No test strips or lancets on the NHS?!!!

type 1 or type 2, or any of the other "types", doesn't matter, as long as you are on medication, you are entitled to free prescriptions in England, and that exemption covers ALL PRESCRIPTIONS, not just your diabetic medication, i have been type 2 since 2001. and only paid for my first ever prescription, but i was able to claim back the cost, it took 2 weeks for my exemption card to come through, and i have just renewed it, i have never ever been refused strips or lancets, i have been with my current GP since November 2012, and have just picked up my 6th prescription for strips!

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Are you type 1 or type 2.
If you are type 1 then this is totally unacceptable.
Type 1 diabetes is a different disease than type 2 although the consequensces of poor control are the same.
Type 1 is an auto immune disease that attacks the pancreas and results in being unable to produce insulin therefore we have to inject insulin at every meal.Only 10% - 15% of diabetics in Britain are Type 1.
In order that we do not under or over inject we need to test our blood sugar levels before every meal.
We also need to test if we suspect low blood sugar levels to prevent hypos.
I understand some type 2's do need insulin but the majority are controlled by oral medication and diet.
Type 2's do produce insulin but cannot process it for a number of different reasons.
As I understand it Type 2 can be well controlled by following a well balanced diet and can sometimes lead to not needing medication at all.
I realise this is not the case for every Type 2.
Therefore I do not see the need for constant testing unless on insulin.
Type 1's could not self medicate without testing.
Therefore I can understand the decision not to prescribe strips on the nhs to Type 2's unless they are on insulin.

deli di said:

Are you type 1 or type 2.
If you are type 1 then this is totally unacceptable.
Type 1 diabetes is a different disease than type 2 although the consequensces of poor control are the same.
Type 1 is an auto immune disease that attacks the pancreas and results in being unable to produce insulin therefore we have to inject insulin at every meal.Only 10% - 15% of diabetics in Britain are Type 1.
In order that we do not under or over inject we need to test our blood sugar levels before every meal.
We also need to test if we suspect low blood sugar levels to prevent hypos.
I understand some type 2's do need insulin but the majority are controlled by oral medication and diet.
Type 2's do produce insulin but cannot process it for a number of different reasons.
As I understand it Type 2 can be well controlled by following a well balanced diet and can sometimes lead to not needing medication at all.
I realise this is not the case for every Type 2.
Therefore I do not see the need for constant testing unless on insulin.
Type 1's could not self medicate without testing.
Therefore I can understand the decision not to prescribe strips on the nhs to Type 2's unless they are on insulin.

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i am type 2, my medication CAN cause hypos, namely Gliclazide and the byetta injections, BY LAW i am not allowed to drive if my bg is under 5mmol, BY LAW i have to test before driving, AND EVERY 2 HOURS, this is not JUST ME, but any diabetic using medication and driving, I CAN, AND OFTEN DO EXCEED 500 MILES A DAY

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KarinB said:

Now I do understand about T2 and how people end up with it but I fail to understand why the country should pay out for your strips and lancets etc. if you don't look after yourself and end up T2. My 19 year old son was diagnosed last year with T1 through no fault if his own and his equipment and medication keeps him alive so T1 should always be free.
I have a visual impairment (macular dystrophy) and apart from receiving a free eye test I have to pay for my glasses, I also have hearing problems and have to pay for all of my medications relating to it.
I really wish T1 and T2 were always stipulated in stories in the media as they are NOT one if the same!

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Sorry to say I find your comments an insult to type 2's as not all are over weight, though I am and have been this weight for a good number of years and tried various methods of loosing it, though have lost a few kilos since Feb.

I have been type 2 for 13 ish years and until recently managed on metformin, due to me now producing less insulin I have been put onto other meds that kick start the pancreas into producing more insulin. I am now in the same class as type 1's of having to test my BS more often due as the new meds can cause hypo's. As DVLA require us to test before and 2 hours whilst driving my test strip usage has further increased,

Type 2's also need to test to find what food affects them, In the followed doctors advice and only test when things were not right. This approach has unbeknown to me lead my BS to slowly creep up over a period unnoticed as my doctors only test the HbA1c once a year. As I am not on insulin If my BS has a real high I can't just inject a bit extra insulin to bring my BS down I have to wait until they come down or when its time for the next dose of meds and hope they come down. If all type 2's tested more often we would probably identify our problems sooner and maybe before they got to a stage where costly meds or operations are needed.

