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

  • Thread starter Thread starter 999sugarbabe
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My GP has me testing 3 times a day on the same drug 3 times a day diagnosed 7 weeks ago type 2 think this is an awful way in how you have been treated very confusing
 
I had my check up with diabetic nurse at a new surgery about 2 months ago. We had a heated discussion as she told me that I was a drain on nhs resources by testing my blood. I admit I am testing very frequently at the moment but I have recently started LCHF way of eating which I told her, I explained that I was regularly checking my bloods before and after my meals. She said I shouldn't be doing this and I argued the same as you how am I supposed to monitor my levels then? She then proceeded to tell me that my levels would be monitored by my 6 monthly checkups with her and that if my readings started to rise then she would just increase my medication!!!!!!! So apparently it's not right to be pro active and try to help ourselves and possibly stop the 'drain on nhs resources'oh no I've just got to hope on a wing and a prayer that my reading don't rise and hey ho not to worry if they do as they will just dose me up with more meds! Stupid woman. Sorry for the rant.
 
Just after going for my yearly hba test I asked my doctor why the reading from the hospital was always higher than when I'd woken up. It seemed odd to me as I had'nt eaten anything. His explanation was that if you don't shovel some food in then the liver starts to produce glucose hence a higher reading with no food.
 
 
I test every day , I take Metformin morning and evening and inject three times daily all overseen by my doc and the diabetes nurses in my local hosp. If I had phoned for advice (on 111) and was made to feel a fraud by some uninformed quack I dread to think how it would affect me with regard to managing my diabetes. As it is I have great difficulty controlling my diabetes and most days my readings are in the high 20's. If I didn't test how would I ever get my bg levels down ?
 
There are many newbies that have started posting on this thread, I will tag @daisy1 to give you all some basic welcoming information.

This thread concerns the T2 patients getting monitors to test their blood sugars.
I am not diabetic.
I get testing strips.
This is because I have to monitor my blood glucose levels every time I eat!
And according to many experts and endocrinologist I have met, they also agree that testing is essential especially when a patient is on meds such as glicizide.

How can you know at what level and amount of carbs that you can tolerate. Whether 5g of grains spike you or 15g. Whether a small new potato is fine whilst an old potato will spike you.
Most advice given by healthcare is purely for cost cutting under this present government overall spending cuts. And for most that have hormonal, liver and pancreatic problems and symptoms.
 
I am t2 diabetic and am supposed to take metformin 850mg 3 times a day I only take 1 a day and have done since being diagnosed in 2008 my doctor kept telling me to take 3 so after starting to take 3 a day and having a bad time with them I cut them down to 1 a day again and been ok with them my doctor tries to get my blood sugar level down at her speed but that makes me very ill
 

Don't understand this.. Are you saying your levels are still higher than they should be?

If metformin doesn't suit you then there are alternatives that could be tried.
 
I think the reason why your blood sugar was high after not eating is that your liver dumps stored sugar into your blood to give you some energy after you have gone without food.
 
It makes a lot of people ill, so does high BG, what's yours like? 7 years after diagnosis I just hope one metformin a day helps. If you have high readings then you need to get them down immediately, if you can't tolerate metformin and I think most people understand that, then you should be speaking to your GP about alternatives. By the way, lowering carb intake helps a lot with the side effects of metformin. It also helps lower your BG.
Metformin isn't really a drug where you can muck about with the dosage willy nilly, some might suggest that 850gms a day isn't going to have much affect on your BG whereas 1700 and 2550 gms would.
It's unfair to suggest that your GP is trying to get your BG down at her speed, it has to be done now, not in several years time. If your current readings are OK, that's great, if not, do something about it now, don't muck about when it comes to your health.
Have you considered Metformin SR (Sustained release) or XR (extended release), both slow acting and much less of a problem.
 
nosher8355 said:
There are many newbies that have started posting on this thread, I will tag @daisy1 to give you all some basic welcoming information.
Click to expand...

To all the new members on this thread - here is the information we give to new members and I hope you will find it useful. Ask as many questions as you feel you need to, preferably on your own thread, and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 140,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
i was told by my dr and nurse NOT to test on meteformin as they say its not needed but i still test my levels ,esp if i feel unwell and on lots of meds which interfere with my sugars
 
My blood sugar is always higher in the morning before I eat. This is what I found on-line but I do not use insulin and take my metformin mid day.

Dawn phenomenon
The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows. Your body has little need for insulin between about midnight and about 3:00 a.m. (a time when your body is sleeping most soundly). Any insulin taken in the evening causes blood sugar levels to drop sharply during this time. Then, between 3:00 a.m. and 8:00 a.m., your body starts churning out stored glucose (sugar) to prepare for the upcoming day as well as releases hormones that reduce the body's sensitivity to insulin. All of these events happen as your bedtime insulin dose is also wearing off. These events, taken together, cause your body's blood sugar levels to rise in the morning (at "dawn").
 
