Must I Do As I'm Told ???

[Thommothebear]

my diabetic nurse told me that if I did not already have a meter then they would make me use te meter with the cheapest strips, but as I already had one that I had been using for a while and was happy with they could not force me to change it and so they still give me a prescription for at least some (but nowhere near enough) strips. I guess this might just be my PCT's rules though

 

[Henry_Sugar]

And how are you doing now with Lantus?

ok thank you. As normal I think it takes a few months for the body to adapt to ANY new insulin.

Things appear to be balancing out finally...... 8)

 

[Henry_Sugar]

I'm type 1 and wonder how I'll feel if I get switched onto a particular meter.

As it happens, I've used the GlucoRx and the problem I'd have over my OneTouch Verio IQ is that often I need to test out and about. The Verio IQ has a case that makes this pretty easy to do without any kind of table or shelf. If I had a GlucoRx (which doesn't have a nifty case), I'd be struggling a bit to find places to do a blood test and would likely have to squat on the floor of shopping centres and supermarkets if I felt my levels were going a bit low. If that puts me off testing sometimes it could therefore increase the chance of possibly severe hypos occurring.

In terms of readings of 15, 17.4 and 20.3, this alone is not unusual. Meters are meant to be within 20% accuracy 90-odd per cent of the time. So if your actual result would clinically be tested at 17.5 say, then all readings would actually be within the specified accuracy range.

I know it can be annoying as 1 unit too many as a possible result can easily be the difference between a normal sugar level and a hypo.

In terms of hypo symptoms, I've found my symptoms have evolved over time. I used to get a tingling tongue often as a child. Then I had bad hypo awareness around early adulthood. Now in my thirties I tend to get an urge to bite the inside of my mouth, develop teary eyes and start yawning.

I think I'd be inclined to test a bit more often each day (unless you're testing 8+ times a day already) and start writing down any symptoms you do get.

There may be some symptoms (difficulty concentrating, feeling slightly more anxious, getting frustrated etc) that you may at the moment be taking for granted because they're not the ones you've been used to depending on.

All the best
Ed

Well when I got my flu jab on Monday the nurse there said she had been changing a lot of type 1 people because the new machine (the GlucoRx) had been causing so many complaints.

Re : Hypo symptoms, thankfully it would appear they are starting to come back 8)

thanks for your thoughts and kind words....

 

[Henry_Sugar]

Hiya Henry,

Approx 9mnths ago my GP changed me to a wavesense jazz tester as the strips were cheaper. However, the tester could not cope at all with temperature changes - the amount of times during the winter having to sit in the car warming the meter up, or when going for a run again having to warm it up first (armpits and groin proved most effective - in case you where wondering!) not good! Also during the summer left tester in hotel room out of sunlight, with curtains drawn - this time too warm!!

I raised the subject @ 6mnth review with consultant, apparently she had had many complaints from various people and therefore was happy to redirect GP to prescribe alternative strips for a new meter - all has been fine since. However, the GP said he was not aware of any problems so I think you should give your consultant or diabetic nurse a ring/email for support.

Well because I've started "carb counting" my DN has given me a new machine, thankfully..... 8)

 

[midlands girl]

Hello everyone :wink:

Just a bit of background info, I'm a type1 Diabetic taking Humalog & Lantus insulin. I live in Staffordshire in England 8)

Yesterday I received a letter from my Doctor stating that "in accordance with local NHS guidelines" that I must now use the GlucoRx Nexus meter. Also my repeat prescription had ALREADY been changed to GlucoRx lancets n strips.

Well I understand that the NHS wishes to cut costs & that the GlucoRx strips are cheaper & I have no problem with that at all.

After checking the review of said meter (http://www.diabetes.co.uk/blood-glucose ... meter.html) I became very worried to read some of the comments posted

Now bottom line I have only recently been changed to the Lantus insulin & am having some issues getting my blood lvls correct so for the moment it's a challenging time for me. The last thing I need right now is a inferior blood meter to test my blood :twisted:

Do I have ANY say is this matter? Is there anything I can do so I can continue to use my old blood meter ?

The other strange thing is from this link below, I was looking for staffordshire NHS guidelines & found this :-

http://www.stokeccg.nhs.uk/news/diabete ... trent-758/

Right at the bottom of the page it states the meter that has been picked is the WaveSense Jazz ????

