Not only doctors giving duff information

ert said:

I'm in a honeymoon period and not on insulin. They must have clear prescription guidelines for insulin and testing strips. There is a couple of GP's who understand the ramifications of having very low c-peptide, but for most, it's something left to the specialist to interpret. However, it's clear in the letters from the specialist that he wants me testing blood sugars and blood ketones and that I will need to start insulin if my blood sugars start rising to 13 with high ketones to avoid DKA, which indicates I've deteriorated further.

Click to expand...

it seems a no brainer that you cant pick up any increase in blood sugar levels if they wont give you strips to test with. WOW. Thats tough.

DianaMC said:

That’s shocking! I’ve been looking at what might be a cause of high morning readings, and decided I should consider my (probably dodgy) habit of picking at food in the late evening. And whether or not I’m physically active in the evenings. I’m only prediabetic, but keen to do whatever it might take to reverse the diabetic trend. I would have expected some advice a bit more like that from your DN!

Click to expand...

I have tried various things but just feel my liver is trying to be more helpful than my pancreas!
It’s only what I expected from the dn, never had any help from her or doctors.

Good point about the liver doing it’s work! I’ve had help with my health from TCM and they mention a body clock of when the organs are busy. It’s 1-3 am when the liver does it’s main processing, apparently: http://www.turningpointeacu.com/blo...-the-chinese-medicine-body-clock-explains-why

Unfortunately current advice from NICE is that type 2s don't need to test - a cost cutting exercise that ignored the whole low carb/diet and monitoring impact.

TriciaWs said:

Unfortunately current advice from NICE is that type 2s don't need to test - a cost cutting exercise that ignored the whole low carb/diet and monitoring impact.

Click to expand...

If it was just down to cost to the NHS I could understand but to actively try to deter someone who is willing to self fund in an effort to improve outcomes? That seems counter intuitive to me and smacks of HCPs unwilling to relinquish control.
Yes, you can call me cynical if you like.

When it comes to the subject of costs, one has to remember that one person’s cost saving is another’s lost profit. It all depends on who’s pulling the strings and where the influence is coming from. Test strip advice clearly isn’t about cost saving in any logical sense, because the strips would save the NHS goodness knows how much in amputations alone, and that’s before we even go down the rabbit hole of hypertension, heart disease, and everything else related to metabolic syndrome. For every penny the NHS saves on test strips, it probably costs them a pound to treat the consequences with surgery and pharmaceuticals. Sadly there are forces at work who have an interest in things staying this way. The NHS itself, as a system, is an innocent victim of capitalism.

Guzzler said:

Yes, you can call me cynical if you like.

Click to expand...

You’ll be vying for the top step of the podium along with myself and @bulkbiker

Guzzler said:

If it was just down to cost to the NHS I could understand but to actively try to deter someone who is willing to self fund in an effort to improve outcomes? That seems counter intuitive to me and smacks of HCPs unwilling to relinquish control.
Yes, you can call me cynical if you like.

Click to expand...

In the old days everyone was given a meter and strips, but were not told how to use them and what to make of any results. I imagine they were told to test at the most once a day, most likely once a week. Clearly this was not helping anyone. HCPs have no idea and have never been shown that testing before and after meals to test out foods actually works. I imagine it was all costing one heck of a lot of money with no benefits. In other words, they were seen as loss makers and virtually withdrawn from use.

I have lost count of how many times I have been asked why bother testing as I cant do anything about the result. I am glad to say that, nearly always, this has led to a teaching moment about carbs and their relationship to blood sugar levels. It only took a couple of years for my DN to get the hang of it, and many other people have benefited from me mentioning it, not just from me speaking, but becasue my DN nw also spreads the word. She still doesnt say to test, but she describes the relationship better now. She told me this good news on my last review.

I wonder if in time to come this will become a massive health scandal that will go to Tribunal (like the contaminated blood one currently which has taken 30 years) because the NHS withheld and discouraged use of a simple tool to prevent serious injury or death to their largest patient group. I just cant see my children’s generation taking that on the chin and rolling over. Its negligence IMO.

busygardener said:

Hi all. A while since I posted but have been getting over my cancer treatment. Everything fine now and feeling very well. BG back under control.
On a slightly different tack - I went to collect a prescription today and was asked to speak to the pharmacist to have my annual medication review. During the course of the discussion he asked me how many times a day I was testing so I said it was several times a day. He looked astonished and said as a T2 I only needed to test once a day or even once a week! It was my turn to look astonished and I explained how it helped my glucose control and meant I knew how various foods/activities affected me and meant I would not be needing loads of medication in the future or have long term complications. Not sure I convinced him but it seems that it's not only doctors and nurses spreading false information and failing to keep up with research and results of low carb eating.

Click to expand...

First of all Congratulations on your recovery.
Secondly pharmacists do say, you don't need to test.

When this forum sends out articles or posts on Facebook. It's amazing how many people say: don't need to test, swap from simple to complex carbs, eat a healthy balance diet because its bad to miss out whole food groups,
Follow the advice given by the Dr, and dont low carb, its bad for you.
Yeh right,

busygardener said:

Don't know if part of it has to do with cost as I get tester strips on prescription. I know I'm lucky but originally I was diagnosed T1 and put on insulin so I got tester strips straight away. Eventually (2 years later) they decided I was T2 after all but my tester strips were kept on the prescription. Or then again maybe it's just ignorance.

Click to expand...

One of my GPs told me that test strips are expensive so they don’t issue them unless there is a risk of a hypo.

