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NHS Direct doctor says... NO testing when taking Metformin

Discussion in 'Diabetes Discussions' started by 999sugarbabe, May 7, 2015.

  1. 999sugarbabe

    999sugarbabe · Guest

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    Sorry for the length of this, it is all relevent...

    I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

    I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

    So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
    I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

    Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

    When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
    He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
    I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
    I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
    I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

    The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
    WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

    For information my reading(s) that day were:

    On waking (my normal testing time) my reading was 7.4
    I don't eat breakfast, as a rule.
    At 1215 (before eating) and after 12 hours + without food it was 12.0
    (Lunch was eaten about 1300)
    At 1410 it had reduced to 8.1
    At 1515 it was 5.8
    I ate again at teatime.
    But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
    I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

    Anyway, if you are still awake after reading all this...
    Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

    How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

    Puzzled.
     
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  2. Croc

    Croc Type 2 · Well-Known Member

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    Nice guidelines state that diet controlled or Metformin only don't need to test.

    Are you taking Metformin in the morning and not having breakfast? Because thats not good.
     
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  3. 999sugarbabe

    999sugarbabe · Guest

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    Hi Croc,
    Yes I take 500mg Metformin twice a day.
    I cannot recall the last time I had breakfast since my childhood. Instead I go for the occasional morning snack once I've been up a while and my juices have settled.

    As for "NICE guidelines" I believe their only reason for saying this is financial, not medical!
     
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  4. sanguine

    sanguine Type 2 · Well-Known Member

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    NICE guidelines are bonkers. If you want to test to check the impact of meals on your BGs or for any other reason it's none of their business. And GPs and other HCPs have no right to give stroppy lectures to us about it. I bet they'd test if they had T2, and I bet they wouldn't follow the Eatwell Plate either.
     
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  5. 999sugarbabe

    999sugarbabe · Guest

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    Diabetics are continually being told to take responsibility for their illness, yet HOW are we expected to do so without testing?
    If I had not tested I would not have even known my reading was so high (12.0 is HIGH for me). I wouldn't have sought advice and could have made the situation even worse. With a family history of strokes (both parents), and suffering with high B.P; cholesterol, DVT's etc I need to be careful.

    I normally use my one and only daily test (which I take before doing anything) as a guideline. From it I can see any trend occurring with my diabetes. If I only got tested as part of my yearly diabetes examination (done by the practice nurse at my G.P's), a lot could change in that year.

    I suffer with several other conditions which, when combined with diabetes, puts me in a higher risk category. I do not want to lose my limbs as a result, as I live alone with no help and I would be unable to do so if I were to be rendered even more disabled.
     
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  6. Enclave

    Enclave Type 2 (in remission!) · Well-Known Member
    Retired Moderator

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    Yes we live in a mad world .. I think most people are ordered NOT to test if their taking metformin .. We are also ordered to eat high carbs .. I personally was told to drink sugar drinks if I felt unwell ! If I had not got my own meter I would have never found out that this was the worst advice I could have ever been given ! Pushed my sugars into the 20s .. So the wife stepped in and I now am testing regularly (self funded, without involving the Dr) and I now low carb high fat with very little sugar .. My bloods are all coming back normal and I have lost 5 stone in a year without feeling hungry. I have also been taken off of metformin, so diet only control.

    I am forced to manage this condition without the full help of my medical team.

    Regards your high sugar levels ..could it be your body releasing sugar for you .. As you had not eaten, small and regular meals are better than one big one .. I found that one out early on in my self testing.

    Hope you are feeling better soon
     
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  7. desidiabulum

    desidiabulum · Well-Known Member

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    Sir David Nicholson, head of the NHS, used test strips systematically to monitor his T2 diabetes and has been evangelical about it -- and he wasn't even on metformin:
    http://www.theguardian.com/society/2014/may/16/diabetes-me-nhs-chief-david-Nicholson

    This should be hurled back at ANY HCP who dares to say that testing is only for avoiding hypos, rather than for regulating sugar levels. How it should be paid for is a separate issue.
     
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  8. Croc

    Croc Type 2 · Well-Known Member

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    As far as I'm aware food helps Merformin work which is why it should be raken with or straight after food. Taking it on an empty stomach is probably worthless which is why its doing nothing to reduce your levels in the morning.
     
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  9. lynne99

    lynne99 Type 2 · Well-Known Member

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    Hi, When I was on Metformin morning and night, I used to go to bed with blood sugars at 5.4 ish and wake up in the morning with anywhere between 15 and 20. The diabetic nurse at the surgery (brilliant :)) recommended and provided test machine and strips. Eventually I was put on insulin which solved the problem. With that and low carbs I now have little trouble. Go talk to your doctor or diabetic nurse and see if they can help you find a sensible way forward. The doctor you spoke to had little knowledge and even less bedside manner.
     
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  10. Daks

    Daks Type 2 · Well-Known Member

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    A good doctor will always advocate tight control regardless of NICE stipulation.
     
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    #10 Daks, May 7, 2015 at 2:56 PM
    Last edited by a moderator: May 7, 2015
  11. Daibell

    Daibell LADA · Master

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    What madness and we pay for it in our taxes. Metformin only ever has a small effect on blood sugar so there is no strong advantge in testing for it's effects BUT you do need to test to see what foods affect you and if you are a mis-diagnosed LADA as a T2, like I was, then testing let's you know something isn't right without waiting a year for the next HBa1C. Some of these doctors haven't a clue.
     
