If they advise testing, more people will see how the dietary advice is wrongI don't like the Self Monitoring advice. I think it should be encouraged for those who want to use it. It was only because I was self monitoring that I found out what some carbs were doing to my blood sugars and took action. The nurse tried to convince me that Weetabix was really good for me until she looked at my readings and agreed for me it wasn't good.
Agreed, but NICE is only concerned with drugs and Big Pharma. They do now include some guidelines about diet and weight control, but as pointed out these are perhaps a little behind the times. They do not yet support 'eat to meter' testing which I think is where you were heading.... it is still difficult getting self monitoring support, These new guidelines seem to be less restrictive than they were, and now ask the physician to engage with the self monitoring process (which is new i think) But you only get strips if you are on certain drug therapies, or a Newbie. Or an out-and-out Hypo chondriac. I like the new additional advice to steer clear of foods specially made for Diabetics, and also the fact that they have come clean about cost being a major consideration when choosing drug therapies. (transparency I suppose). They also introduce the concept of the patient being able to turn down treatments that they are not happy with (<<the person's individual preferences and needs>>)If they advise testing, more people will see how the dietary advice is wrong
Agreed, but NICE is only concerned with drugs and Big Pharma. They do now include some guidelines about diet and weight control, but as pointed out these are perhaps a little behind the times. They do not yet support 'eat to meter' testing which I think is where you were heading.... it is still difficult getting self monitoring support, These new guidelines seem to be less restrictive than they were, and now ask the physician to engage with the self monitoring process (which is new i think) But you only get strips if you are on certain drug therapies, or a Newbie. Or an out-and-out Hypo chondriac. I like the new additional advice to steer clear of foods specially made for Diabetics, and also the fact that they have come clean about cost being a major consideration when choosing drug therapies. (transparency I suppose). They also introduce the concept of the patient being able to turn down treatments that they are not happy with (<<the person's individual preferences and needs>>)
They also introduce the concept of the patient being able to turn down treatments that they are not happy with (<<the person's individual preferences and needs>>)
Do I detect a change of thread here? I take it you are worried about the recent move to introduce a bill in the UK to allow doctors to use unlicenced drugs and drugs that have gone 'off patent'. That attempt was fillibustered out, but may come back. And yes, we have a right to be worried, but it needs to be in its own thread. I use the term ;Big Pharma' because they have a monopoly through NICE, and can charge what they like while under patent. What the bill should have done is to allow other manufacturers to produce generic alternatives, but (and this is crucial) still require it to be under licence control and purchase through NICE as all our drugs are at the moment, not sneak them in by the back door bypassing NICE.The HCP won't force you to take drugs, it's always your choice .
I probably wouldn't be happy if pharmaceutical companies decided to stop manufacturing.
And I certainly wouldn't be as happy if we decided little pharma from a garden shed enterprise was better than a multi national with a proper production facility.
In the Real World such things happen. But at least we have it in writing from the Comittee itself, and can take it up with higher authority if we need to. Even the Do IT or Die mantra has lost some of its power now,When you do that .. they mark your record as being non compliant and then refuse to see you ... the wife has done that (Not for diabetes) and got the teeshirt
You raise a very good point here. I too was surprised to see the Glitazones still being recommended as a general issue drug,. I was on Actos for some time, but got taken off after my heart attack. I had previously been on Avandia, but in that case it got banned before I had my heart attack. The NICE recommendation is for Actos only , which is pioglitazone.I wonder why NICE doesn't recommend Metformin SR if the standard version causes problems until later in the document? Why would NICE recommend a sulfonyl urea (Gliclazide) which will stimulate the pancreas to produce more insulin when many T2s have too much already hence the Metformin? I 'like' the way NICE skirts round the dietary advice on carbs. You can see that they spent a lot of time carefully wording it to avoid upsetting the HCPs fixated on lowering fat and salt having carbs with every meal. Very sad that none of this is evidence-based and NICE is the one body supposedly using evidence-based advice. Glitazones are generally now considered unsafe if the evidence for that is reliable so why are NICE suggesting the use of them other than by rare exception?
Might I suggest Price! Why bother to save patient sufering, if you can save a penny!I wonder why NICE doesn't recommend Metformin SR if the standard version causes problems until later in the document?
Some cannot cope with Metformin, but deal with Gliclazide relatively easily!Why would NICE recommend a sulfonyl urea (Gliclazide) which will stimulate the pancreas to produce more insulin when many T2s have too much already hence the Metformin?
Might I suggest Price! Why bother to save patient sufering, if you can save a penny!
Some cannot cope with Metformin, but deal with Gliclazide relatively easily!
As a T2D who is prescribed both Metformin (standard) and Gliclazide (also standard) I thank NICE for allowing me to get these on scrip. I was moved onto the modified release of both drugs this year, but returned to standard because I found the MR versions pushed my levels up in both cases, and I was unable to adjust either timing or dose to compensate. We all know NICE is price driven, and this year this has officially been declared as a criterion for drug selectionWhy spend a fortune of NHS money, that could be much better used, on a course of treatment that is normally for life, simply because some patients initially have an upset stomach, which usually clears up after a short period.
I had no issue with metformin, and didn't particularly want the NHS to waste the taxpayers money.
If you do have an adverse reaction, fair enough.
Treatment tailored to suit the patient works both ways.
NICE should be, and has to be, price driven./,,,,/.
Provide cost effective drugs, and your market share will increase.
Unfortunately, in a monopoly market, and a sadly increasing but captive audience, then market share will still increase regardless of price. The only way that could change is to assist other manufacturers to bring generics to market.
Yes I agree. I was perfectly happy to be given the cheaper older version of Metformin to try first, as it happens it suited me fine. Why waste money even if it is only pennies?NICE should be, and has to be, price driven.
The taxpayer hasn't got bottomless pockets, and it's a message that needs to be very clear to the drug suppliers.
Increase the costs, and you will drive themselves out of the market.
Provide cost effective drugs, and your market share will increase.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?