Kellrob said:
I had my check up with diabetic nurse at a new surgery about 2 months ago. We had a heated discussion as she told me that I was a drain on nhs resources by testing my blood....
Click to expand...

Hey, so much better if we just f*** off and die quietly... Cheaper, at any rate.
 
I'm T2 on Metformin & Liraglutide, currently getting prescribed after begging 1 strip a day. However having acquired several boxes short date test strips [my fathers - he died from diabetes related causes]. I was in position of having 150 strips to use within a month or waste them. Sore fingers but I have gained more knowledge on what foods affect me, and what I can eat without issue then I have in the last ten years of diabetes. So I will continue to test when I want, regardless of cost of self funding. Have swapped to Dario meter as strips are only £15 for 50 great saving on many other 'main' brand strips.
 
The doctor who you spoke to you is wrong I am type 2 and take insulin 3 times a day plus meterformin 3 x a day and my diabetic consultant has told me I must test my blood sugars 4 times a day. I also have bad and good days sometimes I will have a bad day after breakfast with readings of over 14 and days when I get close to a hypo but different people have different level mine is 5 -11 if I go under 5 I will start to get a feeling of a hypo. So speck to your diabetic consultant or your community diabetic nurse if you have one hope this helps
 

This is almost an exact replica of my last visit to my DN (which I also posted on this forum as I was so upset). I think the worst thing about the conversation was the fact that they want to up our medication if our Hba1c rises! How can it be good for us to eat what we like and take more medication to overcome this? It's beyond belief! I will not be seeing this DN again.

And in reply to the OP - I get high readings if I miss meals and someone pointed me to a thread on here about how the body thinks you are starving, uses the glycogen stored in the liver and converts it to glucose, giving the high reading. It sort of makes sense to me. Not sure if this is what is happening with you.
 
I recently switched from insulin to Metformin and Glicazide - I take the Metformin with my meals and have had really low readings as compared to taking insulin. I was advised to take with meals to protect my tummy but also what good can it do if you have no food in your system? Fascinated that you feel ill at 11, I have been at 22 and felt very little effect

I totally agree that you should eat breakfast, your body needs you!
 
Update to my original posting.

On 12th May I received a phone call (from either someone at NHS Direct or the doctor's deputising service - I'm not certain which) following up on my complaint. The lady was asking what I wanted to be done. I requested the doctor be spoken to about his "bedside manner / telephone etiquette". The lady also requested my permission to refer to the original recording they made at the time of my call to 111, to which I agreed.
I am not expecting to hear back from her.

Whatever happens, I shall continue doing what works for me, i.e. testing my blood once a day, first thing after getting up.

As I buy my own strips (since my G.P. stopped prescribing them) I can continue to build up a reliable reference as to any changes in my condition, or any trend developing over time. I do not consider one single test once a year to be adequate. A LOT can happen in a few days, or less, so just imagine what could happen in a year!

I also continue to monitor my own B.P. daily (using a electronic sphygmomanometer I bought myself when I started having health problems).

The information I get will continue to help ME monitor MY health, even if the medical profession don't consider it necessary. It won't be the doctor losing a limb or two through circulation problems, or having a stroke, heart attack or going blind, will it!
It also gives me ammunition when going to see the doctors. I can show PROOF if they don't want to take my word for it.

With my increasing shortage of breath I purchased my own pulse oximeter. This has been a boon. It is a reliable means of knowing just how much oxygen is getting through my system when I feel like I'm being smothered by a wet flannel.

On several occasions over the last couple of years I've been able to provide a print out or photograph showing my high B.P. or erratic mmol/l readings, and even my pulse oximeter readings. That is usually enough to get the doctors to take me seriously!

With the use of available technology, I've even been able to confirm, for myself, that I have sleep apnoea - without the need of bothering the health service!
I had suspected this for some time; so, using a night vision CCTV camera (recording my movement in bed during the night) it clearly shows me becoming restless then sufficiently agitated to wake myself whilst struggling to get air. Each time it happens a quick check confirms a dangerously low blood oxygen level. Whilst useful information for me, I doubt I'll bother even seeing the doctor about it.

Armed with the necessary proof I suppose most people would be telling the doctor and getting treatment. I on the other hand won't be bothering.
But, the whole point is - KNOWLEDGE can save lives. Without the means to test thoroughly medical conditions can develop unseen, often until it is too late to act on.
 
Oh my goodness, this thread is full of newbies. Will you please read the post from Daisy. It seems that people are still being fed rubbish about diet.
Read Dr Eric Berg or Jason Fung for some excellent advice. Also Blood sugar 101. Your diet should be very different these days. You should be eating more healthy fats, like butter, bacon, avocadoes, olive oil. Plenty of eggs, and green veg. Stuff grown above ground.
And testing should be before you eat and 2 hours after, otherwise they are just random numbers which tell you nothing. The 2 hours after is to judge how the food the you have eaten affects you.
 
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