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

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

  1. graj0

    graj0 · Guest

    Not sure I understand, if you are insulin resistant, metformin would help better response to the insulin being produced or taken. It also lowers the amount of sugar created by the liver and decreases the amount of sugar absorbed by the intestine.(Source: http://www.diabetes.co.uk/insulin/diabetes-and-metformin.html) Doesn't sound like masking anything.
     
    #261 graj0, Aug 23, 2015 at 1:47 PM
    Last edited: Aug 23, 2015
  2. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    Actually, all GPs in NZ do not give out a meter and test strips to all T2 diabetics. And there is no official allowance of one box of 50 test strips per month. You have been lucky with your GP, and treatment, and perhaps your pharmacists! The official line is
    (from recent correspondence with a NZ GP): "Unfortunately the blood glucose metre and strips in NZ are only funded if you are a diabetic and on sulphonylurea medications." Diabetes.org.nz was rather less forthcoming with info - "Pharmac is the government agency that decides what medicines and related products are subsidised for us in the community and public hospitals. They can be contacted on enquiry@pharmac.govt.nz or 0800 660 050". But my own NZ GP says the same thing as Dr quoted above, as does a very gruff but straight talking NZ pharmacist I spoke to about the issue.

    There are some wonderful Practice Nurses, and formal Diabetes Educator Nurses who do in fact give out blood glucose meters , which can then be backed up by sympathetic doctors, pharmacists, and many practice nurses. But you, me, and those medical professionals are playing fast and loose with official guidelines. Thank goodness!

    I got my meter as part of one of the government-health-service self-management courses, which although preach the ghastly food pyramid and 1/4 plate of carbs at every meal, ARE very good in many other ways - just not on diet. (Reading labels, reading the meter! Discussing emotions, and activity possibilities.) And the practice nurse of my much appreciated much trusted GP has been very supportive, as has a pharmacist. But it is not entirely 'kosher'. More's the pity!

    There is much room for healthy lobbying in NZ, also, when it comes to promoting self-management and tight control of BG for diabetics.

    Also, I do want to say, good health support from the medical profession, and perhaps from other diabetics! should not be in the form of big pronouncements on what is reasonable or good for everyone, especially when it comes to the expenditure of public funds. And the use of test strips! Although, I am very aware that I am also being prescriptive by saying - I do not support being prescriptive! ;):) And I must say - particularly on the grounds of boredom!

    I am lucky that I also live in a country (Sweden) that allows me a very generous supply of test strips, officially. I know what it means when this crucial part of my treatment is not a hassle to procure at all, and is supported by the country/tax payers and the medical practitioners. (It is quite simply - wonderful.)

    But before anyone erroneously believes Sweden to be a diabetics' nirvana - many other health services that NZ does easily and generously (like blood tests!) (not to mention accessibility to either a doctor or a practice nurse) - Sweden has its own very real deficiencies. And even though it is THE country for LCHF - that does not mean a diabetic doesn't have to listen to 20 minutes on how to eat bread as part of an official diabetes-management course. (Is there anywhere THAT advanced yet? Not as far as I can see!) (And I say that as someone who regularly crosses the globe with my T2D :-/.)

    I personally use testing my blood glucose HUGELY as part of my gaining as tight control as possible. I would have a very enthusiastic conversation with any health professional, not to mention another diabetic! who wanted to tell me exactly how many test strips I should be using on public health per day! I believe, quite rightly, that what I am doing now is preventative of what could be huge costs to not just me in terms of my life, but to the health services of the countries I live in. Kidney dialysis is very expensive, hospital stays for hypoglycemia/ketoacidocis, CVD etc - very expensive. As is treatment for being blind, amputations etc, less we forget. The test strips I am using in the first years of my diabetes, I hope, will be preventative of dire complications and expensive treatments by allowing me great insight into the affect of food and activity on my wonky blood glucose, that will stay with me for the rest of my life. And because I am only in my early 50s - I hope that will be many many years more.

    I say - yay for test strips generously dispensed on public health!

    (Lobbying the companies that charge a fortune for them is another matter!)
     
  3. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Actually, the Pharmac Schedule is quite clear, 50 test strips available per prescription. The MOH guidelines are also clear that meters and test strips can be given to T2s. If you are in NZ and your GP didn't offer them, then I suggest trying a different GP, and if necessary showing them these two sources:
    http://www.pharmac.govt.nz/Schedule?osq=Blood glucose diagnostic test strip&code=C0115073802
    and pp. 58-59 of:
    https://www.health.govt.nz/system/files/documents/publications/nz-primary-care-handbook-2012.pdf
     
  4. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    You're a hard task master CatLady! :). But I will put aside watching Eastenders while I eat my morning cheese on paleo bread-toast, and read the blasted handbook now instead... (Burnt my toast reading the pharmac thing - we have different ideas of boring! But I am actually grateful for someone forcing me to read the regulations) (I was SOOOO hoping to merely get away with quoting medical and pharmacy professionals!)
     