Many thanks to anybody taking the time to reply...... :thumbup:

Hi there, Just joined this forum and have been looking through the threads and this one really struck a chord. A few weeks ago I received a letter out of the blue from the doctor saying that there would be a choice of 3 meters, which we had to change to, in order to save money for the NHS. A deal had been done with 3 companies, everything all done and dusted! Saving money I understand. However this was done with absolutely no consultation of anyone with Diabetes. I have been more anxious, stressed and upset over the past few weeks than in the whole of the last 13 years since I was diagnosed! In the letter it also said "Sally (the practice nurse) has been very brave and tried out all the monitors ..." OMG I was beside myself. What made her an expert on what is needed in monitors just by pricking her finger once or twice, when we have to do it 40+ times a week!! I tried the first one (True sense mini) - very fiddly, not user friendly and it Errored 3 out of 10 times due to the amount of blood required; now trying the second one (Pura). Better size but still the same problem of the amount of blood needed, which is already making my fingers sore. Feel like I have gone back several years and am so angry that no patients were even consulted or had a questionnaire or anything. It is SO patronising... Anyway rant over, sorry, but am interested to see that similar is happening elsewhere. Mind you, you'd think there would be some consistency across GPs/PCTs, or is that too obvious?! ) EJ

 

[ElyDave]

Surely standardisation of strips is dependent on the meter principle?

Different meters work in different ways, my AcuChek mobile works on IR where my glucomenLX is eletrochemical and there are others as well.

There's also the issue of ketones, T1s should have a meter that can measure ketones, so if they are being changed to those that can't they should be arguing strongly against that.

I'd also say that those who are on pumps have an argument for meters that integrate with their specific pump, so that may mean different meters for different pumps, so it's not a clear cut argument.

Then there's the arguments of usability, vision, feeling/dexterity etc.

I got the AcuChek Mobile because I thought it would be easier on the bike and out running - turned out that it was very tempermental. I used it in parallel with the Glucomen for a while and found that pre-exercise it always read much lower than the Glucomen, post exercise they were similar, but the main issue was that the AccuCheck failed to give a reading at least one in three times, claiming that the sample size was too small when I'd just tested on the glucomen with no trouble

 

[smidge]

I got the AcuChek Mobile because I thought it would be easier on the bike and out running - turned out that it was very tempermental. I used it in parallel with the Glucomen for a while and found that pre-exercise it always read much lower than the Glucomen, post exercise they were similar, but the main issue was that the AccuCheck failed to give a reading at least one in three times, claiming that the sample size was too small when I'd just tested on the glucomen with no trouble

Dave - I use a Mobile and had the same problem with my original one. It turned out to have developed a fault. I rang Roche who took the details and sent me out two new ones (one to use and one as a spare) which I received the next day. I had to clean the faulty one and send it back to them in a pre-paid envelope.

I'm really hoping that my surgery doesn't force a change of meter on me because I use the mobile to test while on the move, in meetings etc as it doesn't require faffing about with test strips, sharps etc. I know my PCT has just made the decision to standardise on some unknown meter taking cheaper strips, but I don't know whether we are going to be forced to change. Time will tell I guess.

Smidge

 

[mo1905]

I agree currently different meters work in different ways but this doesn't mean they cannot be standardised. We used to have VHS, Betamax and Video2000 but VHS became the norm. The NHS has such power with it's spending that in theory it should be able to tell the manufacturers what specs they require and get it made. I know there will always be those who want to choose a certain style of meter but it just doesn't make business sense. Would I be happy if I was forced to change my meter ? Probably not ! Would I accept it ? Yes. If I was in charge of NHS spending would I standardise testing meters ? Absolutely.


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[mo1905]

I agree currently different meters work in different ways but this doesn't mean they cannot be standardised. We used to have VHS, Betamax and Video2000 but VHS became the norm. The NHS has such power with it's spending that in theory it should be able to tell the manufacturers what specs they require and get it made. I know there will always be those who want to choose a certain style of meter but it just doesn't make business sense. Would I be happy if I was forced to change my meter ? Probably not ! Would I accept it ? Yes. If I was in charge of NHS spending would I standardise testing meters ? Absolutely.


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[smidge]

My real concern around this is that we will see the end of any developments, improvements or innovation in diabetes care. At the moment, the big companies recoup all the R&D and support costs in the price of the consumables. I know the strips etc are way overpriced and that needs to be tackled, but R&D isn't cheap and these companies are in it for profit - remove the profit and the R&D will cease - and I can't see the NHS direclty funding that. I hope I'm wrong!

Smidge

 

[mo1905]

My real concern around this is that we will see the end of any developments, improvements or innovation in diabetes care. At the moment, the big companies recoup all the R&D and support costs in the price of the consumables. I know the strips etc are way overpriced and that needs to be tackled, but R&D isn't cheap and these companies are in it for profit - remove the profit and the R&D will cease - and I can't see the NHS direclty funding that. I hope I'm wrong!

Smidge

I get your point but this would have to be agreed as part of the cost. I still believe it can be done so much more cose effectively. Trust me, I'm not saying I want this to happen, it's nice to have a say in meter choice etc. I'm just saying there is certainly a business case to be made to standardise equipment. If I broke my leg, I wouldn't expect to be able to choose my crutches, I'd use what was provided.