I felt rough over xmas and new year and when testing my self my BS was mostly in the 20's. If I followed sensible advice and monitored more often I could of caught the problem a lot earlier. From testing more regularly and checking what the readings were after eating food. I have found that the main culprit for a rapid rise in my BS is anything made with white flour.

I am now in a position where my BS are mostly in acceptable ranges, with a few peaks and lows, still further work required on identifying what else causes the peaks and the latest problem is either rice crispies or cornflakes or both. I am now also having to learn to eat at more regular times as if I have a late lunch I am aware that my numbers get close to the low 4's.

Your case and others on medication that causes hypos and testing every two hours should get free testing strips and I hope you get them, but there are a lot of type 2's who can control by diet and do not need to test sugar levels to know what not to eat.

The problem is the evidence says it doesnt help.
see:
BMJ 2007;335:132
or http://www.bmj.com/content/335/7611/132
Before this standard practice was to encourage testing pretty much all the time. This study showed on a population basis it doesnt seem to make much difference to outcomes. Therefore the NHS decided it wasnt a worthwhile use of money.
The problem is of course that although on average the population doesnt benefit there will be individuals that do. The trick is identifying the individuals who will benefit from testing and make sure they do the right amount - not too much not too little.

Reading through the replies the main reason why some people seem to want to test a lot is to get a feel for how food and exercise affects them and to help them learn a new pattern of behaviour that helps them maintain control. I think this is great and a reason why to have sticks for a while but its not something you have to do for ever.

The NHS is a complicated beast - there will be older doctors and nurses who trained then routine testing was the norm who arent as up to date as they could be who dont know not to encourage it routinely unless there is a reason - hence why some give them out without a thought.

As most on here know money in the NHS is tight and the medicines management people (pharmacists largely who work for the PCOs not you local shop ones) are charged with finding cost savings - its an easy one for them to attack. They have evidence it doesnt work they put out a blanket ban and use all their weapons to make GPs and others adhere to their decision. The few who would benefit suffer - though some enlightened GPs might understand and prescribe.

to the poster who claimed that GPs profit from not prescribing Metformin - i dont follow your argument - the QOF pays GPs for reaching certain quality targets - achieving good HBA1c control in diabetics is one of those targets. Prescribing budgets are indicative budgets GPs don't make any money on them. Some areas have incentive payments for coming under budget - A GP trying to achieve these incentives and they arent availble in all areas - usually in overspent ones - is unlikely to bother withholding metformin as its cheap - there are plenty of much more expensive drugs to look at first.

Finally - the interesting thing that no one has mentioned is urine sticks. These are cheaper and basically tell you when your sugar is above 10. There is an argument for using these.

pav said:

KarinB said:

Now I do understand about T2 and how people end up with it but I fail to understand why the country should pay out for your strips and lancets etc. if you don't look after yourself and end up T2. My 19 year old son was diagnosed last year with T1 through no fault if his own and his equipment and medication keeps him alive so T1 should always be free.
I have a visual impairment (macular dystrophy) and apart from receiving a free eye test I have to pay for my glasses, I also have hearing problems and have to pay for all of my medications relating to it.
I really wish T1 and T2 were always stipulated in stories in the media as they are NOT one if the same!

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Sorry to say I find your comments an insult to type 2's as not all are over weight, though I am and have been this weight for a good number of years and tried various methods of loosing it, though have lost a few kilos since Feb.

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Now you see that comment of yours is typical of a T2 diabetic jumping to conclusions.. Now where in my post did I mention being overweight? Nowhere, What I did say is "if you don't look after yourself". Now seeing as you have brought the word overweight into the subject I will comment on this. If T2 is caused purely by being overweight then why should every taxpayer in the country pay for medications etc. when you cannot keep your weight under control. I live with three other family members and we are all slim and manage to keep our weight to a good weight. If I or any one of us chose to start lying around eating more calories than we were going to burn up, get in the car and drive everywhere and do no exercise at all that would be another 3 potential people requiring free medication if we ended up T2 - our NHS is not a bottomless pit.
When the media report about the enormous strain that diabetes is going to have on the NHS it really makes me annoyed as my son, with T1, as like many others, is tarred with the same brush as the T2 who are the ones that the media are talking about.