  5. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    Relevant bit from handbook (Gee I am pleased you popped in the page numbers - struth!)
    "SMBG [Self Monitoring Blood Glucose] may be of value to individuals with newly-diagnosed type 2 diabetes who as part of self-management wish to determine the effect of changes to food or exercise on their blood glucose levels. Selected individuals may benefit from continuing SMBG where this is having a positive impact on their management. "

    Righto. I am very pleased to read that! But being a "selected individual" is very different to hassle-free, bargaining-free prescriptions - ie I can see how my enthusiastic bargaining has assisted in me getting test strips in NZ! And yes - only 50 test strips at a time - which is what the pharmac regulation said - only lasts me a week. What a bore for me, the practice nurse, the pharmacists, and I have to say - contributes wildly to my stress levels! And stress ain't good for my BG! That is what procuring test strips on the state in my home country is like. (And I can see why it was relatively easy when I was newly diagnosed last year, but was not nearly a year later.)

    In Sweden I get 300 test strips, every month and a half. No hassle. I just fill in a form and off it goes. And the 300 test strips come back in the post. Yes - cost free. My Diabetes Nurse does not need to be bargained with. (However I can wait a month and a half for an appointment with her. And this is rather common in nurse and doctor-deficient-in-numbers Sweden. And don't get me started on talking about bargaining for a ruddy doctor's appointment! The test strip prescriptions are not linked to my appointments though.) My Swedish GP, when I actually get to see her, did not blink an eye, or figure out if I was a selected individual or not. Or need to consider what is 'newly diagnosed'. Stress and hassle-free.

    That is what I believe should be the model for really good diabetes care when it comes to test strip availability. But that's just me.

    And last but not least - suggesting I change GPs in NZ was... a little over-enthusiastic in offering a suggestion? I understand liking to give advice, as I do too - it's how we are helping one another, and share info, which is marvellous. But I actually said in my piece that I have wonderful GPs. We were actually discussing official regulations - and had nothing to do with me requesting advice on GPs. Just a note there!

    But I thank you profusely for getting me to read the actual official regulations. (And I rather like knowing I was individually selected! lol.) And the reading of the official Kiwi regulations is thanks to you for making it easier for me to do so. Thanks again for that. (Now I am going back to catching up on Eastenders ;):).)
     
  6. Apple tree

    Apple tree Type 2 · Member

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    Sorry what's.LADA mean
     
  7. Apple tree

    Apple tree Type 2 · Member

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  8. graj0

    graj0 · Guest

    I can see Apple tree was only quoting this so my comments refer to the original writer.
    I've seen this mentioned several times, is it personal opinion or is there some empirical evidence to back it up? My pancreas produces adequate amounts of insulin (I paid for my own c-pep test) so my major problem is insulin resistance.
    What worries me about these sorts of statements is that if you say them often enough and in a convincing enough manner everyone starts to believe it. Trawling through the immense number of articles on metformin I haven't come across anything that say it only has a small effect. Although some mention that it also helps lower total cholesterol and trig levels.
     
  9. storyman

    storyman Type 2 · Member

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  10. DeepBlue

    DeepBlue Type 2 · Newbie

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    Hi
    I was giventhe same advice when I was diagnosed type 2 and found it strange that the doctor advised me not to test my bloods so I would not be given a meter.
    It was the same when I was put on Glicazide do not test bloods..... even on Glicazide (i know its spelt wrong) however when I went to see my diabetic nurse (who was useless) but I asked her and I got meter from her eventually.

    IMHO I think that the NHS is not giving out blood glucose test meters to T2 diabetics in a short sighted ploy to save money, but it just means that we go through our days with being able to test our bloods and feeling like **** while our diabetes symptom get worse just so NHS gets to save £10M.
     
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  11. treborc

    treborc Type 2 · Member

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  12. Blonde45

    Blonde45 Type 2 · Newbie

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    Hi I have just been diagnosed with type 2 and put on metformin. My doctor.....who is filling in for the diabetes nurse....has told me I don't need a Meyer to test either. He said that the readings aren't important as its the HBA1c that tells you how your diabetes is going as this tells you an average over the last 2 months. I now have to wait till December to find out how things are....I was diagnosed in June, confirmed in July and have only just had my first clinic appointment now. My brother is also type 2 yet was given a Meter etc. Don't know what to think about this as on here seems to be lots of people measuring their BG. Confusing to say the least....and the dizziness and tiredness he's not even interested in which scares me!!!!
     
  13. treborc

    treborc Type 2 · Member

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    My GP is really good and he said if your going to take the medication the metformin then let the medication take the strain and you should diet to take your weight down, cut out and eat a good diet and that should be enough, he said it would be really hard for you with this drug to control by testing.

