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

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

  1. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I am T2 and have always had a meter and test strips, in NZ GPs give them out to all T2 diabetics so they can learn about the illness and in case they need to check while they are sick, eg tummy flu. We are allowed a box of test strips free per month. I certainly agree with testing up to 8 times a day for as long as needed, to learn what to eat and not eat. In my case this was a few months.

    I don't agree that paying for every T2 diabetic to have 8 or more free test strips a day forever is necessarily a good use of public health money. Theoretically, as long as the person knew what to eat to keep their diabetes under control, then regular blood tests ordered by the doctor and occasional home testing should be enough testing to manage the risk of complications. If a large number of test strips were made free for everyone, that would cost a lot of money, that would not be available for specialist appointments, insulin, tablets, GP visits, etc. Both extremes are bad - no free test strips, or free test strips for everyone. Drawing the line somewhere in between is more rational.

    I tested a lot when I was first learning about diabetes. Now that my HbA1c sits around the high 30s/low 40s I just don't need to test every day. I'm bored with the results, I'm not interested in constantly finding out that my BGs are fairly normal. It doesn't add value. But it's good to have a few test strips there in case I want to know for some reason.

    I fully agree that when a doctor or nurse tells someone they should not ever test, that is rubbish, and harmful advice. It's also not what the NICE guidelines actually say.
     
  2. Daphne917

    Daphne917 Type 2 (in remission!) · Well-Known Member

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    Looks good to me!
     
  3. MosheBenYehuda

    MosheBenYehuda Type 2 · Well-Known Member

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    Hi Kev,
    If you do a bit of research on the Glycemic Index and Glycemic Load of porridge, you will see that is VERY high, which causes unwanted spikes to T2s on Metformin -myself one...-.
    I might be good, mainly for tje insulin controlled diabetes, but otherwise to be cautiously considered...
     
  4. louch1

    louch1 · Well-Known Member

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    Wow I wish mediformin would lower my blood levels. It's a game of bingo with some if my levels. Sometimes I can be so good with my diet and exercise but I get such high readings . How as diabetics are we supposed to manage our lives if we get such stupid advice. Surely it's up to us if we test our blood.
     
  5. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    CatLadyNZ it would be great if they did give out meters to T2's in NZ but unfortunately that is now a thing of the past. I have spoken to quite a few older generation diabetics and they get their meter and strips from the doctor as you say but for newly diagnosed diabetics it is a fight to get them. I was actually given my meter from a Diabetes Nurse from a course I attended and I have always had to buy my test strips as my doctor said I didnt qualify to get either a meter or strips.
     
  6. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Wow, that must be a new thing, then. I get free test strips, so you might want to check with your pharmacist whether your doctor is right about that. Here is the relevant page from the Pharmac Schedule. It looks like we can get 50 strips on prescription, and more if we are on sulphonylureas, insulin, if we have gestational diabetes, or certain other conditions:
    http://www.pharmac.govt.nz/Schedule?osq=Blood glucose diagnostic test strip&code=C0115073802
     
  7. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    It is up to the individual doctor apparently as when I was turned down by the doctor, this was the ignorant one by the way, I was told T2's dont qualify so I emailed Pharmac as I was pretty p***ed and they told me it is up to your doctor. Thanks for the link though I will print it out and keep it for reference and the next time I have to go to the doctor I will take it with me and specifically ask to be given a prescription for test strips. It will be interesting as my new doctor is really nice and now my Hb is down to 34 they still might not let me have them.
     
  8. peterlemer

    peterlemer · Well-Known Member

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    several posts here have mentioned that metformin has little effect on BG levels. If so, then what is it prescribed for? I take 4 x 500mg plus 100mg januvia + 2 x 80mg gliclazide per day. My BGs are now within good limits and I am reducing my glic.
     
  9. dannyw

    dannyw Type 1 · BANNED

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    It helps with insulin resistance. It will have a small impact on BG levels but not much. It basically enables your body to better make use of naturally produced insulin.
     
