning urine sample with you. One week
later you should visit the Practice Nurse for a check up and to discuss the blood test results

.


As you see all the blood tests are non fasting. They are however vitally important to monitor your health. They are also important for the income of the GP practice. If you don't have at least an annual check and relevant blood tests then your doctor will not be able to tick the appropriate boxes to fulfil the quality standards for diabetes If this were the case for most of the patients on his/her list with diabetes, then they wouldn't get paid for getting enough patients above those targets.
diabetes standards here:
http://www.nice.org.uk/guidance/quality ... andard.jsp

Some cholesterol tests can be done non fasting. An non fasting test is OK for measuring total, and HDL cholesterol, so for many people that's all that is thought to be necessary.(by the NHS) A full lipid profile ie total cholesterol, low density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides is normally done fasting (though was evidence reported in the press a couple of years ago suggesting that wasn't necessary )

As you have a particular history of stroke and high trigs you should ask your doc if you should continue to have a full lipid profile. (and if not, why not)

 

[IanD]

Hi Ian,
Thanks for your reply...the only Diabetic group that I know about is the one run by the NHS at our local hospital!!
Talk to other patients there - compare notes & complaints. Patient power!


My GP has been very good for the last 30yrs but it seems that Diabetic services are now run from a small community hospital quite a few miles away. My GP cannot even prescribe Insulin. I had to see a DNS and that has been the only time I have seen her!

I get the impression that the GP and nurses at my surgery are quite upset about this. I just hope that they are not using us diabetics as pawns in some sort of political game!! :thumbdown: Maybe that when you reach pensionable age they think it is not worth the effort!!!

It is a very serious matter if your GP cannot care for his patients. An I passed pensionable age 8 years ago - & I still expect, & get the care I need & expect.