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

  • Thread starter Thread starter 999sugarbabe
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I totally agree with you , also when I have tested and have high reading 16.5 I had no unwell symptoms I only have noticeable symptoms when I have Bg of low 4's and mid 3's .So without testing I would not have any clue as to what damage I am causing .
 
Hi ,this was Hi there ,this is so me of late ,I'm also type 2 and test my sugars ,they have been up to 11.9 which is high for me ,I was exactly in your situation ,headaches ,sicky ,craving sugar ,all in all unwell and not knowing what to do in the end I just sleep but like you worried about waking or not waking up ,as being single mum on my own who would be there for my son ,my GP tells me not to test as worry myself but he knows I only do in a morning ,when unwell and at night ,I understand you totally lol xxx
 
 
My own GP recommends that I only test if I feel unwell (although I do from time to time out of curiosity and to check all is in order). He did point out that I should be aware that my own test results could cause unnecessary worry. So every now and again I test for a few days pre and post pransial etc and average out the results. And when I do I feel much better for it.

As far as eating goes, If I haven't had food at my usual times I always feel a bit wobbly, usually cured by having even a small snack, especially if I'm out walking/cycling or even gardening!
 
Hi,I was diagnosed with type 2 last year,at first I was told to do a daily reading,which I did,then when I went for a blood test the nurse I saw was quite rude to me and told me I have no authority to do any readings and I was wasting her NHS money and was never to do it again,which both upset me and annoyed both myself and my husband who was with me at the time this happened,luckily we moved and have a new doctor now whole is very nice,I explained things to him and he said that if I wanted to check my readings then that was up to me and agreed that yes it does help by giving warnings of any trouble or problems that could come about and that it was helpful to any doctor if the readings are shown to them,as yet I've not taken him up on his very kind offer,I will be asking next time I see him though,the way you were treated by this doctor is out of order,I would see my own Dr if I was you show him your readings and tell him how you wete treated,as that was diabolical and should not be aloud,yes they have a stressful job and and any Dr should be grateful for every little bit of help and doing readings is important to you and should be to him,I'm really sorry you were treated like that...
 
Type 2 diabetic, I was on metformin, I tested my blood glucose occasionly and when I felt weird, I should point here out I was on a 2nd course prednisolone for an asthma problem. On one of these weird occasions I tested my blood glucose and the machine said "higher than 33 mmol/L seek medical advice". When I visited the doctors, the blood ketone test meter was showing the highest reading, above 1.5 mmol/L which caused some concern, I took glibenclamide over the next 24hrs the ketones came down, but the glucose readings were always in the mid twenties, the steroids had killed off my insulin production to a level where I needed regular insulin, I am on a mixed insulin pen twice a day 58 unit and 32 units. If I wasn't testing my blood glucose how would I have known I had a problem before getting diabetic ketoacidosis and ending up in hospital. Like other people have said before, regular blood glucose testing can reduce Hb1C, therefore reducing future diabetic problems, therefore reducing NHS costs for diabetics over time. The decision is of politicians and their appointed manager cronies thinking of short term financial management which keeps them in office.
 
999sugarbabe said:
How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

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This is precisely the point. To make matters worse, since i was diagnosed with Type 2 Diabetes some three years ago, i have had reasonably regular fasting blood tests. Now, suddenly, I've just had a non-feasting test. Apparently this is the new standard. But I haven't a clue how this is going to affect the results.
 
I was diagnosed nearly 7 years ago. I'm 5'6" & then weighed around 95Kg (nearly 15 stones). Not good. Set about reducing the amount I was eating with only marginal input from the practice which by & large I was happy with. However when I asked about testing I was given the usual line that the twice yearly Hba1c test was adequate & that if I followed a sensible diet I'd be fine.
2 years after diagnosis I had got down to around 78Kg by making "sensible" choices. I knew I needed to lose more weight (I have a personal goal to get down to around 75Kg in the short term & eventually 70Kg long term).
Two years ago I moved to another part of the country. Almost immediately my metformin was doubled even though my Hba1c was still around 6.5-7 as it had been for the past 5 years. Presumably my LFT had revealed a few proteins so I was put on Ramipril for my BP (side effect I get a cough now & again & yes I've checked this isn't something more serious) which is supposed to lessen the effect of the Atenolol. At the new practice not much advice about diet other than "eat sensibly".
I am about to embark on the self testing regime (I will probably start tomorrow being the first of the month) and reduce my carbs & meal size portions.
I get plenty of exercise (minimum of 5 hours/ 11 miles a week strenuous walking with two groups - I live in the Peak District, plus I always walk to the shops which adds another 3-4 miles per week, and a little cycling). I think my mental health is quite good - I sleep well apart from getting up in the night to visit the loo - normal especially when I think I hit 70 in 10 days time.
I am looking forward to mentioning my self testing when I ask if the surgery will take my sharps boxes for disposal. Even if I get an adverse reaction I will still carry on (my last 3 years of work was in a GP surgery looking after clinical systems so I'm not too overawed by the medical profession, especially as I'm seen only twice a year at the diabetes clinic).
Might even consider setting up a blog with my experiences if I can find the time.
Good luck to everyone & remember - nil carborundum.
 