  10. Erin

    Erin Type 2 · Well-Known Member

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    Hmmmm.... When I was first treated for Diabetes 2, I was given 3 tablets of Metformin (huge dose) and instructed to exercise and be on a diet (3 months or so). For some reason I did not reach a good number; infact the number was something like 17 so they had to add a sulfanurea drug which definitely lowered the blood glucose. This doctors may have confronted paitents who were not so advanced in diabetes as I was and it does sound like there is an economic need. I am very sorry to hear this, and I would not be surprised if the same problem will spread all over the world. Frankly, I do not understand the diabetic epidemic, especially as it has spread to poor countries.
     
  11. akindrat18

    akindrat18 Type 2 · Well-Known Member

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    My doctor today refused to give me testing strips even though i'm on sr-metformin, gliclazide, ramipri and invokana. My blood sugars are still not stable with my morning blood sugar at 13.7. I told my doctor and asked him for strips and to change my medication, he flat out refused me strips and told me that I should contact my diabetes nurse. I don't even have one yet as my doctor was suppose to schedule appointment with them and he will not change my medication even though I am still high and . I can't change my doctors as its based on my postcode. I cannot pay for test strips as i'm claiming JSA and half of that is or rent and the other half is for weekly bus travel and a gym membership that I can't get out of the contract.
     
  12. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I think the most important part of this problem is not being able to change your doctor... perhaps others in the UK can advise on what the situation is legally, as I thought people had a choice of doctor. Once you have a new doctor, they can review your meds and your BG levels and come up with an action plan to help you get your BG levels down. They should give you test strips if you are on meds that carry a risk of hypos. But it doesn't sound like your doctor understands that or even what your meds should be.
     
  13. robbo5662

    robbo5662 Type 2 · Member

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    Hi
    I have been told by my doctor I do not need to test,
    I have stopped testing but not because of what the doctor said but like you I was getting
    strange reading so I tested myself twice within 2 minutes and got 2 very different readings
    did it again and each time I got a different reading, between 5 and 9 I phoned the company up
    accu-check, they said that the readings were within there limits!!!
    so I don't waste my money on testing anymore,
    I just control by diabetes by eating the right food.
     
  14. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I guess the proof will be in the pudding, as they say. If your HbA1c level is ok, then you probably don't need to test, unless it starts rising. I prefer to test so that I don't get an HbA1c result that is higher than what I was expecting.
     
  15. kiskutya

    kiskutya · Member

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    I'm newly diagnosed T2. I'm 52 years old, female, overweight. My brother and father have both late onset T2. I've felt very unwell for approximately 8 months but having not been to the doctors in over 6 years I struggled through until my feeling unwell was affecting my ability to work or lead a normal life. I had moved areas so needed to register with a new GP. As a new patient I was offered full blood testing. This took place on 17th July 2015. Fearing the outcome might be diabetes due to my weight, family history, diet, lack of exercise I immediately searched the internet and found a recommendation on this site for LCHF so I immediately stopped eating bread, rice, pasta, potatoes, fruit juice, pastry, sweets, cake, below ground vegetables etc. I was given an appointment with the doctor for 26th July at which point I was diagnosed with high cholestrol (6.1). BG was high (8.5). BP was high (153 over 89). An appointment was made with the nurse to take more bloods - the result of fasting bloods HbA1c results were 58 (7.5). An appointment was made within a week to see the practice DN at which point on 29th July I was prescribed Ramipril 2.5mg 1 x daily, Simvastatin 40mg 1 x daily and Metformin 500mg 3 x daily. I was given a foot examination, a test meter, lancets, test strips, diet sheet, referral for Exercise Scheme, podiatry referral, eye test referral, referral for XPERT course and weighed. I started off taking the metformin but delayed the Ramipril and Simvastatin. The metformin immediately caused the most horrendous stomach upset with haemorrhagic diarrhoea necessitating A & E treatment. I stopped taking them. I had to wait 3 days for an appointment with the DN who prescribed Bolamyn 1000mg SR metformin (to be taken in the evening with/after food). My weight at this time showed a loss of 9lbs since 17th July (12 days). I put this down to cutting sugars from my diet. BP down to 118 over 70.
    I test daily, usually first thing after fasting o/night, and whenever I feel like it during the day (some days I don't test, most days twice, some days once, others 3 times. My 7-day average is 7.1 / 14 day 7.3 / 30 day 6.9 - fasted mornings tests vary between 5.8 - 8.3, after meals between 5.7 - 9.3.
    Having changed my diet completely and being on the medication I feel much much better, no symptoms that I had daily, no bloating, no ibs, no lethargy, sleepyness, shakyness, headaches or muscle fatigue.
    I try to eat breakfast if only 4 Finn Crispbread with butter, 30g Philadelphia cheese, and blueberries. I take my Ramipril 1 x 2.5mg, Fenugreek 1 x 610mg, Chromium 1 x 200ug with breakfast, (and Simvastatin 1 x 40mg and Bolamyn 1 x 1000mg after my evening meal).
    I'm trying hard to be a 'good' diabetic - have cut out as much sugar as I can, read every nutrition label, don't drink fruit juice or alcohol or fruit squashes or sodas, avoid bread, pasta, rice, pastry, cake, sweets, puddings, bananas, prepared 'tv supper' style meals and fast food takeaways.
    Thgis site was recommended by my DN (who is also T2). I find my new GP practice to be 'on the ball' with my diabetes. I hope to be joining a diabetes 'self help' group locally and my appointments with my DN are scheduled fortnighly.

