i was "lucky" in that I was diagnosed in hospital and had access to their team, but had I been diagnosed at my GP, my total resources would have been via a "practice nurse" who deals with everything Diabetes, Asthma, Pregnancy.Fergus I agree that HCP's poor knowledge is often the problem with diabetes management and think that all people with diabetes should have access to their local diabetes specialist team. .
Well phil I am sorry to sorry but i will not be spending the last bits of my saturday afternoon trawling through pubmed, cochrane data bases etc to find studies that you can't be bothered to find yourself. They are there and easily available if you want to find them, although it is time consuming. I did however try to find the page on diabetes uk which states that although they advocate testing they admit there is a lack of evidence for it and this is a direct quote - "the current lack of evidence does not mean that smbg is not effective for those not treated by insulin, it just means there is NO EVIDENCE."
the link for tjis document is below.
ww.diabetes.org.uk/Documents/.../Test%20strips%202011.pdf
I use diabetes uk as they are heavily involved in diabetes research and will of course have done systematic reviews of all the available evidence, for which they admit there is none, and it saves me spending hours pulling up all the research to prove my point to you.. Of course this may change over with time with more studies, but I stand by point that currently there is no evidence.
Yes well I'm sorry if I came across as a little rude, I didn't mean to be. But no I dont happen to have all the studies on my tablet unfortunately. I see what you are saying but you still need the evidence before you can make decisions, and currently it is lacking. You could say it about anything couldn't you? Some people swear by homeopathy, but there is currently no evidence to support it, therefore the nhs does not usually fund it. You must be able to see that evidence is required for such things? Of course the evidence may come about one day, but it isn't here now and therefore the nhs cannot base it's decisions on treatment for which there is no evidence.
NICE guidelines for T2s are between 4 and 7.00 before meals and no more than 8.5 2 hours after - how are we able to tell whether or not we are within those limits if we do not test. I'm lucky and have access to the internet and can afford my own strips which enables me to bepro-active but there are some who are less fortunate.
Thank you for your reply katiek
I hope you stick around and continue to join in the forums
We can be a passionate lot on here lol
Hello, well well Katiek, what a dictatorial rant. Do I take it you are in the nhs, or have money in your pocket??.Although I can understand why people want to test their blood glucose levels the reality is that there is no robust, conclusive evidence that it improves diabetes control for those with type 2 on diet/diet and metformin. The NHS is in crisis finacially and will not fund interventions for which there is no evidence, this is for any healthcare intervention, for any condition, not just diabetes. Even on diabetes UK, where they advocate testing, they admit that numerous studies have failed to produce evidence that bg testing improves control for T2 on diet/metformin, and that HbA1c remains the gold standard in monitoring for this group of patients. They justify the use of blanket testing by saying it makes people feel better and more in control, but this does not justify the huge financial cost of funding. The reality is that it is impossible for the NHS to fund the cost of treatments that have no evidence base, there just isn't the money. As another poster pointed out, if you don't qualify for the strips on the NHS you can always buy them yourself. Many people with health conditions do not get free prescriptions and have to pay charges for their medication every month. People with diabetes are fortunate in the sense that they qualify for free prescriptions, but I really don't see why this should extend to a very costly intervention for which there is a lack of supporting evidence. You do not need bg testing to see how foods will affect your bg levels. We already know what foods will do this without testing - carbohydrates. Evidence does show that the best way to manage T2 diabetes on diet/metformin is to limit your carbohydrate intake (and in general eat healthily), participate in moderate physical activity, and have regular HbA1c tests. The carbohydrate content of foods is easily obtainable, if you aim for 40 to 50 grams of carbs with each meal, with maybe 10 to 20 gram carb snacks either side, this is a good basic starting point for most. If after so many months a sensible diet and some moderate exercise has not brought your HbA1c down then there would be justification to use bg testing to improve control. But blanket prescribing for every single person with T2 diabetes is unjustifiable and unsustainable. on the issue of hypoglycaemia, of course people who are at risk of hypos should without question have access to bg testing, but T2 on diet/metformin do not fall into this category. I am not saying it is impossible to suffer with hypoglycaemia on diet/metformin, but it is rare. As for hyperglycaemia, again, this can be prevented with sensible carbohydrate intake, and the odd high blood sugar is not harmful. All the evidence shows that it is persistent hyperglycaemia, evident from continually poor HbA1c results, over a number of years, that contributes to the serious complications associated with T2 diabetes. I do feel that in an ideal world it would be great if everyone with diabetes could test their bg levels, as people clearly feel it helps them, but in a world where the NHS restricts proven drugs for cancer patients because it "only adds a few weeks or months onto their lives" then a reality check is needed, blanket bg testing is just not going to happen, not because the NHS has it in for diabetics, but because there simply isn't the money for an intervention with no supporting evidence. My family is blighted by T2 diabetes and we often discuss the issue of bg testing, and when I have suggested buying the strips if it is felt to be so important for their health, paying 20 pounds a month, the issue of being unable to afford it inevitably comes up, yet they all pay around 100 quid a month for their sky tv packages! If and when the evidence becomes available that bg testing is an essential part of the management for all T2 diabetes it should be fully supported, as it is for now, it is a preference, not a need, and therefore must be funded from your own pocket.
This man got test strips without any problems. When I hear that it is all about money, I read this post. that I made last year.
Anyone remember when one of our members was trying to get a petition up for test strips in light of the fact that the Chief of the NHS had recently been diagnosed with Type 2 diabetes?
http://www.diabetes.co.uk/forum/threads/petition-to-david-nicholson.44393/page-2
Individual forum members e-mailed him with little success and the petition did not get the numbers that were hoped for.
It has been announced that he will be retiring soon and he has said that it was a matter of profound regret that the NHS was letting down so many sick and elderly people, as he announced his retirement with a £2 million pound pension pot.
http://www.telegraph.co.uk/health/h...-Sir-David-Nicholsons-reward-for-failure.html
He was in charge when the Mid Staffs Hospital scandal erupted.
http://www.bbc.co.uk/news/uk-england-stoke-staffordshire-20965469
He has recently been named as having enjoyed overpriced hotels, travel and food at the expense of the NHS. He was not alone in this, they all had a jolly good time at the taxpayer's expense.
.
http://www.independent.co.uk/life-s...-on-hotels-fine-dining-and-taxis-9359381.html
He has recently written an article for Diabetes Uk detailing how he has got his diabetes under control. This would include testing for him so when your GP refuses you test strips or an expensive medication, just think of how this man has behaved. He was in charge of the NHS.
http://diabetes.org.uk/About_us/New...fe-changing/diabetes-education-life-changing/
phil is that an actual diabetes nurse that told you you didnt need to increase your metformin dose, or a practice nurse? The therapeutic dose of metformin is 2 grams, it doesn't work like other tablets where you increase or decrease according to blood sugars. Unless there are issues with tolerance all the evidence (sorry to mention that pesky evidence again!) says that metformin should be taken at the therapeutic dose of 2g.
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