Is t2dm anyones fault?
Does being fat cause diabetes or does being predisposed to being diabetic make it more likely you will be fat?

to KarinB - can i send my sympathies - having a son recently diagnosed with T1 is hard, particularly if you are unwell yourself. The acute nature of T1 makes it difficult to deal with. The fact that its started early and will be a life long daily grind is upsetting. T2s have it easy in comparison. The good news is I know loads of T1s who have full lives and have achieved great things - though most go through bad patches. Having loving relatives and friends helps and i'm sure you must be a comfort to him.

Unfortunately im not sure i can agree that developing T2 is always the persons fault - if thats what you mean? (perhaps ive misunderstood?) The situation is so complex. There is a large genetic component to T2. The insulin resistance that is the key problem in T2 is perhaps what makes people more hungry and therefore they eat more and gain weight leading to a destructive positive feedback loop. there is a lot of evidence that high fructose corn syrup a large component of modern diets is a culprit in causing problems with insulin sensitivity and no one is choosing to eat this its being done to us - its added to all sorts of food stuffs to make them sweeter cheaply.

Don't get me wrong - poor dietary choices, comfort eating, sedentary lifestyle, high alcohol intake have a part to play but who actually develops T2DM and when may be more genetic that just the amount of calories one has eaten in a lifetime. Indeed there may be 2 types of obesity - the just eats too much like Greg Wallace -who apparently eats out at a restaurant every night and when he cut back lost weight and the intrinsically overweight that really just cant loose weight.

I find it strange that smokers in some quarters are treated so lightly yet overweight people are the butt of jokes and its always assumed its their fault rather than socioeconomic, behavioural and genetic factors. even alcoholics seem to be immune to criticism when was the last time you heard a joke about an alcoholic - why are they less to blame than obese people?

As TheLovelyTarotLady says reprogram might be right - some overweight people might be fighting as hard as drug addicts to kick the habit with their own bodies making it harder for them.

Im hoping the trials of GLP1 drugs in obese non diabetics have successful outcomes, weight watchers isnt enough for everyone and the drugs we have had so far havent helped real numbers.

Unfortunately, being overweight and sedentary does lead to the majority of T2 diabetes. Note I said majority, there will always be those who don't fall into this category. As will a few non smokers get lung cancer. A lot of the problem is education and the media. It's only when you get diabetes that you learn about it. Prior to diagnosis, I too thought ( incorrectly ) that type 2 diabetes was a "lifestyle" problem.
What we need to avoid though, is bickering between type 1's and type 2's. I think both should get the oppertunity to receive test strips to monitor their own BG levels.


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mo1905 said:

Unfortunately, being overweight and sedentary does lead to the majority of T2 diabetes. Note I said majority, there will always be those who don't fall into this category.

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There are large numbers who are classified as non obese who get it, particularly in asian populations. Ironically, they are less likely to know that they are at risk, because they tend to be thin. The problem is the intra organ fat and, according to Taylor, the liver and pancreas triglycerides. In the west, most obese people do not have diabetes but they know they are at risk because they can see for themselves, fats are accumulating. People like Ran Fiennes who are thin and run marathons don't know the fats are accumulating in their organs. I suspect that types of food together with several interacting genetic mechanisms are involved. In obese patients, the tipping point, the point at which insulin production is adversely affected, is unpredictable. For some patients it may be a BMI of 25 whilst others with a BMI of 35 are unaffected. In non obese patients, the picture is even less clear, but there are large numbers out there.

Non-obese patients with type 2 diabetes and prediabetic subjects: distinct phenotypes requiring special diabetes treatment and (or) prevention? http://www.ncbi.nlm.nih.gov/pubmed/18059616

It seems that now the genetics is better understood, type 2 diabetes is starting to be classified as an autoimmune disorder rather than a metabolic disorder.

Type-2 diabetes linked to autoimmune reaction in study http://med.stanford.edu/ism/2011/april/engleman.html

Hi Everyone,
I’ve type 2 diabetic for 2 & a half years.
Today because of my blood Glucose was always high for last 6 months, been given a Blood Glucose monitor.

Although Doctor would have given me one on prescription, they gave me one they had at the Surgery. Apparently reps give them loads, because the manufactures’ make all the money from testing strips.
The Doctor also gave me a prescription for 2 months’ supply of testing strips, prickers & told me to repeat prescription when necessary.

