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

Xan2cv · Sep 11, 2015

Its all about the cost of test strips that's all no matter what testing machine you have and companies give them away we know that from this website they just want you to buy the test strips for £25 a box and 3 boxes a month equate to £75 per patient if your on insulin then there is the rest of drugs they want to pump down your neck for cholesterol and conditions caused by the diabetes, I go to the hospital once a week for an INR test because I am on anticoagulants to stop my blood clotting the machine they use is portable and it costs £600 to save that journey and sitting in the waiting room to have a finger prick test for two hours this machine would make a lot of peoples lives easier especially on a Friday afternoon when traffic is bad.

But the test strips are £800 for a pack of five to the public, doctors would never allow you any test strips on prescription.
let alone pay for the machine.

Unfortunately this world is all about greed and greedy people, many of us would invent something for diabetes and virtually give it away if it made peoples lives better but big corporations don't see it as helping people they see it as making a profit.
This is what angers me about the price of wheelchairs and electric scooters. its taking advantage of the sick.

Sugars test strips should be relatively cheap now but the companies are holding the prices high deliberately and GP's are always being told to cut the cost of prescribing drugs and equipment, I have just gone through a cost cutting exercise with my new doctors same drugs less than half the price they work just as well shame we don't have the same choices with blood sugar meters and test strips.

Xan2cv · Sep 11, 2015

If your refused testing equipment you could quote what this chap says below
about testing before driving, ask the GP if they would prefer you to drive
just before a likely Hypo and ask for statement that in writing for you to
give to DVLA and your insurance company.

They will see sense you could put it another way and say.

imagine being out in your Landover car full of kids
and a type 2 diabetic that didn't test before driving has a hypo at the wheel
smashes into your land rover and kills some of the occupants
would you then argue for all type 2 diabetics to test their
blood sugars or would you shrug it off to save money?
richard256, Aug 31, 2015

ptrmetNewbie

I haven't read all 15 pages of this thread but I am staggered by some of the information given. I am was diagnosed asT2 diabetic over 25 years ago and I was taken off metformin some time ago because of its apparent effect upon kidneys although recent articles would seem to refute that. I take rapid acting insulin before each meal and long acting insulin once a day. Although there is always 'pressure' to reduce the amount of testing it is imperative that I test my blood sugar levels before eating and also late at night before bed to avoid a hypo during the night. I get the test strips needed on prescription.
However there is also another reason for regular testing and this is a requirement by the DVLA for persons using insulin to test levels before driving. If blood sugar readings are not taken within the DVLA guidelines before driving there is a strong possibility that an application for renewal of your driving licence will be refused arbitrarily. For many of us that would be a drastic life-changing event. I am not prepared to let cost led pressure on me to reduce testing to jeopardise my life style. Am I unreasonable in this? .

ptrmet

sidtommo · Sep 11, 2015

999sugarbabe said:
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.

sidtommo · Sep 11, 2015

I have been on Metformin for just 3 weeks, and I asked at the diabetic review, if I should monitor my bloods, and was told it's not necessary as it would not cause a hypo (or is it hyper). Is this right?

billiejean · Sep 11, 2015

CatLadyNZ said:
He's incorrect, metformin does lower BG levels, by up to 1 mmol/mol. In rare cases it can cause the BG to go under 4, which is not very pleasant and can sometimes cause problems. Perhaps he was meaning it doesn't have a high risk of lowering them dangerously like some of the other meds and insulin.

Thanks for that. Really interesting.. Maybe I misheard him

ButtterflyLady · Sep 11, 2015

sidtommo said:
I have been on Metformin for just 3 weeks, and I asked at the diabetic review, if I should monitor my bloods, and was told it's not necessary as it would not cause a hypo (or is it hyper). Is this right?

Checking for hypos is only one reason someone might monitor their bloods. Metformin doesn't cause hypos. But there are lots of other good reasons to test. It really helps with knowing which foods increase your blood sugar. That's how you can control diabetes and potentially achieve non diabetic HbA1c blood test results, when your diabetes is in "remission".

sarahlou72 · Sep 11, 2015

When I was first diagnosed T2 I asked about self testing, I was told like many of you here that it wasn't necessary.
The Hba1c was enough and a better test as it looked at your bg over 3 months.

Originally diagnosed with bg 6.5
3 months with diet and exercise then put on metformin even though my bg had come down slightly. my dn gave a case of it helping prevent diabetes related illness (ie heart attack, stroke etc) given family history I though prevention was better than cure.
next appointment 3 months
then 6 months
then 12 months (bg 6.2)
then 12 months.(bg 7.2)

If we only have dn appointments every 12 months, how do we know we are on the right track if we don't self test?
Because of the increase my next appointment is in December.
I know we spend enough time at the docs as it is, but surely if they don't want us to self test the NHS should do more regular testing regardless of your previous results.

