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NHS Direct doctor says... NO testing when taking Metformin
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<blockquote data-quote="Phil-Clements" data-source="post: 864948" data-attributes="member: 79838"><p>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.</p><p></p><p>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.</p><p></p><p>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?</p><p></p><p>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?</p><p></p><p>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.</p></blockquote><p></p>
[QUOTE="Phil-Clements, post: 864948, member: 79838"] 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. [/QUOTE]
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