Ive got to keep a diary of readings, before Doctor deciding whether im to go on Insulin.

So im not sure what to make of it, is it the Doctor who decides who gets these strips on Prescription or circumstances?

kennethingram said:

Today because of my blood Glucose was always high for last 6 months, been given a Blood Glucose monitor.

Ive got to keep a diary of readings, before Doctor deciding whether im to go on Insulin.

So im not sure what to make of it, is it the Doctor who decides who gets these strips on Prescription or circumstances?

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Both. the doctor decides based on your circumstances.
There is no evidence for routine use of sticks in stable individuals on oral meds only. You are obviously having problems and you therefore count as one of the people who may well benefit from more intensive monitoring so you are eligible for sticks.

To ALL DIABETICS [TYPES1 AND 2].

Diabetes is a a killer disease.

We are ENTITLED under Law and the BRITISH EUROPEAN PEOPLE'S NHS , to have FREE ACCESS to MEDICATION and TESTING MONITORING.

If there are ANY DIABETICS IN THE UK, who are being denied this FREE ACCESS either from your GP, Diabetic Nurse,Etc

YOU MUST IMMEDIATELY GO AND SEE YOUR GP FOR WHATEVER YOU NEED BECAUSE YOU ARE LEGALLY ENTITLED TO IT! DO NOT BE FOBBED OFF BY THESE OVER PAID AND SELF-EXHAULTED PEOPLE. GET YOUR MP AND MEP INVOLVED.

YOU CAN BE ASSURED THAT IF ANY GP ETC, SUFFERS FROM DIABETES, THEY ARE GETTING EVERYTHING THEY NEED FREE ON YOUR NHS!!!

I ALSO STRONGLY RECOMMEND THAT THESE LAWBREAKERS ARE NAMED AND SHAMED, WHOEVER THEY ARE. SO COME ON, GIVE US THEIR NAMES. SEND THEM A STRONG MESSAGE.

DO NOT ALLOW YOUR POWER TO BE ABUSED OR PUT DOWN. YOU HAVE LEGAL RIGHTS; DO NOT EVER FORGET THIS.

Its ok saying YOU ARE ENTITLED in nice shout capitals, but actually telling what part of law actually says these things, so we can go into the Dr and say law xyz section 739 says we are entitled and etc, rather than just encouraging people to go shout without full comprehensive follow up...will await answer before i shout. Don't really care what Dr themselves get, i want to know completely how to back up my claim.

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kerrycakes said:

Its ok saying YOU ARE ENTITLED in nice shout capitals, but actually telling what part of law actually says these things, so we can go into the Dr and say law xyz section 739 says we are entitled and etc, rather than just encouraging people to go shout without full comprehensive follow up...will await answer before i shout. Don't really care what Dr themselves get, i want to know completely how to back up my claim.

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kerrycakes, may I ask, do you drive?

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Unfortunately, there is no law that states you are entitled to test strips. There are NICE guidelines, but even theses have many grey areas. Generally, type 1's will get free test strips, amounts vary. Type 2's newly diagnosed will generally get strips, for a while. After that, some type 2's on any meds that can cause hypo's will get strips. Again, this is not always the case. I would suggest not screaming and demanding strips from your GP but try to reason with them and perhaps negotiate what you can. There will always be certain GP's that are more compassionate with diabetes than others though. Good luck to all !


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Nope, im medically exempt from driving on other grounds.

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By law, if you drive, you must test before and every 2 hours. However, nowhere is it written that these must be obtained free on prescription. I don't agree but I just think it's usually more beneficial to persuade than demand.


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mo1905 said:

Unfortunately, there is no law that states you are entitled to test strips. There are NICE guidelines, but even theses have many grey areas. Generally, type 1's will get free test strips, amounts vary. Type 2's newly diagnosed will generally get strips, for a while. After that, some type 2's on any meds that can cause hypo's will get strips. Again, this is not always the case. I would suggest not screaming and demanding strips from your GP but try to reason with them and perhaps negotiate what you can. There will always be certain GP's that are more compassionate with diabetes than others though. Good luck to all !

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See, this sounds much more sensible than shouting and stuff. It just annoys me when people come along, and shout abpit stuff and don't back it up with actualities. Also, being aggressive and shouting at gps could end in you being removed from the surgery, by police, and leave you in need of a new gp if you can find one who will take you...Js...

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