ButtterflyLady · Sep 12, 2015

sarahlou72 said:
When I was first diagnosed T2 I asked about self testing, I was told like many of you here that it wasn't necessary.
The Hba1c was enough and a better test as it looked at your bg over 3 months.

Originally diagnosed with bg 6.5
3 months with diet and exercise then put on metformin even though my bg had come down slightly. my dn gave a case of it helping prevent diabetes related illness (ie heart attack, stroke etc) given family history I though prevention was better than cure.
next appointment 3 months
then 6 months
then 12 months (bg 6.2)
then 12 months.(bg 7.2)

If we only have dn appointments every 12 months, how do we know we are on the right track if we don't self test?
Because of the increase my next appointment is in December.
I know we spend enough time at the docs as it is, but surely if they don't want us to self test the NHS should do more regular testing regardless of your previous results.

Yes, they should. Blood tests are relatively cheap, so I don't understand why they think long intervals between them are a good idea. I can get an HbA1c test basically any time I ask for one. My result in April was 33 and has almost certainly not increased even into the prediabetic range, so I don't need a test until next April, but the other day my GP happily ordered one when I said I was starting to diet again and wanted a baseline for comparison. I think people should be able to get tested every 3 months until they themselves are happy to reduce to 6 months. And they should have meters too of course.

Daphne917 · Sep 12, 2015

I was told that there was no need to test as I'm diet only and my BS is well controlled (hba1c 36 in July) however I've accepted that if I want to keep at this level or go lower it is up to me to keep an eye on my levels so I bought a meter and strips etc. I'm lucky in that I can afford them but am well aware that others may not be able to and I think that the NHS should recognise this fact and also realise that by us controlling our BS by self testing we are, in the long run, saving it money by not developing the complications that can occur with high sugar levels. Although I haven't seen my GP for nearly a year (not diabetes related) I still have a review with my DN every 6 months which, provided we agree to disagree over statins and a LCFF diet, I'm quite happy with - except the next one is in January

boppa18 · Nov 4, 2015

A lot of people having problems with Metformin - I don't know if this would help..
I was started on Metformin at a pretty high dose and despite always taking it with food, it pretty well made me incontinent with embarrassing consequences - including having to go home to change my underwear!!
In the end, I just stopped taking it and told the doctor it was causing me terrible problems.
Some years later, having moved house and registered with a new doctor, it was suggested I try Metformin!
I explained what had happened previously and my new doctor suggested we try 'phasing it in'.
He started me off really slowly, taking just a quarter of a tablet each time, then half a tablet etc
Eventually, I was able to take a full dose without any of the previous problems.
I'm now on 1 x 500 with b/fast, 1 x 500 with lunch and 2 x 850 with dinner - higher eve dose to try and cope with DF.
All without problem, as long as I make sure I have food with them.
Really hope this might help someone x

Scouser58 · Nov 5, 2015

Hello to all, sometime ago I read a post about a letter that a member had written to the DOH and they reply that was received was reported in full. The letter even gave the name of the writer, I am trying to find this post as I thought the letter was very accurate and pointed to the testing for T2's in keeping the condition under control and mentioned that the PCT should be contacted if the doctors are not providing the kits, and subsequent strips and lancets.
If any other member has come across this, please bring it to the forum's attention, so that more can be pursued in getting the necessary kits. I do wish my brain would hold onto important information, it might be helpful to others here, ttfn from Karen.

graj0 · Nov 5, 2015

boppa18 said:
Eventually, I was able to take a full dose without any of the previous problems.

XR/SR (Extended/Sustained) release versions will also help.

graj0 · Nov 5, 2015

sarahlou72 said:
The Hba1c was enough and a better test as it looked at your bg over 3 months.

But it doesn't look at the peaks and troughs and only looks at the previous 8 - 12 weeks.

sarahlou72 said:
If we only have dn appointments every 12 months, how do we know we are on the right track if we don't self test?

You're 100% correct, especially if your dn thinks that a test that looks at the previous 3 months (8 - 12 weeks) is OK to give every year, it's a no brainer, what does the dn think happened in the previous 9 months?. You need to monitor your blood glucose, whatever the dn says because even without being medically qualified, logically the dn's reasoning is floored or is that flawed?

laharvey999 · Nov 5, 2015

carliannie said:
Hi there...i have recently been diagnosed with T2 and was also told by diabetic nurse not to test unless I felt unwell, this is due to the fact that metformin lowers your bs but will never lower them enough to cause a hypo, however i still check them every so often to make sure they are stable as T2 does progress and I also monitor when feeling unwell. I was classed as prediabetic for 3 years beforehand and only by monitoring regularly did I discover that I had moved over to full blown diabetes. Personally if you feel you would like to continue monitoring your bs then do so you are paying for the strips yourself as I do and its your body and your health.

