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

[TyTy]

to me it makes sense to monitor your sugar when on the diet. well i also went on line filled out a request for a free glucose machine to monitor it and did not think i would be sent one, but completed the form anyway. this morning it arrived a bit of surprise , but not compalining

 

[Dillinger]

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.

If you are unwell it is very common for your blood sugars to rise. This is probably what happened here. You conversation with the 111 doctor was obviously of little use.

If you feel unwell but still hungry try and only eat low carb foods to avoid a spike. If you don't feel hungry then don't eat.

I don't eat breakfast either and have no problems with that; everyone will have some form of dawn phenomenon where the liver releases glucose to help wake you up and get you going of a morning; not eating does not affect that.

As with everyone else who has posted; you need to test your blood sugars.

The doctor that you spoke to is obviously wrong and may find the handy guide below of some use.

Best

Dillinger

 

[Ali H]

to me it makes sense to monitor your sugar when on the diet. well i also went on line filled out a request for a free glucose machine to monitor it and did not think i would be sent one, but completed the form anyway. this morning it arrived a bit of surprise , but not compalining

they give machines away like confetti, it is the strips that cost money and most GPs issue frugally or not at all!!!

Ali

 

[TyTy]

i have just come from my DN and gave me more strips

 

[Ali H]

i have just come from my DN and gave me more strips

As I said, "most", not all! I have always been given strips no questions asked but the vast majority can't get them unless on insulin.

 

[Rrar]

I'm type 1 & take metformin plus my insulin & my doc says I should test at least twice a day, I actually test about 7 times a day tho lol

 

[st1984]

As a type 1 diabetic I feel type 2's do get a raw deal on the meds and testing front. You should be entitled to test if you feel unwell, feel low or feel high. You should make a complaint to the 111 service to say you were not happy with the service you received.

As for the 12.0 reading before lunch, it may well be because your body dumps glucose in to your system if it feels it is getting too low on glucose. This can happen during the night as well prior to a hypo and I wake up with a reading of 15.0 if that happens. This happens whether you are feeling well or unwell.

Keep testing as much as you feel is necessary, my Mum is also Type 2 and I haven't seen her test for a week at a time and I wonder how the hell she can judge it without the tests.

 

[kate78]

I was diagnosed 2yrs ago now and I've never self tested, I was told by my diabetic nurse that it wasn't necessary for me to do it. And yes I too am on metformin. I have only had 2 checks since being put on the tablets exactly 2yrs to the day! Is this how it should be?

 

[Moosepig]

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!

i was told both by my DN, pharmacist and DESMOND course advisor that metformin must be taken after or with food i.e twice a day meaning after breakfast and after dinner. I do this, and take sitaglyptin before breakfast as I was told that works best on an empty stomach. There do seem to be a lot of doctors who don't know that much about diabetes but aren't prepared to admit it!

 

[graj0]

I was diagnosed 2yrs ago now and I've never self tested, I was told by my diabetic nurse that it wasn't necessary for me to do it. And yes I too am on metformin. I have only had 2 checks since being put on the tablets exactly 2yrs to the day! Is this how it should be?

It depends, if you want to know what your BG is and it's the high BG that will cause all the damage you hear about from retinopathy to manky feet to bad heart, then you need to monitor your BG. If you're not worried and you start to have eye problems through retinopathy then you can ask your DN, "How come I wasn't warned?"
It really is that simple. I would strongly suggest that you get yourself a monitor and start monitoring your BG. Personally I think it's criminal to suggest to a person with diabetes that there is no need to monitor. Once a year isn't enough, even if the HbA1c was 4 times a year, I would still monitor regularly.
I don't know what sort of regime (diet) you follow, but knowing if you have high BG, you'd have a chance of altering things.

 

[Daphne917]

I was diagnosed 2yrs ago now and I've never self tested, I was told by my diabetic nurse that it wasn't necessary for me to do it. And yes I too am on metformin. I have only had 2 checks since being put on the tablets exactly 2yrs to the day! Is this how it should be?

It's not necessary how it should be but, unfortunately for the majority of Type 2 diabetics, that's how it is particularly as the medical profession seem to do all they can to discourage it. I didn't test for at least 3 years after being diagnosed but, after joining this forum, I was curious as to how different foods affected my bs readings - it was, to say the least, an eye-opener!! However it is up to the individual if they test or not particularly if their BS levels are ok. I certainly do not test as much as I did because I now know what foods I can and cannot eat but I still tend to test once or twice a day just to see what my levels are doing

 

[kate78]

My first couple of readings we're fairly high if I remember correctly 13.4 & 11.9. But when I had my 'annual' check last year she said I was obviously doing things right having lost 2.5st in the first year and my blood sugar level was down to 7.3. I take metformin and watch what I eat, sugar free items and less white carbs.