Jim Lahey said:

When it comes to the subject of costs, one has to remember that one person’s cost saving is another’s lost profit. It all depends on who’s pulling the strings and where the influence is coming from. Test strip advice clearly isn’t about cost saving in any logical sense, because the strips would save the NHS goodness knows how much in amputations alone, and that’s before we even go down the rabbit hole of hypertension, heart disease, and everything else related to metabolic syndrome. For every penny the NHS saves on test strips, it probably costs them a pound to treat the consequences with surgery and pharmaceuticals. Sadly there are forces at work who have an interest in things staying this way. The NHS itself, as a system, is an innocent victim of capitalism.

Click to expand...

I would have written all of this with my caps lock on.... except I have been told off already for shouting Jim.

Jim Lahey said:

When it comes to the subject of costs, one has to remember that one person’s cost saving is another’s lost profit. It all depends on who’s pulling the strings and where the influence is coming from. Test strip advice clearly isn’t about cost saving in any logical sense, because the strips would save the NHS goodness knows how much in amputations alone, and that’s before we even go down the rabbit hole of hypertension, heart disease, and everything else related to metabolic syndrome. For every penny the NHS saves on test strips, it probably costs them a pound to treat the consequences with surgery and pharmaceuticals. Sadly there are forces at work who have an interest in things staying this way. The NHS itself, as a system, is an innocent victim of capitalism.

Click to expand...

You are right, of course. However, it is very clear that the NHS has not "discovered" that testing meals and so forth is an option. Everyone was prescribed test strips at one time but no-one knew how to use them to their advantage. They were told to test at most once a day, testing meals was never recognised and still isn't. It must have become clear that this was a waste of money because they didn't help people to improve their diabetes and did not reduce the dangers of complications or increased medications.. It was unknown for T2s to attain remission or good control with the use of test strips. So ... in the absence of advice to test before and after meals, hardly anyone got better. Therefore withdrawal of these prescriptions was seen as a good cost cutting measure, and that is the status quo. NICE and HCPs need to be made aware of how testing does help enormously when done properly in a structured fashion. Maybe once that hurdle is overcome, they may be made available again.

I sometimes wonder whether the reason they won't give strips and a meter to the type 2s who WANT to test, is because they know that those people care about their health to the extent that they will take precautions no matter what. They know that those people are more likely to buy their own if they don't get given them so they are probably thinking 'Why should we bother'. It's a similar principle for the allocation of a libre, talk about jumping through hoops. Those showing an active interest in monitoring and managing their diabetes are NEVER the priority when it comes to help. I do get that the NHS has a budget but I also think they could make better decisions based on the individual in front of them (who is TRYING) rather than a blanket NO. I wonder whether type 2s who do not manage their diabetes as such get offered a meter & strips in order to improve?

Gotta love bureaucracy... don't need to test. Type2's newly diagnosed literally have very poor control, often accompanied by poor blood test results in general. You'd think it would be a priority to try and get better control and that can't be done without measuring. So let's offer nothing to these poor unfortunate people in the way of help for measuring their levels, unless they are on hypo inducing drugs. They are struggling with the shock of diagnosis and don't know what to do next. They receive horrendous dietary advice that is backed by decades of complete failure, which if followed worsens one's health by accumulating complications, but somehow it's expert advice. And not only denied strips, but actively told they shouldn't test and some are berated for wanting to. It makes no sense to me.

I don't know who is responsible for these decisions. It's a shame these officials can't be taught a lesson to make them understand what not testing is like. These officials should be asked to try and drive a car while blind folded. You wouldn't even get them behind the wheel, they'd think you're mad to suggest such a thing. To me that would be the point, because that's what not testing is like, you can't see what your levels are doing because you are effectively blindfolded by an unhelpful and at times deliberately aggressive system.

Hats off to all those who self fund to test, even though they've been told not to.

I am leading a 'walk and diabetes' talk course aimed at pre diabetic and newly diagnosed type 2s.
Am telling all to invest in a glucose meter and test at appropriate times. Not to make anyone neurotic but just so they know what is happening when they eat different foods. They seem receptive to the concept and it makes sense to the 2-3 people who do not want or need to lose weight but do need to improve their metabolic health.
Ideally these guys should get a freestyle libre and use it for a couple of weeks with unlimited testing but a basic meter is cheaper obviously.

I think that those prescribing test strips for those not on insulin feel that they would give themselves more work plus cost in terms on explaining how to test and how to interpret the results rather than actually help the patient help themselves.
After all if you believe that weight loss and calorie control are the key to diabetes resolution then you will not expect your patients to lose weight (most people can't do that via calorie reduction) but merely to progress their diabetes whilst you keep an eye on the 'co morbidities' and hand out more drugs.

NicoleC1971 said:

I am leading a 'walk and diabetes' talk course aimed at pre diabetic and newly diagnosed type 2s.
Am telling all to invest in a glucose meter and test at appropriate times. Not to make anyone neurotic but just so they know what is happening when they eat different foods. They seem receptive to the concept and it makes sense to the 2-3 people who do not want or need to lose weight but do need to improve their metabolic health.
Ideally these guys should get a freestyle libre and use it for a couple of weeks with unlimited testing but a basic meter is cheaper obviously.

I think that those prescribing test strips for those not on insulin feel that they would give themselves more work plus cost in terms on explaining how to test and how to interpret the results rather than actually help the patient help themselves.
After all if you believe that weight loss and calorie control are the key to diabetes resolution then you will not expect your patients to lose weight (most people can't do that via calorie reduction) but merely to progress their diabetes whilst you keep an eye on the 'co morbidities' and hand out more drugs.

Click to expand...

Which glucose meter is the best one to get - I am newly diagnosed Type 2 and I also think that if I test, I would like to know which foods to avoid.

1spuds said:

Would have stood up after her yelling at the man,and informed her she needs an education ,what she is spouting is nonsense.Then security would escort me out.

Click to expand...

I did just that when I did the worthless course. Plain simple language that what they were saying was outright dangerous! Then I walked out.