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T1's having strips limited?

Discussion in 'Diabetes Soapbox - Have Your Say' started by Dizzyangel75, Mar 19, 2014.

  1. Dizzyangel75

    Dizzyangel75 Type 2 · Member

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    As a T2 my strips were firstly withdrawn (no discussion or warning) and then limited supply reinstated due to medications im on. This is all in accordance with current NICE guidelines. However, I understood the same NICE guidelines say that T1's have no restriction on testing strips and should be provided with them?

    So why did my Mum (T1 insulin dependent), recently forcibly have her monitor changed to a cheap horrible inaccurate one and the new testing strips limited to 1 tub per month? Previously she received at least 3-4 tubs per month and had a much more accurate monitor.

    Again there was no discussion with a doctor, simply a letter informing her this would be happening.

    As I have argued T2 cases about testing strips with GP's before, I know the NICE guidelines pretty well and so did the same with our local surgery after we received this letter. They rather sheepishly reinstated more strips for her but she has no choice on the monitor. They are also changing her lancets to a different make and size which she does not get on with, but again has no choice.

    Any other T1's out there having similar experiences or is this local to our surgery!? Is this the next step in the NHS ongoing diabetic attack?


    -----------------------------------------------------------------------------------------------------------------------------------------------

    Classed as T2 (hereditary gene on both sides of the family, 4th generation diabetic)
    hbA1c at diagnosis (old numbers) 29.7
    Last hbA1c (new numbers) 34 (told this is too low, I disagree!)
    500mg Metformin x3 (lowered recently from 850mg)
    40mg Gliclizide x2
    Low carb diet
     
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  2. LMG

    LMG HCP · Newbie

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  3. mo1905

    mo1905 Type 1 · BANNED

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    I've heard of people being given new meters but no restrictions on strips. Have you had a word with surgery to ask why ?


    Sent from the Diabetes Forum App
     
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  4. phoenix

    phoenix Type 1 · Expert

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    Following concerns expressed by DUK and others that
    " increasing numbers of people with Type 1 diabetes being refused prescriptions for sufficient SBGM testing strips to be able to carry out daily testing needed to safely and confidently self-manage their diabetes."
    The Department of Health sent a letter to GPs last year reminding them of the reasons for glucose monitoring in T1 .They concluded

    "GPs and pharmacists should work collaboratively with patients to ensure the optimal amount of testing strips are prescribed and supplied to type 1 diabetics. Too few can lead to serious clinical consequences. Too many can lead to wastage"
    https://www.gov.uk/government/uploa.../Safe-care-of-people-with-type-1-diabetes.pdf

    Seems like your mother's doctor hasn't taken note of the letter.
     
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  5. LMG

    LMG HCP · Newbie

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    My advice would be to write to your local doctors surgery and Clinical Commisioning Group in your area to find out if there is a local policy for restricting blood glucose test strips for people with type 1 and type 2 diabetes, and if there are any local restrictions on what blood glucose meters and lancets you can use - if there is, what is their reasoning for doing this as there in nothing in either the NICE guidance for people with type 1 diabetes or people with type 2 diabetes that prevents people with diabetes from self monitoring or restricts them to just one tub of test strips per month, one particular blood glucose meter or type of lancet - this is more about saving money, not prescribing based on a person's individual needs.

    Self-monitoring of blood glucose provided it is supported by appropriate diabetes education, can be beneficial, as it enables a motivated person with diabetes to monitor the affect of their food and drink intake, physical activity and lifestyle and their diabetes treatment, and help them in consultation with theie diabetes healthcare team to make decisions about changes to their diet, liefstyle and diabetes treatment. Also it is a DVLA legal requirement if you have insulin treated diabetes that you test your blood glucose before driving in order to make sure that you are safe to drive and are not hypoglyacemic ( have low blood sugar). The DVLA also advises 'it may be appropriate to monitor blood glucose at times relevant to driving' if you have type 2 diabetes treated with tablets that carry a risk of hypoglycaemia auch as Gliclizide, Glipizide and Glimperide - this is a legal requirement if you drive a Lorry or bus.