This is a topic that goes round and round in circles every time that it comes up. In my own case I bought a meter before even going to the GP - I was fairly confident that I knew what the problem was (couldn't stop going to the toilet, feeling dizzy and tired, generally 'unwell' and with a wicked case of Thrush). My BG was over 28 mmol so it was pretty obvious that I had finally succumbed to Diabetes after years of poor weight control and bad food and exercise habits.

Once formally diagnosed I asked for more test strips and was told that it was bad practice to self-test, especially in the first few months after diagnosis as my BG would stabilise due to changing my eating regime, increasing exercise and because I would be regularly monitored in that time anyway. Sure enough my BG dropped dramatically and my HBA1C was stable at around 5.6 within weeks. I was reluctantly given 1 tub of strips at my first annual check up but only because I drive long distances and for safety reasons it was agreed that I should test if I was due to make an especially long journey and if I felt dizzy or weak beforehand as this could indicate a low BG. To be honest I am still (just) on the same tub of strips almost 5 years later. I have perhaps experienced a handful of occasions where I have found my BG to be low on testing but certainly don't test so long as I feel OK. My annual HBA1C has never been higher than 6 ish and I eat normally and at more sensible times, no special diet, I walk a fair bit more than before and other than that I just keep taking the tablets. I have never been told to avoid particular foods, just that everything in moderation and exercise more was more appropriate.

The problem for health professionals I suppose is not isolated purely to the issue of cost, although it must be a common factor. As we all know, no Type 2 is the same. We all have different degrees of symptoms and react in different ways to certain foods. Some (like me) seem to be able to eat relatively normally whilst others will suffer some fairly drastic BG effects with certain foods. As is evident in the posts above (and in the OP's original one), so many people do not know how certain meds work, others will follow certain diets and although not always the case, some will use testing to self-diagnose, change diets from one to another fairly regularly or to vary their meds. Without a doubt there are many, many people who definitely need to test, manage their BG effectively and are healthier for it, but equally there is a high percentage who just test routinely without knowing how to interpret results, and worse still who then do not take appropriate action. That is the problem for the NHS - issue test strips to every Metformin treated T2 without proper education, or only to those where there is a genuine need?

I suppose what I am saying is that there can never be a one size fits all approach to the management of T2 and the fact that so many people are still in the dark and wanting to rely on testing says more about general NHS underfunding than it does about purely saving money on test strips. I am lucky that in my area I have no problem with access to a GP who is also a Diabetes specialist if I have any concerns, and I am called promptly for annual checks and retinopathy screening, but it seems that many people are not so fortunate. How many, I wonder, would benefit more from a monthly check up, bloods, current dietary advice and a meds review rather than testing for the sake of testing?

As I say, I do not think there can ever be a single 'best practice' way of doing things but there should be better support based on each person's individual needs.
 
That GP is ignorant! I suffer from diabetic neuropathy and I am instructed by my diabetic clinic to test 3 times a day. Now,not having breakfast is very bad for you!
 
NHS Scotland appears to work differently to England and Wales. I am Type 2 and have been encouraged by my practice diabetes specialist GP, to test on a regular basis. This, since I was first diagnosed, and on diet only regime. I was put on Metformin some years ago, and continued to test, as advised. I am now also taking Gliclazide in conjunction with Metformin, and still test 3 times per day. This helps me control my diet far better. This appears to be one of the few occasions when NHS Scotland is better than NHS England. I must add that NHS 24, is far superior to NHS Direct, and their doctors would never give you such poor advice.
 
Nhs direct was effectively disbanded in England and got renamed as 111. Now its 111 and being run by all sorts of different services... The tender for our CCG's 111 and out of hours GP services are currently run by 2 different organisations and is coming up for the contracts to be renewed. Even the 111 services aren't given by one provider for England... So Dorset and Somerset and Birmingham could all have different people giving 111 information and GP outside normal hours contracts are exactly the same.
So wasteful of money... Every CCG will have people in charge of tendering rather than 1 person taking in tenders and we are paying extra money for these people in every single CCG rather than one person looking after for England!!!
 