    If you decide not to take the drug and your going to control your bloods by fasting or diet then you will need to test and if you do that he would give me the testing equipment and show me how to do it.

    He tests me once ever three months until he was satisfied my diet and my bloods were under control, he did say people can get really worried they wake up in the morning take a reading and it is high, then they do not eat breakfast and the reading is still high because your getting all worked up come lunch you retest and it still hight, but you have not eaten breakfast so why would it be lower .

    So you really do need to have a good old hard chat with your GP if not sure then ask for a second opinion your entitled to do so by law, he will either send you to another GP or the hospital or the clinic .

    I've been told not to test any more because after a year they knew the medication was working my test were all within range.

    If you do not trust your doctor or have issues then ask the local NHS for the data on testing this will be universal and will have nothing to do with costs..


    Robert
     
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  14. storyman

    storyman Type 2 · Member

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    Hi all. When I was first diagnosed with T2 the Consultant told me to test my blood every day as prevention was cheaper than cure. I was also told that I should always eat a breakfast (at the time I didn't) as I was likely to have a high sugar readings because I would possibly experience a 'liver dump' to make up for low sugar readings. True because if I decide to stay in bed for an extra hour or so my sugar readings are always higher.

    The nurse informed me during my last visit at the beginning of this year, that I have now got my sugar levels down to below diabetes levels! This is due to my monitoring and a lot of hard work watching what I eat and when, doing my best to loose weight and taking up exercise. I started concentrating on this after the shock of getting eyesight problems, (all sorted now) though I still have problems if my sugar levels rise. I have been rewarded for this by having my test strips removed and told that I shouldn't test as it is not necessary and will only worry me! They are still going to keep me on Metformin 500 three times a day, though I expect they will soon be withdrawn to save money.

    My advice for what it is worth is to ignore the doctor you spoke to and eat more regularly, watching what you eat, not eating can cause the body to go into starvation mode and do all sorts of things to the way you feel. The consultant also told me to listen to my body as it will tell me everything I need to know. I expect it will also be more truthful than the doctor you spoke to.

    T
     
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  15. DeepBlue

    DeepBlue Type 2 · Newbie

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    Hi Robert
    I understand what your doctor is saying but i find it comforting in a wierd way to know the reason i feel tired and lethargic is because my bloods are not right. This can only be checked with a meter. It does not mean i am going to change my metformin dosage.
    At the moment bloods are all over the place which to me means i need to watch what eat closer.
    DeepBlue
     
  16. Aberhonddu

    Aberhonddu Type 2 · Member

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    Hi all; Until earlier this year I was on Metformin in the morning only, I would have a small breakfast everyday and controlled my diet. My average readings would be around 6.8 to 8 and I was testing at my own cost so I could monitor my levels. Then in mid April my readings started to go berserk averaging 12 and rising to a all time high of 19 one night, I discussed this with my diabetic nurse and she started letting me have strips on prescription so that I could test more regular, it was also agreed that we would record all readings. After 2 weeks of this irregularity my nurse suggested I spoke to the doctor. During this appointment my doctor who has known me for many years and started me on my diabetes treatment and also increased my metformin dose, she told me that being on metformin I could not have high BS, she told me to stop testing immediately and took away my strips prescription, she also told me to stop recording my BS levels as it was not needed.
    I was shocked and so was my neighbour. My BS levels have calmed down but still average 7.5 to 9 and on a recent annual diabetes review where I informed the nurse I was not feeling very good and hadn't all night during my check I collapsed, the nurse took a BS reading and I was 15.2. After being sent to hospital because of the collapse it transpired that on top of the high BS I also had a minor lung infection. The infection aside which has cured I was a little surprised that my BS went that high.
    I have decided that I am going to ignore my doctors advice and start testing again and foot the strips cost myself.
    As some of the above have indicated the issue of T2 testing is most likely a financial point, but for a doctor to say that when on metformin one cannot have high BS readings is worrying to say the least
     
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  17. ray2

    ray2 Type 2 · Member

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    I must be lucky I get prescription test strips etc etc and a very supportive nurse. The simple fact is that if I didn't test I would never have known for example that white bread and all such products send my levels over 13 and I fell dreadful. Without testing it's like Russian roulette in the dark !!!!! Yes Metformin works up to a point but you have to know what causes the spikes etc or else as you say your bloods are all over the place
     
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  18. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Your post was so long I forgot you had said you had a good GP. You had made it sound like the test strips situation was so bad (when I have never had a problem getting the strips from my GPs) that trying someone else seemed the obvious solution. Still, it's handy to know you don't like getting suggestions - I'll know for next time.
     
  19. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Hi and welcome. Sounds like you're getting substandard care. If I were you I would look around for other doctors/medical practices as your health is too important to leave to chance.
     
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  20. josie2843

    josie2843 · Newbie

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    I have type 2 Diabetes on Metformin, I was told I don't need to test my blood sugar . If the reading was high there is nothing I could do about it.
     
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