    Diabetes group education programmes such as DESMOND and X-PERT for type 2 diabetes, DAFNE and other Type 1 diabetes education programmes such as the Bournemouth BERTIE course teach people how to self monitor appropriately, so you may find it easier to persuade your doctor or practice nurse to prescribe you enough blood glucose test strips if you have been to one of these courses. These programmes run all over the country so if you haven't yet been to one- contact your local diabetes care team to find out what is available in your local area.
     
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  6. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

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    Unfortunately there has been a few members of late say that their PCT have changed them over to another meter manufacturer, I'm not sure there's much we can do about it except complain to the PCT's, all they will say it's all down to cost savings as bulk buying from one manufacturer for the test strips will ensure that the prices are kept down.

    As for restrictions for a type 1's, I would have posted the link that Phoenix has kindly provided above and taken this letter along to remind the Dr what was sent to them in February last year, when my own gp said I was testing too much and that 4 strips a day was sufficient I just got my Endo to write to him to say this was not true and that I needed to test more on basal/bolus, it did the trick as there's been no mention of restrictions since.
     
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  7. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    I'm type 1. And I mostly use visually read strips (in addition to the meter): either Glucoflex-R or Betachek Visual. (They're both on the UK Drug Tarrif, though only the former currently has a UK-based distributer.)

    One's blood sugar needs to be fairly well controlled to make best use of them. But they are both excellent for readings below around 8mmol/l. And for low readings, they are especially accurate.

    Each strip can be cut into 4 with scissors. (You certainly can't do that with meter read sticks.) And that brings the cost down to around 1/20th of the cost per test using a meter.

    So I can test my blood sugar as often as I want. And that means a low cost to the NHS, both in the short term and the long term. Indeed, I expect to have no long-term complications.

    http://www.betachek.com/uk/
     
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  8. Charles Robin

    Charles Robin Type 1 · Well-Known Member

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    If I had my strips limited, I would go as far as I needed to get them unlimited. First I would book an appointment with my surgery, show my control before the high testing, and then show my excellent control with high testing (saving the NHS money looking after me in when I have hypos and when complications start to set in). If that didn't work I would submit complaint letters. If that didn't work I would change surgery. If that didn't work I would get legal advice. If that didn't work I would contact my MP, start petitions, and become the squeakiest wheel I could be until the NHS relented and gave me the strips that are essential to monitoring my diabetes control.
    If you are requesting test strips because you live the way they look and want to make wallpaper out of them, that is grounds to refuse prescribing them. If you are requesting them because you are aggressively attacking your diabetes, whipping it into line and making sure it does not get away with anything, you should be entitled to as many as you need. I have said it before, and I am pleased to say it again: these doctors are paid with your tax money. They work for us, and your health is a right, not a privilege. Never feel you are being unreasonable asking for tools to be healthy.
     
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  9. ))Denise((

    ))Denise(( Type 2 · Well-Known Member

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    I'm a Type 2 and had my meter changed to a Glucolab one, it read consistently high. I mentioned it to my GP and had it changed to a Wavesense Jazz which seems to read to about the same as my One Touch one. If you google, you will find documents from different areas of the UK and what meters they are recommending. On them there is usually exceptions and those people are usually allowed to have strips prescribed for their previous meter.

    When my strips were changed on my prescription the nurse put that I could only have one box a year on repeat (this was a mistake), this has now been changed by my GP with the change of meter.
     
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  10. CollieBoy

    CollieBoy Type 2 · Well-Known Member

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    But what happens when the police/DVLA want to see your BG records?
     
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  11. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    Well, then I guess I should show the police/DVLA my meter.

    I only said that I mostly use visually read strips.

    I didn't say that I never use a meter. (Indeed, I wrote these words in parentheses: "in addition to the meter".)

    So how could there possibly be a problem?
     
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    #11 michaeldavid, Mar 19, 2014 at 6:28 PM
    Last edited by a moderator: Mar 19, 2014
  12. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

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    Hi,

    A couple of weeks ago I suspected my meter was reading too low..
    So I booked an appointment to get the meter & myself checked out. To which my suspicions were correct!

    My DN had no meters in the surgery but told me to ring Accu Chek & advised me to get a spare..
    I rang AC & after a consultation on the type of meter required, was sent two types to decide upon which meter suited me the best. Then they would send a duplicate..
    I had an Aviva along with a Mobile model sent to me the following day.
    I settled on the AC Mobile which took ribbon cartridges as opposed to strips....
    Thinking I may have an issue obtaining this new fangled technology on prescription I rang my DN to check before finalising my decision on the model..

