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

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

  1. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    Sometimes if you dont eat much during the day you can get liver dumps which keeps your BS elevated. Do you have any snacks like peanuts during the day.
     
  2. carpcatcher

    carpcatcher Type 2 · Member

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    hi there im t2 since 19th aug 2015 on metformin 500grmx2 lost over 2 stone i was told no need to test both by nurse and gp however i felt the need to buy my own machine acuchek mobile i dont test every day but once aweek mainly sunday morning after fasting from previous tea time and test again after breakfast around 2hrs later my average is 6.0 my highest was 9.1 i just wonder if i need to be taking the metformin and just control through diet (low carb) which seem to be working
     
  3. geoffross

    geoffross · Newbie

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    So the doctor is a clever man
    So he must be right?
    I live in the country with no buses, so l have to break the law to go anywhere? I am on metfornin and insultard and according to the DVLA leave house to drive without testing is breaking the law, three hours later if I want to drive I have to test, to drive so forget we are ill ??? Testing is a not only for our piece of mind, information on are body and to please the law of the land, so strips are definetly a big yes,l am nearly 70 years old and paid national insurance for 50 years I am sure the doctor on his pittance pay ( out of hours pay omg a weeks pension an hour) I am not bitter and twisted but ! Keep testing and one hour slow walk a day and keep smiling it helps.
     
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  4. Katchoo

    Katchoo Type 2 · Member

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    I haven't read through the whole thread as it's so large but I'm disgusted with the way the original poster was spoken to by the 111 doctor. Although I can't say as I'm particularly surprised. When I was diagnosed my BS was 28.1, the doctor was convinced I had ketoacidosis and bundled me off to hospital. It took me about a month to get my BS down to around 8 - 10 and in my first visit to the diabetes 'specialist' doctor I was told *not* to test. She said "you'll get obssessed with it".

    My second visit was 6 months later when my repeat scrip for 2x1000mg of metformin a day was due for a re-issue. I've never been on a repeat before so I assumed I had to see a doctor and made an appointment. That was last September. I haven't seen anyone since.

    Despite being told not to, for months I tested religiously twice a day and got down to an average of 4.9 to 5.4, and I lost 36lb in weight. I was so proud of myself, I felt better, healthier and pretty much OK. During all of this our family was going through hell, my father died of end-stage dementia and my mother ended up in hospital with extensive pneumonia and respiratory arrest. But I managed, and I got better. My Hba1c when diagnosed was 88, it was 33 when I saw the doctor for the second time.

    Then around Christmas last year I started to space the testing out more, I lost track of it and I also stopped keeping an eye on my food etc. In the last 12 months I've been sliding backwards, mostly because of a combination of depression, anxiety and worrying about a couple of other diagnoses unrelated to the diabetes. I stopped testing. That was my biggest mistake.. testing keeps me focussed, lets me know if I'm doing OK or if I need to try and look after myself a bit better. I don't get anything from the doctor as they don't approve so I have to fund it myself.. but I do it, because if I don't. I get ill again.

    To my knowledge metformin has *never* interfered with testing. If testing helps you, do it.
     
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  5. minidvr

    minidvr Type 2 · Well-Known Member

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    My GP and DN and even the Pharmacist insist that I don't need to test. I've been diagnosed since March last year taking three metformin a day, at meal times. I have ignored the advice not to check, although, I normally only test weekly,unless I'm feeling a bit 'iffy' when I will test straight away. It does seems that one time I tested, my BG was way down in the 2.6, and I knew there was something wrong. And was glad of having ability to check myself and to take remedial supplements to raise the BG.

    Another time, more recently I was feeling a bit strange, again, testing showed BG now quite high, close to 10, which is higher than I've ever seen it.. Not a clue why, but have been told that being under a lot of stress can contribute to it. But, again, If I wasn't testing, I wouldn't have been able to monitor it or to know what was wrong.

    The DN is adamant that self testing at my stage of diabetes, is a waste of time and money, but has at least acknowledged that it doesn't do any harm to monitor BG if you feel the need.

    GP's and Healthcare Professionals can be awkward and will continue to tell us what they KNOW is good for us, without actually listening to what you might be telling them about symptoms, changes etc. A shrug of shoulders or outright denial that they are wrong might be the only response I get.

    Who can you trust to care and support you with health issues accept yourself, using your own judgement.
     
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  6. alangarry

    alangarry Type 2 · Active Member

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    This is what it says on the internet about Metformin and Hypoglycemia.

    Precautions
    Drug information provided by: Micromedex

    It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

    This medicine may interact with the dye used for an X-ray or CT scan. Your doctor should advise you to stop taking it before you have any medical exams or diagnostic tests that might cause less urine output than usual. You may be advised to start taking the medicine again 48 hours after the exams or tests if your kidney function is tested and found to be normal.

    Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

    It is very important to carefully follow any instructions from your health care team about:

    • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
    • Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
    • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur with lifestyle changes, such as changes in exercise or diet. Counseling on birth control and pregnancy may be needed because of the problems that can occur in pregnancy for patients with diabetes.
    • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
    • In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
    Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite; diarrhea; fast or shallow breathing; a general feeling of discomfort; severe muscle pain or cramping; and unusual sleepiness, tiredness, or weakness.

    If symptoms of lactic acidosis occur, you should get immediate emergency medical help.

    Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

    Symptoms of hypoglycemia (low blood sugar) include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty with thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

    If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. The members of your household also should know how to use it.

    High blood sugar (hyperglycemia) is another problem related to uncontrolled diabetes. Symptoms of mild high blood sugar appear more slowly than those of low blood sugar. These may include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination (frequency and volume); ketones in the urine; loss of appetite; sleepiness; stomachache, nausea or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; or unusual thirst.

    High blood sugar may occur if you do not exercise as much as usual, have a fever or infection, do not take enough or skip a dose of your diabetes medicine, or overeat or do not follow your meal plan.

    If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

    This medicine is only part of a complete program for controlling diabetes. It is important that you always eat a healthy diet, watch your weight, and get regular exercise.

    With this information does this mean that because I drive Buses for a living I have to follow the following,

    Diabetes - Managed by tablets which carry a risk of inducing hypoglycaemia (this includes sulphonylureas and glinides)
    See INF188/2 (PDF, 95.5KB, 1 page) .

    Group 1 entitlement ODL – car, motorcycle
    Must not have had more than one episode of hypoglycaemia requiring the assistance of another person within the preceding 12 months. It may be appropriate to monitor blood glucose (depending on clinical factors including frequency of driving) at times relevant to driving to enable the detection of hypoglycaemia. Must be under regular medical review.

    If the above requirements and all of those set out in the attached information onINF188/2 (PDF, 95.5KB, 1 page) are met, DVLA does not require notification. This information leaflet can be printed and retained for future reference.

    Alternatively, if the information indicates that medical enquiries will need to be undertaken, DVLA should be notified.

    Group 2 entitlement vocational – lorries, buses
    Must satisfy the following criteria:

    • no episode of hypoglycaemia requiring the assistance of another person has occurred in the preceding 12 months
    • has full awareness of hypoglycaemia
    • regularly monitors blood glucose at least twice daily and at times relevant to driving
    • must demonstrate an understanding of the risks of hypoglycaemia
    • there are no other debarring complications of diabetes such as a visual field defect
    They must also be under regular medical review.

    I have been diagnosed with type 2 since August, I test up to for times a day, have gone from nearly 19 stone to just under 14 stone, I have changed my eating habits and portion sizes , I used my testing to regulate and control what I eat, I eat no bread, no pasta, no pastry, replaced with almond and coconut flour. I was lucky enough to get tester and test strips on NHS, REPLY FROM DOCTOR, JUST KEEP WHAT YOU ARE DOING BECAUSE IT SEEMS TO BE WORKING!!!.

    I also take 2 200mg Chromium tablets a day with a vitamin D tablet with my 2 x 2 500mg Metformin tablets, Doctors suggests I also take Vitamin 12 tablets.

    Blood readings regular at 4.9 to 5.6
     
  7. welsh polly

    welsh polly Type 2 · Member

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    Funny that it just so happens my GP has sent me a blood test form to have a blood test done because I AM ON METFORMIN. What are they playing at, and yes I agree with you how the hell
     
  8. Bernie 59

    Bernie 59 Type 2 · Member

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    Hi !
    I have had diabetes for about 13 years. First it was diet only, then metformin. My doctor has always told me to still check my sugar levels as normal. Also at my diabetes checks the nurse always wants to see my meter so she can check the results.
    As for your needles, the doctor has to prescribe your needles. He can't refuse.
     
  9. Bernie 59

    Bernie 59 Type 2 · Member

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    I forgot to say that he has got to also prescribe test strips. There is no way you should be buying these yourself.
     
  10. rinfrance

    rinfrance Type 1 · Well-Known Member

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    It depends for me, on what I eat, I have SERIOUS problems with anything that sniffs of Metformin. Took six weeks to be able to ride my motorcycle after 2 tablets of Metformin in a (French) hospital. Anyway, I am on insulin have been for 14 years, however the feeling unwell will, if you track what caused it, not only be down to the numbers, but also what you have eaten. I know if something contains hard wheat sugars, for example drink something made with barley, a double barley malt whisky, and my figures after a load may hit 13, yet no problem not even drunk per se, BUT 1 glass of stuff made with wheat, hard wheat, a beer say 1664, and although my figures do not alter, say still at 5, within 20 minutes, sleep! Wake up some time later and feel knackered. This extends to soups, pies, gravy's , mixers, and virtually anything and it seems hard wheat may be in it. Luckily, those of you in the UK most of what you get in bread and cakes is soft wheat, but some cheap bread is made of hard wheat and many non bread things like ice cream sweetener. Weetabix used to be all soft wheat grown in the area, and the same is true of Ryvita. Both manufacturers stated that they would not have hard wheat on the premises. I wonder why!
    So go and look at what you eat.
    As to the comment that those on metformin should not test, stupid, and a comment from a French dietician was that that could only be because they knew it was not wholly effective. Sure it works on borderlines, but 90% are NOT borderline. Guess where Metformin came from. J'habite la!
     