    I apologise for the long winded response as a first posting but wanted to explain for newly diagnosed UK diabetics what they could hope to expect from their GP/DN.
     
  16. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Thanks for posting, that was a very interesting description of best practice for doctors and nurses in dealing with T2 diabetes. I wish more of them would use best practice instead of causing stress and poorer diabetes management outcomes with their outdated advice and often rude behaviour.

    I think your BG levels will continue to gradually improve if you keep eating with low carb, higher fat methods. I'm glad the SR metformin is helping, without causing bad side effects.
     
  17. debdebc

    debdebc Type 2 · Well-Known Member

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    This subject shows the best and the worst of the NHS. I am very lucky and grateful that I have a really good G.P. and my exeperiences to date have been very positive.

    I am stunned that the Health Service think they are saving money by restricitng monitoring, how are we supposed to know how we are doing if we dont test?

    I realise how lucky I am, but just starting this journey I do know that if I need to, I will fund my own testing, I am working out the costs compared to all the expensive take away **** I used to eat :)
     
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  18. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I am lucky to live in a country where most T2s can get 50 test strips per script without too much bother. If I need more than that I buy them myself. I am testing a lot at the moment as I am making some positive changes with my eating. However, I can understand governments not paying for unlimited test strips for T2s and I will explain why below. I don't agree with the harsh restrictions and unprofessional behaviour from staff that seems to happen a lot in the UK. I think it would be better if the approach was more like NZ's.

    I believe that T2s need plenty of test strips when they are starting out, or making changes, or are sick, etc. But using up to 8 strips every day, week in week out, doesn't seem a good use of limited health funds. I don't think long term daily use adds value to diabetes outcomes eg by preventing complications and early deaths. Daily use for a few months and sporadic use here and there does add value because it can get the person on track to send their diabetes into remission and keep it that way. Once the person has learned how to do this, I think if they want to monitor every meal all of the time, they should fund that themselves. The money saved could be used to educate HCPs to provide better care for the most unhealthy diabetics.

    I believe it's good to fight for better prescribing of funded test strips to T2s, to enable remission and its maintenance, but I wouldn't join in with fighting for the amount of strips that T1s get.
     
  19. Fuggs

    Fuggs Type 2 · Well-Known Member

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    Hi guys, I will chuck my two pennyworth in the hat for what its worth...

    I was diagnosed as T2 going on T1. with strong insulin resistance [I am 65] my MMol was usually 9-18. My Doc wanted to put me on metformin but I felt this was masking the problem not solving it. Did a lot of research. Lots..

    Newcastle University have it sussed which bizarrely my Doc. didn't know anything about???? Why wouldn't a so called professional want to be up with current medical findings? When I gave him a copy of the trials and published data he dismissed it as a fad.....So he knows more than Newcastle BioMedicine research..Yeah....NOT

    http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

    As they say, "It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss."