    She put both the AC Mobile & Aviva on repeat prescription.. Quite literally throwing em at me...!
     
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  13. ChloeAlisha

    ChloeAlisha Type 1 · Member

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    I'm type one and had exactly the same issue. I was restricted to 50 test strips for one month and advised to test less (against my specialists instructions) I ended up having a debate with the GP until the smarmy fool gave in.

    Sent from the Diabetes Forum App
     
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  14. Danaemac

    Danaemac Type 1 · Well-Known Member

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    I recently had my prescriptions blocked by my GP because i was using too many strips on contacting the surgery I was advised i would have to wait 31/2 weeks for an appt with any gp 4 days of worry and stress with not knowing when my next lot of insulin would be given to me numerous calls to the surgery and hospital (who had advised all the testing ) eventually I get a call from the practice manager to give me an appt the next day for the doctor to up my strips to 200 a month a 5 min discussion and another appt wasted when people cant get appointments I was asked by the GP how long this was for ? (how long were they to be at this level ) I just said it isnt going away is it and that was the end of that discussion seriously the stress sent my levels through the roof so fight for what you need they will give in their is a lot of jobsworths in the NHS who think they know best and actually do not have a clue
     
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  15. Adamski

    Adamski Type 1 · Well-Known Member

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    I'm pretty new to all this, but the thought of having strips limited is a scary one for me.

    As T1, I have to test before getting in the car, and I regularly check when exercising. To limit test strips would be a false economy and could be dangerous when it comes to exercising. We're all advised to be active and regularly exercise, so to limit test strips would make it impossible to keep good control.

    So far I haven't had any issues getting strips, but will challenge if they ever try to reduce my supply.....
     
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  16. Riri

    Riri Type 1 · Well-Known Member

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    Scary indeed. We all need to make sure that this is 'out there' so it doesn't happen. I wrote to my MP on this just to make them aware of what's happening elsewhere and seek reassurances that our local surgeries didn't have any plans to follow suit.


    Sent from the Diabetes Forum App
     
  17. Alanp35

    Alanp35 Type 1 · Well-Known Member

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    When I had a problem obtaining medication I wrote to the practice manager and advised what the treatment was and what was required in order for the treatment to be carried out. She discussed with my GP and prescription was available for collection in 48 hours.

    These things do cost, plenty and I can understand budgets. Why the NHS hasn't taken control of test strips I do not know, but then who are we to wonder ?




    Late onset T1, several auto immune issues.
    Humalogmix25 twice a day, Methotrexate 25mg once per week, FolicAcid 5mg once per week, prednisolone 5mg daily, Allopurinol 300mg, Calcichew-D3 800iu, Levothyroxine 50mcg, Atenolol 50mg, Losarten 100mg, Aspirin 75mg, Nicorandil 20mg, Nitrolingual GTN spray, Metformin 2000mg, Allimemazine 10mg, Lanzoprazole 30mg, Atorvastatin 20mg, Co Codamol 8/500mg, Depo Medrone (Methylprednisolone) or double Prednisolone for 7 days in case of RA flare.
     
  18. Riri

    Riri Type 1 · Well-Known Member

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  19. Alanp35

    Alanp35 Type 1 · Well-Known Member

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    Take over and control manufacture and distribution of test strips.



    Late onset T1, several auto immune issues.
    Humalogmix25 twice a day, Methotrexate 25mg once per week, FolicAcid 5mg once per week, prednisolone 5mg daily, Allopurinol 300mg, Calcichew-D3 800iu, Levothyroxine 50mcg, Atenolol 50mg, Losarten 100mg, Aspirin 75mg, Nicorandil 20mg, Nitrolingual GTN spray, Metformin 2000mg, Allimemazine 10mg, Lanzoprazole 30mg, Atorvastatin 20mg, Co Codamol 8/500mg, Depo Medrone (Methylprednisolone) or double Prednisolone for 7 days in case of RA flare.
     
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  20. Riri

    Riri Type 1 · Well-Known Member

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