Klangley · Nov 5, 2015

A doctor advising you not to test your blood sugar is like a policeman advising you not to look at your speedometer......just wait a few months and see how many tickets you get.....

laharvey999 · Nov 5, 2015

I have been a t2 diabetic for over 10 years. I am now on metformin 850 x3 glicazade 80x 2 twice a day for a long time. My Hba1c has always been under 7 last Hba1c the nurse told me not to worry as I was under 10% My bs was up over 15 some mornings as high as 20. Went back after 6 months my Hba1c was 17 the nurse bluntly told me that she was recommending another drug tragenta and if the bs did not improve I would be on insulin. No counselling very offhand. The specialist doctor at my practice also told me not to test it was not necessary. I actually feel that the so called specialist professionals do not really care and the older you get the less interested they are. Personally if I didn't have this site and Dr Bernsteins site I would have no support at all.

Keep testing get your strips on prescription I have mine stockpiled. It's your body your diabetes manage it so you get the results you want and let the "professionals" go to he'll in a bucket. You can bet your bottom dollar if they had diabetes they would every tool available.
Sorry to rant but I feel let down by our NGS.

shekindevon · Nov 10, 2015

I test twice a day sometimes 3. (my reading can vary from 4.1 Lower sometimes, i feel hypo when it 4 and lower of course,) mostly my reading are between 9.0 and 15.00 like this morning it was 15 yet when i went to bed it was 6. i try to keep to a balanced diet.
I take 850gr of metformin twice a day. my first D/N told me to take the metformin straight after my evening meal, but did not say anything about breakfast i suppose on reflection i should have realised , after 7years i have discovered i should do so, i had been taking them along with tablets for my high blood pressure ( i had it before the diabetes) it could be sometimes an hour after eating my Weetabix or porridge, I feel silly not having done so, from now on i will take it as soon as i have eaten my break

Michael W C H · Nov 10, 2015

Xan2cv said:
Its all about the cost of test strips that's all no matter what testing machine you have and companies give them away we know that from this website they just want you to buy the test strips for £25 a box and 3 boxes a month equate to £75 per patient if your on insulin then there is the rest of drugs they want to pump down your neck for cholesterol and conditions caused by the diabetes, I go to the hospital once a week for an INR test because I am on anticoagulants to stop my blood clotting the machine they use is portable and it costs £600 to save that journey and sitting in the waiting room to have a finger prick test for two hours this machine would make a lot of peoples lives easier especially on a Friday afternoon when traffic is bad.

But the test strips are £800 for a pack of five to the public, doctors would never allow you any test strips on prescription.
let alone pay for the machine.

Unfortunately this world is all about greed and greedy people, many of us would invent something for diabetes and virtually give it away if it made peoples lives better but big corporations don't see it as helping people they see it as making a profit.
This is what angers me about the price of wheelchairs and electric scooters. its taking advantage of the sick.

Sugars test strips should be relatively cheap now but the companies are holding the prices high deliberately and GP's are always being told to cut the cost of prescribing drugs and equipment, I have just gone through a cost cutting exercise with my new doctors same drugs less than half the price they work just as well shame we don't have the same choices with blood sugar meters and test strips.

Well I am type 2 on 1000 mg twice daily, I am now not sure if I should test or not, these threads are more confusing than anything I have been informed by medically trained persons, I have tested in the past but stopped for a month, I now do not know what my readings are neither do I know if my other medication is causing me problems my diet is as directed plus as stated on this site. Yours confused.

4ratbags · Nov 10, 2015

It can be very confusing with all the conflicting advice but the best thing you can do is to trust your own gut instinct. You say yourself that you stopped testing and now you dont know what affect your medication or diet is having on your BS. I rarely test anymore as Im quite well controlled but every now and then I will buy a pack of test strips to exclusively full on test for a week to see what my levels are doing. I do try and have test strips on hand in case I have a hypo. It is a very individual situation for each of us and only you can decide if testing is of any benefit to you. Personally I would most probably still technically be a diabetic if I hadnt started testing and it can be a very useful tool but like any tool it is only as good as the person using it so if youre not testing at the right times ect you may find that you are not getting much benefit from the results.

islelassie · Nov 10, 2015

I was told not to test as well although I read NICE Guidelines saying newly diagnosed diabetics should test. I bought my own strips and tested a few times a week. I discovered that my fasting blood sugar is higher every day than my levels taken four hours after a meal. I was told this only happens with type 1 ( so I kept a chart and showed the diabetic nurse. She didn't tell me to stop testing,she just wanted me to keep taking more and more Metformin. I am supposed to take 4 according to her but I watch my diet and take 2. My glucose levels seem no different whether i take two or four metformin. I get diarrhoea with metformin. At present, i have one metformin with a mug of hot chocolate first thing, then I go swimming for an hour.I have a main meal around 5pm with the second metformin. I have never seen a doctor about my diabetes, The only option is the nurse led diabetic clinig and I have come to think I know more about it than she does. My average level is 8, I have not got lower even when I ate very little low carb. It also doesn't get higher than 12.

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

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