    So after reading all the junk my Doc gave me about balanced diets, grains, fruit, low fat diet etc etc the same old misguided tosh we have had thrown at us for the last 20 years [Which clearly isn't working as Diabetes is even higher now despite us all being on the lowest fat consumed for years] I binned it all and decided to go go on the Low carb high fat diet, much to the horror of all around me. I decided to train my body to burn my fat for energy not the carbs I eat.

    4 weeks on my morning BG test is usually 7 ish, [The dawn phenomenon] which I am working on, but it is getting lower.
    After breakfast my postprandial BG then drops to about 4.8 to 5 within 3 hours then slowly down over the day to 4 - 4.5 [ish]

    http://www.diabetesselfmanagement.com/blog/controlling-the-dawn-phenomenon/.

    But I NEVER - EVER miss breakfast now. Ever....Its a fallacy to miss breakfast in the hope your BG will drop. If you do your liver will dump more glucose into your blood to make up for lack of it from food and to supply you with energy for the day [Dawn phenomenon again].
    Eat some fatty food, salami, fatty pork/ Oily fish [NEVER Tuna, too much mercury in it] and and the BG drops nicely.

    Two/three scrambled eggs, few chives, chunks of fried Polish bacon mixed in and a good dollop of thick cream in, topped with 2/3 tablespoons of organic grass fed unsalted butter.

    Set for the day, never get hungry for 4/5 hours. No afternoon flagging like the old days and I stay on low carb food, lunch maybe big salads, and I mean big, half a Cos lettuce etc. 1/4 Avocado evry day, loads of mayonnaise, [Home made of course], Olive oil and Mackerel fillets, NEVER any bought salad cream or dressings.....deadly stuff.

    Dinner big plate of steamed vegetables, cabbage, Brocoli, [No carrots or root veg.] loads of butter or coconut oil. small handful of meat or fish, my BG never goes above 5.

    If I have a sandwich or any appreciable carb other than veg it rockets to 7/8 plus. always, and takes ages to come down unless I exercise hard to burn the glucose. [1/2 hour usually did it]

    Coffee is black with a big dollop of thick cream....no sugar...Tea the same.

    Dont eat bread, rice, potatoes or anything white. No fruit [Fructose] Other than fish and meat etc. No breakfast cereal trash, scrutinize every box/packet and jar label if its got more than 3g carb don't touch it.. Always fry in organic coconut oil.
    NEVER any oil such as Canolo, Palm oil, etc.etc. all junk.

    Social drinking is Becks Blue beer, [only 3.8 carbs, no alcohol] or 100ml of red wine topped up in a tall boy glass with soda water.
    Dining out is alwasy steak, large salard loads of butter. NEVER chips, onions rings or junk like that [carbs...] Sweet is cheese no biscuits.
    Do drink loads of Volvic water. [Has lots of Silica in it good for Aluminium removal]

    I always used to drink 2/3 good measures of Scotch every night but have now gone off it.

    My LDL gone down, HDL about 85, Triglycerides down big time.[Yes despite all the fat ?......]

    I always walk more than 10K steps a day or cycle for an hour or so.

    I also check my BG 3-4 times a day with AccuCheck Mobile tester and keep a full food diary.

    Definitely a low carb high fat diet suits me, and I have much much more energy than before and nicely dropping pounds as well. [Was 90.6 Kg, now 83.4] Dont miss carbs, dont want or need them.
     
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  20. Mose

    Mose Type 2 · Newbie

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    I'm T2 and I am on insulin and Met.

    As others have said this is about COST not what is good for the patient.
    That stroppy 111 Doctor needs a rollicking.

    Metformin SR gives me the guts ache ( the guts rumbles sound very loud) It also give me the eartha kitts after taking it. I'm better of with insulin only.

    I have been testing for a number of years even before being diagnosed and I find that my fasting is always high ( dawn phenomenon?) but the rest of that day is adequate.

    Before, when I was pre diabetic, supposedly, my HBA1c was good, and still is. So I am not sure why docs are so hung up on the fasting test as a diagnosis.
     
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