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  12. graj0

    graj0 · Guest

    Supposedly there was some research done that showed taking BG didn't help diabetics in fact was more likely to cause them worry. They must have gone out of their way to pick those people who were, shall we say politely, a bit on the panicky side when they did that piece of research.

    They'll be telling us that we shouldn't check our BP either. I think they quote the research because it justifies them not supplying test strips any more, so all very political.

    May I respectfully suggest you ignore this particular KNOB, I remember mine went up to 23 and the emergency doctor I saw wasn't worried in the slightest. I have no idea what was happening but like you, at least I knew what my BG and therefore had a rough idea of why I felt rough.

    This whole thing about monitoring is a classic case of the medical profession not singing from the same song book because in the last 3 years I've had 2 three day stays and one four day stay in hospital and each time they have made sure I took my own BG, even using my own meter if I wanted to.
     
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  13. Tm6t7

    Tm6t7 Type 2 · Well-Known Member

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    My GP and nurse are brill, I'm T2 and on 500mg metformin at tea time and I asked for a meter, the nurse said 'no problem and I'll get you strips and lancets on prescription ' it's helped me no end. I guess it's the luck of the draw, which is ridiculous as they're meant to work to standards (the same standard would be helpful!!)
     
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  14. chri5

    chri5 Type 2 · Well-Known Member

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    I think the reason we are told to take metformin with or after food is to avoid stomach upsets. As someone has already said, metformin has a fairly minimal effect on blood sugars. It is also very common for bg levels to rise if you haven`t eaten for a long time, I know mine do. As for not testing, someone on this forum once said, " would you drive a car without looking at the speedometer?".....says it all for me! It`s YOUR body and if you wish to self test then it`s no damned business of a doctor who doesn`t even know you.
     
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  15. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    It is your body, it is your diabetes, you have learnt how to control your condition, because you have been through it.
    The idiot hasn't, he is following the wrong guidelines.
    This forum is necessary because of the stupid advice given by our health care.

    Control.is the key to feeling well. You know this.

    I had to fight through all the ridiculous unknowing doctors.
    I had to fight for my test strips even though it is so necessary for my condition.
    I have eventually after years of misdiagnosis, got myself in good health.

    The problem the NHS has is that there are so many unique symptoms and what suits someone doesn't suit any one else. Everyone is unique. But the advice is for everyone no matter the different symptoms and other problems.
     
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  16. DianaRose

    DianaRose Type 2 · Active Member

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    Metformin should be taken with or after food because it is highly acidic and can cause stomach problems. I take 500mg although my Diabetic nurse says I may come off it in August. I was diagnosed in December last year just before Christmas! Anyway my BG was 15 then. The nurse suggested a meter although I couldn't get one on prescription and she said to aim for around 9/10 at first and was so supportive. I am lucky I know. Now I have had the results of my HBac1 etc and my average came down to 8. For the first time today I hit 5! I was amazed and so chuffed but wouldn't have known without my trusty meter. I am usually about 8/9 fasting in the am. I tested my BG for everything I ate that had carbs in it and have been amazed at what I can't eat anymore but don't care. I think having a meter should be compulsory and ignore anyone who says you shouldn't have one.

    By the way I feel unwell now when it goes to about 11(rarely) or drops very quickly. But I know that is what it is now so just go carefully. Pleased you are ok though.
     
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  17. mrspuddleduck

    mrspuddleduck · Guest

    There have been numerous articles about the 111 service and how incompetent it is on relation to giving specific advice. My advice COMPLAIN about the service you received! Specifically, that you were spoken to in such a way that you felt too intimidated/scared/worried to call back when you needed further help so the doctor concerned directly put your health at risk. They should investigate, and if you give them details of the date and time of the call they should be able to identify the doctor and "retrain" him. Regardless of the politics of testing, it was NOT HIS JOB to comment whilst acting in the 111 advisory role so his comments were both inappropriate and harmful. Your complaint may just save the next callers life!!!! Sue xxx
     
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  18. plonkish_

    plonkish_ Type 2 · Well-Known Member

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    I had a similar issue with my doctor. He was pleased I had managed to get my BG level down and I told him that was because I had learnt what to eat and what to avoid through testing. As soon as I mentioned testing his eyes widened and he told me I shouldn't test because that would cause me anxiety and there was no need. I just told him that if it wasn't for the testing I would be on medication by now (I'm T2 diet only).
     
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  19. Bewildered

    Bewildered Type 2 · Well-Known Member

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    Not testing in T2 is a cost thing, my nurse told me not to bother as eating right and taking mess wil rule out the need.... Mm mm. Could it be that your body released sugar because you had gone so long without food?
     
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  20. Cornman

    Cornman Type 2 · Newbie

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    I have Type 2 and the one thing drummed into me was have breakfast, especially porridge, because it has slow release of energy .
    I think you're poor body is being starved of energy for hours, which means it starts drawing what resources it can muster up, having gone into panic mode. This, I believe, results in a whole load of sugary stuff being sourced from the far reaches of your body, resulting in sky high blood-sugar readings. Diabetis UK called its magazine Balance for a very good reason - unless you have a balanced diet, and that means regular meals, you'll get eratic readings, which are not good for your well-being. Force yourself to have breakfast, ideally porridge and you'll quickly notice the difference.
     
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