 

[Moosepig]

I agree

I disagree with you about oats and porridge. I think it probably varies from person to person. Oats are an excellent soluble fibre and will make you feel full as well as releasing the small amount of sugar very slowly. If you have porridge will full cream milk etc that will slow it further as well as tasting extremely yummy. I couldn't do without breakfast and wouldn't if I was working or going to the gym or walking - as I do. I think breakfast is the most important meal of the day after fasting for 12 - 14 hours.

i agree with you - while everyone is different my levels are good if i have porridge made with water and a few seeds and a pinch of cinnamon, and I stay fuller till lunch, don't spike or feel dizzy. I cant cope with high fats as i had my gallbladder out, but on about 100-150gms carbs a day i seem to do pretty well and keep my levels fairly good.

 

[henrytt]

I am astounded by some of the things I have read here. People not taking meds, not taking meds in the correct manner, not understanding the meds and how they work etc. and a host of conflicting nutritional advice. The most valuable figure for understanding you condition is HBA1C it is the long term indicator of how your diabetic condition is progressing and being controlled. It is nonsensical to test blood sugar levels if you are on metformin alone, I have never test my level as right at the very beginning my doctor said it was unnesessary.

Where I live we now have a program of sending newly diagosed diabetics on a course know as Xpert. http://www.xperthealth.org.uk The course is 6 weeks 2-3 hours a week in hour area it is given by the NHS diabetes nurses and NHS nutrition experts it covers in great detail what the various drugs do, the importance of a good diet, labeling, exercise and a host of other invaluable things. I am a 7 year diabetic, my wife was diagosed last year, and as such she was informed about the course so we both attended. It has proven invaluable to us both. My HBA1C has fallen from 51 to 39 in 4 months my blood pressure is the lowest its been in 10 years and I have been able to come off liraglutide and only need metformin, My wife controls hers by diet alone.

 

[ronialive]

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.

This is my belief.. it is just a vital for someone with type 2 diabetes to do a blood sugar as a type 1. With type 2 there are many causes and people can start with one and things can change and they can have a second cause also. without blood tests we do not know of changes. Body weight affects sugar levels also. However it doesn't matter the cause- the result is the same complications if sugar levels are too high. I am type 1 but I also have insulin resistance now after 42 years on injections and so I also take metformin. does this mean I no longer need blood tests`/

in uk this is purely about money and prescription costs and for anyone who can self fund this is the most responsible way to care for your health. diabetic complications cost the health service millions and these can be avoided. The only difference is with type 1 the low blood sugars make it obvious immediately- the high blood sugars and damage is more checked for however this should be equal for type 2as the damage is the same. There is no faster or slower as it depends on the individual and their control. How do we know what to expect- blood test.

When we fast for some time the liver will give off the sugar which is stored there- it is called the dawn phenomenon in type 1. I would say this is what is happening. Maybe try and orange juice or glass of milk if you cant eat and jut break that fast especially if taking metformin. You must not take this on an empty stomach r could end up with ulcers.

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.

 

[kate78]

Well Henrytt all I can say to that is u obviously live in a good area. Nothing like that has been offered to me. And as for HBA1C.... I haven't a clue what that is. No one has ever told me what that is. Yes I may be a little nieve but surely I should be told just the simplest of things??!! Please don't criticise everyone just because we haven't been given all the information out there

 

[Shahana786]

I was told by my GP in 2007 to stop testing....and I did for few years. Each time I went to my diabetic clinic appointments my sugars would be on the high side...so then I decided to start testing my sugars again and now my sugars are in much control, simply because I know whether to eat more or less when sugars are up or down. It is in my view essential to keep testing your sugars so that you know how to control it. These days you can't rely on GPs etc coz they simply fob you away just to save time and money! Now a days I'm reading that patient's get misdiagnosed with their symptoms...really deep down we know what's going on with us inside our bodies but the professionals try not to go down the costing route to check it out. So yh I'd say keep testing!

 

[chazelder]

Before I went on to insulin and I was on Metformin and Victoza only I was told not to test, it's all a money thing, my diabetes nurse wouldn't issue me with a meter or prescribe strips and lancets, now I'm still on both and insulin. They just don't want the cost and that's the bottom line, I have recently been told to change my meter to one approved by the surgery and they actually said it was because test strips for the one they wanted me to use were cheaper.

 

[larfozash]

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.

I have been diabetic for a number of years now on Metformin and I am also on Gliclazide. I have never been given a meter to test my blood. You only get given a meter if you are on insulin.

 

[xxmaria79xx]

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!!)

My doctors are exactly the same as yours, and gave me 2 monitors and strips and lancets on prescription, and this seems to vary in different areas.