I am one of many Diabetics (type 2 ) Who are unable to eat breakfast as it makes us extremely lethargic,yet Bg levels are fine. I can eat at around 11:00 to 11:30 with no problems so that is when I take my tablets I have arranged my tablet schedule to coincide with my eating schedule and it appears to work just fine for myself and a few others. I have to contact my Dr tomorrow (Monday) as I did not receive my testing strips and they are not on the repeat form. I take metformin and Gliclazide and according to the Dr I am supposed to test..Odd how I did not get my strips and I asked for them specifically hmmm
 

Useful to hear, m'friend- and I'd surely dip into a blog from someone who nows both sides of the counter as 'twere!
 
Hi. The HBA1C does not need a fasting test and the previous fasting blood sugar test was waste of time so in this the NHS have done something sensible. The cholesterol results will be less reliable but some us believe cholesterol levels are not of any significance
 
This is only because no one is teaching the glycemic load of foods. If you're on Metformin and your blood sugars are high, you need to cut down on high glycemic carbs. You shouldn't just take more Metformin. And if you're not willing to learn about what foods are causing the problem, then you are in big trouble. A tiny few have diabetes? I'd say 70% of adults have diabesity - obese (BMI 30 or higher) and problems with their blood sugar.
 
hi im in australia and was interested in your post i just wanted to say my blood was at 20 when first diagnosed and put on the melfomin at 500 but was upped tp 1000 and is now to around 6 to 8 depending how the day has been,anyway my doctor originally had me testing often but once it was down he was pleased and has told me to test occasionly prob once or twice a week but not to stress about it. also i was told to take my tab at night after dinner, i wanted to take in the morning but he said no at night anyway i hope you have yours under control and just thought i would let you know how it is down here i couldnt imagine my doc saying dont test at all as you say how do you know if your sugar is under control
 

In my experience, your current blood sugar problems need medical attention, as the metformin is obviously not working so well for you.

Metformin works in 3 key ways - 1) it reduces the amount of sugar produced by cells in the liver, 2) it makes your muscle cells more sensitive to the insulin in your body, and 3) it delays the absorption of sugar from the intestines into the blood stream.
It is important to take metformin just before,with or immediately after food. Taking it with food not only helps it to work much better, it also reduces the risk of gastrointestinal side effects.
If metformin, diet and exercise are not working for you, the next step could be increase your metformin dose, or to add in another medication such as gliclazide.
If you have problems also controlling your weight, you may be suitable for a medication called liraglutide, which is a once-a-day injection.

So my advice, as well as eating breakfast with your metformin (or leaving your fist dose until you do actually eat something) I would suggest you make an appointment to see your GP or even better, your specialist Diabetes Nurse.

On the subject of self testing your blood glucose, I believe every diabetic should be given access to a free meter, testing strips and lancets. When I was first diagnosed with diabetes at the age of 27, I was told I needed to test four times each day to begin with, so I could build up a picture of what was happening with my blood sugars in relation to the food I was eating, exercise taken, etc. So I started a "Diabetes Diary" whereby I recorded all food and exercise I took along with the times taken. I was also referred to a dietician, who advised me to replace white bread, rice and pasta with the brown or wholegrain varieties, as well as reduce my carbohydrate intake and increase my protein intake. After a short time (about 4 months) I had a good idea of what to eat, when to exercise, etc..., and reduced my BMs to once daily and continued to do so for many years until I became insulin dependant 4 years ago.

I know these days there are many different camps regarding dietary advice for diabetics, and things have changed quite a bit in the 12 years since my diagnosis. But it is important to try different approaches, whilst continuing to self monitor, and find the dietary advice that suits you.

Anyway, get in to see your GP. Ask him or her for a referral to a specialist Diabetes Nurse, and take it from there.

Best of wishes with your health.
 

You're quite correct about metformin and food to avoid stomach upsets, but also because one of it's actions is to reduce the amount of sugar absorbed from the intestines.
Also, yes, your liver will produce sugar and release it into your blood stream if you don't eat enough or regularly enough. This is also part of the bigger picture in T2 diabetes, as the chemical pathways which lead to the liver producing sugar can be triggered by the muscle cells because they're not absorbing insulin properly, so they call out for more fuel, and the liver responds, sending your blood sugars ever higher!
Metformin is supposed to help reduce this mechanism by helping the muscles absorb insulin better so they can use the blood sugar more effectively, and thereby reduce the calls on the liver to produce more sugar. It also helps to stop the liver producing more sugar directly by acting on the liver.\
Sadly, metformin does not seem to be effective for everybody , and is often used in conjunction with gliclazide for this reason.
 
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