Oral medicine ""no need to test""

Hi and welcome

Your profile is incomplete, so I don't know what type of diabetes you have, or what medication you are on.
Type 1s should always have access to testing equipment, because of the insulin they inject.
Type 2s should always have access to testing equipment if they are on insulin or other blood glucose lowering medication such as Gliclazide.
Type 2s who manage with diet/lifestyle/Metformin are usually told they don't need to test, and are patted on the head and told 'don't worry, we will run periodic tests.' But the reality is that the NHS cannot afford to provide testing equipment to all T2s.

Most T2s on this forum self fund their own testing equipment, because they consider self testing to be very important to their diabetes management, and don't think that HbA1c tests every 3 or 6 or 12 months are enough.

You may find this thread an interesting read
https://www.diabetes.co.uk/forum/threads/have-you-been-told-not-to-test-your-blood-sugars.66574/

PaulRR said:

I very recently had a A1c of 8.8,so decided to do some thing about it. I do intense weight training 4 times a week and cardio 2 times a week . I decided to test before and after training, before after meals and before bed time ( 6-7 times a day) I soon found that my training was causing long lasting spikes so changed my routine with success, but I soon started to run out of test strips so contacted my care team.They told me "that if you are on oral meds there is no need to test". I have tested daily for nearly 15 years so I'm now very confused can any one shed any light on this please

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All I know is that I am type 2 and my GP follows current NHS guidelines which is they don't see it necessary for a type 2 to self test unless on insulin. Some surgeries will either give a meter and strips or some just strips. Most of my diabetic type 2 friends were not given anything. My DN said not to test because often it causes more stress thinking about why your numbers have gone high which in turn makes it worse! I know I am in that category so I stopped testing.but if you want to self test then carry on doing so. Someone else on here was saying medication for diabetics should be free and you can get an exemption form from your surgery. This is something I didn't know.

.....But the reality is that the NHS cannot afford to provide testing equipment to

While I don’t necessarily disagree with this surely the powers that be should realise that if people are willing to monitor their numbers they can use a monitor as a tool to learn i.e, to your meter).
If a person can’t afford the strips (you can get free monitoring systems) then their blood sugar is more likely to continue to be uncontrolled and lead to more expensive health issues for the NHS to deal with? An amputated leg isn’t just an amputated leg. It’s hospital bed days, nurses, doctors, specialists appointments, surgeries, equipment, cleaning and PPE, physiotherapists, occupational therapists, wheelchairs, prosthetics, disability benefits, the list goes on.
I would have thought by comparison a meter and strips would be a very good investment!

The "you don't need to test," is just absolute nonsense. This is partly how T2 can become progressive. Ignore it, it's detrimental cost cutting advice. If you have to self fund your own strips then that is money well spent in my opinion and what I'd do if in your shoes.

I'd go as far as saying it's bordering on absolute negligence to proffer advice that you "need not test".

Knowing what I know now, if I was told that starting out, then a challenge to their authority as a medical professional would ensue.

Mike d said:

I'd go as far as saying it's bordering on absolute negligence to proffer advice that you "need not test".

Knowing what I know now, if I was told that starting out, then a challenge to their authority as a medical professional would ensue.

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Clearly the following is UK specific, I don't know about other countries

it's NICE guidelines, may not agree but the rules have to have boundaries somewhere. I don't agree with everything the NHS funds or not but it's not an infinite bucket.

They make choices and we can try and make these changes by campaigns etc but as it stands, the belief is built into the NHS that if you aren't at risk of hypo that self testing is not cost effective

But we know on the forums that testing has a place. We advise where possible to do so, unfortunately I don't see NHS guidelines changing as they have already been in place decades. But given the cost of newer drugs maybe they might see cost effectiveness changing? Or maybe we should all wonder why the cost of strips are let's be honest, really rather high...

EllieM said:

They are just obeying the NHS guidelines, even if they don't agree with them.

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And the "Hippocratic Oath" ?

There is an option to provide a meter and strips if T2s are using diet to control/reverse their diabetes, but most GPs don't. I can't see how we can find out how many carbs our body can safely have without testing. A 3 month average every 6 months or a year is useless for this.

TriciaWs said:

I can't see how we can find out how many carbs our body can safely have without testing. A 3 month average every 6 months or a year is useless for this.

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Absolute truth, & as we know some T2s could be spiking & crashing all day long which might result in a nice HbA1c but rasies your complications risk.

Nomadathome said:

.....But the reality is that the NHS cannot afford to provide testing equipment to

While I don’t necessarily disagree with this surely the powers that be should realise that if people are willing to monitor their numbers they can use a monitor as a tool to learn i.e, to your meter).
If a person can’t afford the strips (you can get free monitoring systems) then their blood sugar is more likely to continue to be uncontrolled and lead to more expensive health issues for the NHS to deal with? An amputated leg isn’t just an amputated leg. It’s hospital bed days, nurses, doctors, specialists appointments, surgeries, equipment, cleaning and PPE, physiotherapists, occupational therapists, wheelchairs, prosthetics, disability benefits, the list goes on.
I would have thought by comparison a meter and strips would be a very good investment!

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I totally agree.
But the bean counters of government, the nhs, and just about all organisations weight their budget decisions on this year, next year, and (possibly) a 5 year plan.
They are forever putting out current fires, rather than anticipating the forest fire in 20 or 30 years.
Is it sensible? No.
Is it storing up amputation horrors, blindness and years of dialysis for the people told not to test? Very likely.
Nevertheless, the docs and nurses at the patient coalface keep telling unmedicated T2s ‘you don’t need to test’ with all sorts of assorted excuses, including the NICE guidelines.

Personally, I spend upwards of £700 on test strips and Libre sensors a year, in order to monitor my blood glucose.
If I got them ‘free’ from the NHS, that cost would be much higher to the NHS, because I would test more regularly and the test strips used would be those approved by committee, and not my good value Tee2s. Nor would the NHS consider me a candidate for the Libre (which has been invaluable to me), because I do not fit their Libre prescription criteria.

While i hear the "$" argument is this years budget, etc, ( and imho very short-sighted )

Having recently broken my legs i wasn't just sent off to "get on with it"
and told to only jump so high ( aka eat 10% less carbs even though carbs ARE the issue )

i got treatment, advice and a pair of crutches, to help support me during recovery.
and once that ended i now get physio each month (zoom because of covid )

i could have just accepted being less able in future,
but that was NO good for me OR the country at large.

I wanted to get better,,

And THAT was the default position of the NHS took.
why it's different for t2d i don't know

Help AND support for the short time it took my bones to knit and allow me to adjust to a new reality for a short time
(pace, expectations)

Which is what i found i needed to adapt to T2D, and LCHF WAS my crutch,
that is what took me from crippled to walking under my own steam, so to speak.

Perhaps we should adopt the Aussie approach @EllieM points out ?
Those who really can't be bothered can simply ask fur the traditional route

And those who CAN see the reasoning will at least have a few months of getting to grips with LCHF
AND managing the disease in a visible, immediate way by testing,

Rather then waiting 3 months to find out that they were doing it wrong,
but NOT knowing what it was they were doing wrong.....

AND left to Repeat at each HBA1C, ad infinitum until hospital stays finally beckon.