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  11. Diaplatees

    Diaplatees Type 2 · Newbie

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    Well-being and peace of mind do not fall to the front when testing your bloods and can indicate a higher reading. I agree,with Doc, it is not so necessary to check if your on Metformin. I come up mostly 6 every single morning with my D1. I only check if I feel ill,or every 3 or 4 days. Also It is a comfort knowing I have to keep an eye on my health but not stress over it. Imagine taking your readings every single day??? Kinda like not trusting your medication ha ha .
     
  12. Lizzy Loo

    Lizzy Loo Type 2 · Well-Known Member

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    Drs are wrong to say no testing on Metformin.I did an hrs excersise in gym if I hadn't checked my sugars after. I would have driven the car. But my sugars were only 3-3
     
  13. CollieBoy

    CollieBoy Type 2 · Well-Known Member

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    I find with exercise my BG can drop but rebounds back to the 4's but heavy mental exercise can leave me down in the 3's:wideyed:.
     
  14. Lizzy Loo

    Lizzy Loo Type 2 · Well-Known Member

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    Yes excersise lowers sugars. This is why you need to check them. I'm not saying do them all the time. But how do you know what you are doing is right or wrong.
     
  15. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    @Diaplatees I was actually having lots of hypos of 3.6 and under while on Metformin which is why I stopped taking it. Just by running inside to answer the phone would have me sitting down shaking like crazy and when I stopped my meds the hypos stopped. Metformin can be more effective for some patients and less for others. A meter is a great tool to have but I also dont stress over it. I may do a bit of extensive testing every now and again especially if I am trying new things. It is like any tool you have, it all depends on the way it is used.
     
  16. Celeriac

    Celeriac Type 2 · Well-Known Member

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    I'm on Glucophage SR (metformin) and GP hasn't suggested reducing dose from 500mg x4 daily though I've been low carbing for years. I just tested, am just sitting here and got 4.8. Feel fine though .8 above what DSN told me was the 'floor.' Am now wondering whether the nauseous feeling and slight shivers when I haven't had anything to eat are me going hypo. I didn't bother testing because I've always been told you can't go hypo on Metformin !
     
  17. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    The best way to be sure is to test, they say its not dangerous for a T2 to go low but it sure feels horrible. My lowest recorded was 2.9 and I felt fine but I sure did eat my dinner fast.
     
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  18. Scouser58

    Scouser58 Type 2 · Well-Known Member

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    Hello to all on this page, I have found a copy of the letter regarding testing. It was in reply to another member who had written about the problem of being told that 'to testing' was needed,
    The member had written the details into the post, but not scanned in the letter on headed paper.

    From Daniel Cavill, Customer Service Centre, Department of Health in it he quotes from the NICE Guidelines.

    "Self Monitoring of blood Glucose is helpful only as part of an overall package of support for self care, and it is vital that the results of self monitoring are fully understood.

    Any Primary care Trust (PCT) that is automatically discourage the prescription of glucose testing strips is not acting in accordance with NICE'S advice.

    I hope this helps with the discussion and helps any member who is being denied the testing of blood glucose. I found this back in august 25th'ish on one of the posts concerning this subject, I have been fortunate in that I have had testing strips and lancets from the beginning, of being diagnosed as T2, and I understand the stress and frustration of members who cannot get these things on repeat prescription.

    I have always maintained that testing is a vital part of the care and understanding of diabetes and the maintenance of good health and well being.
    ttfn from Karen
     
  19. Michael2457

    Michael2457 Type 2 · Active Member

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    Looks like I'm In for "telling off" at my first diabetes nurse appt since diagnosis then! lol As I have been testing every day as I'm trying to find out which foods are better for me. I plan to take three weeks of readings in! lol

    I am on 500mg,my dosage increases to a 1000mg tomorrow.Do I take that all at once or 2 separate 500mg doses please?
     
  20. Scouser58

    Scouser58 Type 2 · Well-Known Member

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    Hello Michael2457, your metformin dose should be taken in one dose, (unless your gp, tells you differently) after the meal, as it works with the pancreas. Most T2's take this dose twice a day after the breakfast and evening meal, your gp will give you the plan. Make sure you understand the directions for taking it, I take my metformin this way, with the gliclazide before meals. We are all here to help you and support you. The foods that you have eaten, the ones that push your bg readings up are the ones that might need to be left out, and when you achieve the balance you want then trying taking back foods could be tried. Good luck and let us know how you get on with the gp, ttfn from Karen.
     
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