Type 2 Practice nurse said not to test

[SimonCrox]

With the greatest of respect I was and am fully aware of what the NIHCE Guidelines state. They are however purely guidelines. We have mounted challenges and assisted other type 1 and type 2 diabetics to mount challenges which have overturned decisions to routinely refuse testing equipment. I do directly blame GP's because they enter into a Contract with the Secretary Of State For Health to provide patients in their care with appropriate medical advice and equipment to best manage their own conditions. Refusing testing equipment does in fact, at least in my own opinion put them in breach of this Contract.The guidelines as you have quoted do suggest not to routinely offer test equipment to type 2 diabetics not taking medication likely to induce hypoglycemia. They do NOT suggest routinely refusing testing equipment. Each request for equipment should be assessed on a case by case basis. If proof can be offered that self testing has a positive direct effect on any type 2 diabetics lifestyle then GP's are in fact provided latitude to prescribe testing strips. This is why some type 2's do actually receive them on prescription. In short if a type 2 tests and does nothing about the results they are highly unlikely to continue receiving test equipment on prescription. If however as a result of testing they change aspects of their lifestyle and diet their GP may support them with further means to do so and quite rightly so in my opinion. Some hide behind or misquote guidelines. If you challenge them however you do have a chance of nudging them toward a Damascus moment. The direct cost of a foot amputation which can be associated with poor diabetic control is around about £25,000.00 tag onto the end of this the on cost of associated after care on a year on year basis and your GP will start to perspire at the prospect of what this will potentially cost them. If you then point out the trade off in terms of how many years testing equipment this will fund rather miraculously they tend to remove their blinkers.
On a semi related matter which is close to own heart there appears to be a growing opinion among a number of type 1's that the Freestyle Libre system should be offered to type 1's on prescription. This opinion usually makes me terribly unpopular with my own type 1 peers but I personally feel it morally bankrupt for type 1's to expect this while type 2's are expected to self fund. This however is a different debate for a different thread to this one.

Totally agree with these posts about NICE. The very first text of any NICE guideline is that these are just guidelines, and the experienced, knowledgeable clinician and the informed patient should agree on the plan and not necessarily follow the guideline. Catch is the amount of time and knowledge available.

 

[Bettsy1960_]

Hi everyone,returned from Doctors last night and told I'm borderline diabetic, after two bloodiest reading 50 I'm on medication of metaformin. They wasn't going to prescribe until I told them my father is type 2 also plus for good measure have some statins .i would have liked to use some natural method.I go to the gym play squash three times a week so I have got to lose 8 kilos still in shocked mode

 

[MikeTurin]

If you like a more "natural" statin you could ask for lovastatin because the production can be done by farming Pleurotus ostreatus and extract from it.

Or you can eat them, if you like the taste, actually ;-) I suppose that the lovastatin content in whole fungi is quite low...
https://www.epicurious.com/recipes/food/views/sauteed-oyster-mushrooms-351872

 

[Bettsy1960_]

Does anybody recommend testing and keeping a diary along with diet intake

 

[bulkbiker]

Does anybody recommend testing and keeping a diary along with diet intake

Yes and yes... very much so .. also reduce the carbohydrate content of your diet.

 

[busydiabeticmum]

Does anybody recommend testing and keeping a diary along with diet intake

Yes. Like this you have something to show the dn and a record for yourself... how your body reacts is different to others reaction!

 

[Bluetit1802]

Does anybody recommend testing and keeping a diary along with diet intake

definitely yes, otherwise you can't learn how different foods affect your levels.

 

[Bettsy1960_]

I've just checked my blood and it is measuring five only took my first metaformin this morning.,my cholesterol blood test is not until six weeks time and not had one since 2015.i have not shown any diabetic symptoms previously puzzled any advice

 

[CoreyG]

Thank you everybody. I was just so shocked at the reaction I got it was like I was so naughty.
Still going to keep testing and keep an eye on things.
Thank you again

Liam, Check out www.dietdoctor.com for a lot of good information, videos and recipes for low carb advice.

 

[maureen5752]

Been told my testing strips are being cut to half ration, & to see doctor about cholestrol, doctor wants to double my cholestrol tablet which I refused politely , he wasn't happy, then I was told not to take gliclazide any more to just stop taking it as its not a good med , to which I said then why did you put me on it, I was told it was needed at the time, then told I'd be given strips to cover next 6 weeks as a favour to me to test, then told no no more strips as won't be on gliclazide any more, then told that I had a 'fixation' with testing! He was very rude rolling his eyes up to ceiling. I told him he was being very rude. I said its my body & I was told he's the doctor he knows best, was told not to believe everythink I read. I give up, No one seems to care about diabetics any more

 

[maureen5752]

Forgot to say I was told to eat carbs in fact to eat everythink in moderation.

 

[MikeTurin]

Forgot to say I was told to eat carbs in fact to eat everythink in moderation.

I think the advice you can everything IN MODERATION is a sensible advice. Because if you really like to eat a slice of pizza or a slice of cake now and then you can and if you don't eat other sugars and starches you are fine.

