Sitagliptin

[Kittycat_7_]

Hi All,
I have been started on Sitagliptin, I have noticed that hypos can be a problem.
My GP is refusing to prescribe test sticks and lancets. I think my only option is to refuse to take this drug.
I can't afford to self fund sticks etc. I drive and I know testing is mandatory.
What can I do?

 

[Bluetit1802]

Hi All,
I have been started on Sitagliptin, I have noticed that hypos can be a problem.
My GP is refusing to prescribe test sticks and lancets. I think my only option is to refuse to take this drug.
I can't afford to self fund sticks etc. I drive and I know testing is mandatory.
What can I do?

You need to query his decision. Do you follow a low carb diet? If so, hypos are are a possibility. You need to be able to test for your own safety and the safety of others. This is what NICE has to say: https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#blood-glucose-management-2

Self-monitoring of blood glucose
1.6.12Take the Driver and Vehicle Licensing Agency (DVLA) At a glance guide to the current medical standards of fitness to drive into account when offering self‑monitoring of blood glucose levels for adults with type 2 diabetes. [new 2015]

1.6.13Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  
  
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]
  

1.6.14Consider short-term self-monitoring of blood glucose levels in adults with type 2 diabetes (and review treatment as necessary):

• when starting treatment with oral or intravenous corticosteroids or
  
  
• to confirm suspected hypoglycaemia. [new 2015]
  

1.6.15Be aware that adults with type 2 diabetes who have acute intercurrent illness are at risk of worsening hyperglycaemia. Review treatment as necessary. [new 2015]

1.6.16If adults with type 2 diabetes are self‑monitoring their blood glucose levels, carry out a structured assessment at least annually. The assessment should include:

• the person's self-monitoring skills
  
  
• the quality and frequency of testing
  
  
• checking that the person knows how to interpret the blood glucose results and what action to take
  
  
• the impact on the person's quality of life
  
  
• the continued benefit to the person
  
  
• the equipment used. [2015]
  

 

[Kittycat_7_]

I do follow low carb diet, my GP just keeps saying I don't need to test.
The specialist diabetes nurse wants me to test, yet doesn't prescribe me anything.
Really poor diabetes care in my area.
Thanks for your advice

 

[Bluetit1802]

I do follow low carb diet, my GP just keeps saying I don't need to test.
The specialist diabetes nurse wants me to test, yet doesn't prescribe me anything.
Really poor diabetes care in my area.
Thanks for your advice

Copy those NICE recommendations, show it to your GP/nurse and point out this one

1.6.13 Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or ......

You fit this criteria. They should prescribe you a meter and strips. They don't have much choice really.

 

[membrew]

I do follow low carb diet, my GP just keeps saying I don't need to test.
The specialist diabetes nurse wants me to test, yet doesn't prescribe me anything.
Really poor diabetes care in my area.
Thanks for your advice

Same Attitude InWest Yorkshire under Leeds Health Authority.