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Test strip quantities - Type1.

Paul520785

Well-Known Member
Messages
95
Location
Norfolk - UK
Type of diabetes
Type 1
Treatment type
Insulin
My first struggle was what was the best title for this question - One thought was ~ best approach to ? lower moron grade surgery staff and incompetence with ignorance as well ?

My write up to explain the feeling of despair!

Background -
Type 1 on twice daily insulin and diet -
Now retired for 2 years and have been on insulin for just over 59 years.

Conclusion - Must have been doing it right as have no diabetic related issues.

Test strips - daily use

1) 7.00 - Before breakfast & injection
2) 8.50 - Before driving/using powered tools
3) 10.30 - before midmorning snack and with opportunity to eat more when appropriate
4) 12.30 - before lunch usually sandwiches with a sticky cake if activity levels are significant!
5) 13.15 - before driving - DVLE rules (before and every 2 hours) and wise if using power tools - Chain saw / tractor etc etc
6) 15.00 - driving rules
7) 16.45 - driving rules
8) 18.00 - before large evening meal & injection
. .. . 19.00 - relaxing in warm room on settee - TV is then an instant sleep switch!
9) 21.00 - test to verify BG level before going to bed
10) 23.00 - test to confirm BG is at a level to leave a 4 t0 5% BG at 7.00am on the following morning. If too low then a sweet drink and >>>
11) 23.45 - Retest to verify level if required

Note - if not driving then the use of powered equipment means that these test times will be wise.

Facts -
Vehicles driven regularly - 4WD - 2 x cars - ATV - tractor - small fast boat (fishing and regatta rescue)
Power tools - bench drill - bed saw - grinder(s) - planer(s) Chain saw(s) Hydraulic log splitter cement mixer
All of these have the ability to cause major injuries if anything affects the level of concentration or judgement.

Hypo awareness - for me first signs are apparent at 4.1% but this can be masked / misinterpreted due to numerous factors
- Warning / fully aware at 3.6% essential to eat at this level
- at 2.4% a shaky / confused / hungry idiot!
- at 1.8% a conscious idiot wanting to eat but only just able to walk (last time this level experienced was about 8 years ago!)

Test strips -

For many years 300 ordered monthly and an almost good/brilliant HbA1cmaintained.
>>>>>> Arithmetic 30 days per month at average of 10 per day = 300
Jan 2012 - strips suddenly reduced to 50 per month - 2 phone calls and turned out that local NHS trust had a junior clerk who had sent instruction that the max level was set at this level. My consultant taught me 4 new swear words and fixed in 48 hours!
Feb 2015 - quantity reduced to 200 per month without any consultation
Mar 2015 - changed to 250 per month after I complained politely
May 2015 - changed to 250 then 200 on alternate months - was told that a letter from my consultant had stated that only needed that many - I was not offered or able to get verification of this.
Aug 2015 - puzzled that only able to order 4 and checked quantities over next 2 months.
Sep 2015 - visited surgery to determine what was going on - then told that my GP had reduced the quantity to 200 per month - on basis that was the correct diabetic quantity without advising / talking to me. I only just resisted the reaction to go ballistic and the dispensary manager issued an extra 250 strips to cover shortfall up to end of the year.
Oct 2015 - unable to order any strips on monthly schedule so called at surgery to get 200strips before 3 weeks away on a sailing trip. None in stock so agreed to pickup when I got back.
Nov 2015 - surgery lost the 200 strips held and refused to re-issue!

Now wondering which action first -

Visit the surgery and go ballistic - I have tried telephone and a brief visit to the surgery just to get told by the dispensary manager that what I remembered she arranged was not correct -
- - - - - - - - - Probably not the best first step!
Find out where and to whom to complain (in and out of the surgery)
Accept that NHS wants the bill if I have a major injury
Accept that NHS wants the bill if I have an accident which injures other people.
Wait till next see consultant in January
Change surgery in March when my 3 year driving licence has been renewed.

Suggestions and / or information would be helpful.
 
I would write to the surgery and ask how they can deny you something which is basically (in the long run) saving money on diabetes complications and as a type 1, I thought there wasnt a limit on how many strips you can order as long as you arent taking the p*ss with it.

Also, can you not write to local MP? Ask them to help fight your corner
 
@Paul520785 , firstly may I apologise! You have made me feel almost relieved as I have a similar problem. Since February I can only get 100 test strips a month despite being a type 3C brittle diabetic prone to night hypos. I have tried everything with my surgery without success. And more recently other of my vital drugs are also being 'rationed' to the extent it's now effecting my health. I have to buy the shortfall in test strips and lancets, and the hospital consultant had to give me a prescription in the shortfall of the other drugs but they just ignore his letters! The dietician told me the other day that she has actually booked an appointment with the senior partner at the GPs to try and resolve the problem as its now threatening my health!!! So sorry I can't give you any solutions but at least I can sympathise. It's obviously a local problem in my area as I changed GPs 18 months ago as my last one had started to this rationing too! Sue x
 
If you cannot get any joy with yr GP over the prescribing of strips, then make an appt with GP and ask to be referred to see a hospital consultant. If asked why, say that you are not happy to continue using a regime where your safety in using it, is now being jeopardised and you would like to discuss an alternative. On seeing a consultant, you should be able to get a letter sent out to GP reminding him to use his discretion a bit more wisely.
With regards to car driving, a GP isn't really obliged to prescribe teststrips to enable a vehicle to be driven safely but most GPS look on car driving as a basic necessity for day to day living and because of the uproar of teststrip prescribing restriction, the DVLA have carefully changed the wording on the DIAB1 form and people only need to bg test within 2hrs of driving a vehicle and not directly before. I might be a bit wrong on this but I don't think so..
 
Firstly -
Thank you all for the suggestions and thoughts
The letter is could be helpful to may of us.
Keep them coming!

Secondly
How does one get the surgery prescribing to discuss changes in prescriptions before just making changes without any notice.
And if discussed, listen to the points identified, refer to someone with detailed knowledge, then document and make the changes

Thirdly
The other worrying aspect is the quality and accuracy of Test Meters when Cost rather than Quality becomes the deciding factor.

Perhaps these should be on another thread - I am just so totally ###### ### / appalled by the whole system.
 
What I did many years ago at a different surgery, was to go in and see the GP and ask for a meds review.

I then asked him to remove my insulin from the repeats as I wouldn't be needing it anymore due to the lack of test strips which enabled me to stay safe.

Test strips were reinstated :)

Perhaps also ask your GP if he has good medical ins coverage as obviously you will need to sue for any injuries etc.
 
Firstly -
Thank you all for the suggestions and thoughts
The letter is could be helpful to may of us.
Keep them coming!

Secondly
How does one get the surgery prescribing to discuss changes in prescriptions before just making changes without any notice.
And if discussed, listen to the points identified, refer to someone with detailed knowledge, then document and make the changes

Thirdly
The other worrying aspect is the quality and accuracy of Test Meters when Cost rather than Quality becomes the deciding factor.

Perhaps these should be on another thread - I am just so totally ###### ### / appalled by the whole system.

The letter quoted in this thread would have already been sent out to all GP practices a while ago but it's worth reminding some GPS to use their discretion a bit more wisely.

A GP practice is meant to contact a patient first before changing any type of medication on a repeat prescription. There is a paragraph relating to this in a document The Patients Charter. It's a long document to read through but it's there.
@donnellysdogs should be able to bring this document up I hope.
At the end of the day, it's all about managing how money is spent and on what treatment through the budget that a CCG uses
 
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