 

[Biggles2]

then told that I had a 'fixation' with testing! He was very rude rolling his eyes up to ceiling. I told him he was being very rude. I said its my body & I was told he's the doctor he knows best, was told not to believe everythink I read. I give up, No one seems to care about diabetics any more

@maureen5752 he should see you as a treasured patient who takes an active role in co-producing her own health, and incidentally, in doing so you are also increasing the capacity of the NHS. That should be a positive for any GP! He may be the doctor, but he doesn't have the power to bestow good health on you - only you have that power! Congratulations on being so proactive with your health!

 

[maureen5752]

I think the advice you can everything IN MODERATION is a sensible advice. Because if you really like to eat a slice of pizza or a slice of cake now and then you can and if you don't eat other sugars and starches you are fine.

Hi thanks, what worries me is doctor said stop taking gliclazide, he said your sugars will go up but we will check in January & then decide about other meds, well why stop glic if it's gonna put my bgs up again, worked hard to get it down, is stopping glic to help me or just to stop giving me strips? Afraid doctor was very patronising & I wasn't happy with this & got up to leave & said perhaps I should find another surgery, Is gliclazide a good/bad medicine

 

[maureen5752]

@maureen5752 he should see you as a treasured patient who takes an active role in co-producing her own health, and incidentally, in doing so you are also increasing the capacity of the NHS. That should be a positive for any GP! He may be the doctor, but he doesn't have the power to bestow good health on you - only you have that power! Congratulations on being so proactive with your health!

Hi thsnks I'm afraid doctor didn't share your opinion, he made it quite clear I'm the patient who knows nothink & he the doctor who knew it all, I said its my body my chioce, but the response was he's the doctor & I should not believe everythink I read is what he told me, I'm still angry, he really upset me with his attitude. We try to help ourselfs & get rude insults

 

[woodywhippet61]

Hi thsnks I'm afraid doctor didn't share your opinion, he made it quite clear I'm the patient who knows nothink & he the doctor who knew it all, I said its my body my chioce, but the response was he's the doctor & I should not believe everythink I read is what he told me, I'm still angry, he really upset me with his attitude. We try to help ourselfs & get rude insults

Sounds like he's threatened by you. By which I mean he is lacking in confidence and can't cope with anyone questioning what he says.

There are people on here who take glic why not ask a specific question to see if they have some idea why he'd stop you taking it. Bet someone on here has been taken off it and they could tell you why.

Btw well done for sticking up for yourself I just close down and get away as soon as possible.

 

[SimonCrox]

Hi thanks, what worries me is doctor said stop taking gliclazide, he said your sugars will go up but we will check in January & then decide about other meds, well why stop glic if it's gonna put my bgs up again, worked hard to get it down, is stopping glic to help me or just to stop giving me strips? Afraid doctor was very patronising & I wasn't happy with this & got up to leave & said perhaps I should find another surgery, Is gliclazide a good/bad medicine

I totally agree; if stopping a glucose lowering drug, one wants to either start a replacement there and then or see what happens after the orignal drug is out of the system; a paerson who tests is great cos one knows when control is being lost, but if not testing, I would suggest reviewing in about 1-2 weeks.

Is gliclazide a good drug? UKPDS showed that a similar drug did prevent retinopathy, so a useful drug. Metformin is a better drug cos just as good at dropping glucose levels but does not put on weight or cause hypos (both of which gliclazide does). Comparing monotherapy with metformin vs gliclazide, there were fewer heart attacks, strokes and deaths on metformin. If on metformin, a gliptin is a better drug than a gliclazide type drug cos many studies show fewer heart attacks, strokes and deaths..

So gliclazide is an OK drug if used carefully, but there are better drugs around

There is so much going on in the diabetes world that it is diffiuclt for the non-specialist to keep up to date; in some parts of the UK, 10% of residents are known to have diabetes, which is why people worry about costs, unfortunately.

Best wishes

 

[SimonCrox]

Back to the original comments about the nurse saying don't test; she suggested increasing the metformin; why? Cos the glucose testing showed highish levels. Rather two faced. Doing the HbA1c would add little to the great value of the self testing

 

[maureen5752]

Hi my bgs were 23.4 when diagnosed, I worked hard & being dissabled in my legs & have macular in both eyes already & nerve damage, I've worked hard & last 3 hbc1a showed 5.8 &. 5.9. So that's good, doctor said sugars will go up to when gliclazide is stopped but will sort that out when it happens. If I'm doing do well why change? Is it cos of stopping my strips. Is is cos of money, spoke to pharmasict this morning who said if sugars go up then damage can occur so ask to see practise manager & query it, but to do that it upsets the focus & we are the baddies then. I'm not happy

 

[satindoll]

I would like to believe its not a cost cutting measure, as whilst you are taking the gliclazide he is supposed to provide the strips to ensure you don't have hypo's .........however if you are able to prove to the Dr that stopping the gliclazide has a detrimental effect on your numbers by doing careful testing whilst he's still providing the strips, then you will have the ammunition to take him to task over it as he won't be providing you with the best care possible, which he is bound by duty to do.