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[ElyDave]

I agree currently different meters work in different ways but this doesn't mean they cannot be standardised. We used to have VHS, Betamax and Video2000 but VHS became the norm. The NHS has such power with it's spending that in theory it should be able to tell the manufacturers what specs they require and get it made. I know there will always be those who want to choose a certain style of meter but it just doesn't make business sense. Would I be happy if I was forced to change my meter ? Probably not ! Would I accept it ? Yes. If I was in charge of NHS spending would I standardise testing meters ? Absolutely.


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you haven's anwered the point about meters integrated with pumps etc, there's a whole load of different pumps out there with different characteristics that suit different users. Should we standardise those as well? What about standardising insulin while we're at it?

 

[mo1905]

I would think pumps could be standardised ! I am just saying it is possible, not that I'm advocating it. Are you saying then that there is no way they can be standardised ?


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[Scardoc]

you haven's anwered the point about meters integrated with pumps etc, there's a whole load of different pumps out there with different characteristics that suit different users. Should we standardise those as well? What about standardising insulin while we're at it?

Tricky issue. On one hand you have to argue that providing the best individual treatment will lead to fewer diabetes related complications and thus save the NHS money in the long run. However, on the other hand, we're £1.3TN in debt now and 10% of NHS spending is going on diabetes. Are there too many products out there? Is it necessary? If you look at the NHS as a business it has tremendous spending power and could that be better utilised?

Choice is great but the reality is the spend needs to be reduced now. What's the result if the financial state gets any worse? Means testing?

 

[ElyDave]

10% of NHS spending on diabetes.

What fraction of the £1.3TN debt is that?

What fraction of teh NHS busget is being spent on maintaining a choice of meters, strips, insulin types and pumps for T1? Considering T1 is about 1% of all diabetics, I'd say not much.

I'm quite happy on Levemir and Novarapid - switch me to Lantus I'd probably be less happy as it's characteristics do not match my needs.

Standardisation is OK to a point where it can be justified, but I don't think this is one of those cases.

 

[Westie2]

Switching to one of the cost effective strips will save the NHS millions across the country. Prescribing is under pressure and although we do not like change this is less challenging than other cost savings.


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[mo1905]

10% of NHS spending on diabetes.

What fraction of the £1.3TN debt is that?

What fraction of teh NHS busget is being spent on maintaining a choice of meters, strips, insulin types and pumps for T1? Considering T1 is about 1% of all diabetics, I'd say not much.

I'm quite happy on Levemir and Novarapid - switch me to Lantus I'd probably be less happy as it's characteristics do not match my needs.

Standardisation is OK to a point where it can be justified, but I don't think this is one of those cases.

We're talking about standardising BG testing strips, that's all. Not insulin. It would be a huge saving, year after year. It could be done. That's all I'm saying. I'm not saying I want it done. Do you think it is impossible to do then ?


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[Scardoc]

Around 2.9M people in the UK have diabetes, approximately 4.6% of the entire population. 400K have type 1 which is 0.06% of the population and 13.8% of all diabetics.
It doesn’t matter how much of this accounts for the £1.3TN debt we have. Doesn’t matter at all. What matters to Westminster is reducing the deficit, that’s reducing and not eliminating. They are happy that this year the deficit is only looking like being around £90BN.
The justification behind standardisation or cheaper test meters will never, at this moment in time be about the needs of the diabetic patient. It should be. It will, however, be a cost issue.

 

[Alanp35]

Around 2.9M people in the UK have diabetes, approximately 4.6% of the entire population. 400K have type 1 which is 0.06% of the population and 13.8% of all diabetics.
It doesn’t matter how much of this accounts for the £1.3TN debt we have. Doesn’t matter at all. What matters to Westminster is reducing the deficit, that’s reducing and not eliminating. They are happy that this year the deficit is only looking like being around £90BN.
The justification behind standardisation or cheaper test meters will never, at this moment in time be about the needs of the diabetic patient. It should be. It will, however, be a cost issue.

Interesting facts n figures - many thanks.
I doubt that the best interests of any one with diabetes will be taken Into consideration when making these decisions; it is the finances that is driving this alignment. It is happening in every business up and down the land.



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[cally]

Hi,
I received a similar letter last year. I didn't want to change from my Contour next as I am quite happy with it and have several of them which I keep in different places at home and at work.
So I told my GP that I didn't wish to change and she seemed quite happy with that.
I can see why it would be a good idea if strips were cheaper. But I think it would be better to put pressure on all the manufacturers to reduce prices instead of trying to fob us off with cheaper versions which are not reliable.