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Worrying Facebook Post

Discussion in 'Diabetes Discussions' started by Schillers, Jan 9, 2017.

  1. Tipetoo

    Tipetoo Type 2 · Expert

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    Down load the application form from the NDSS to join the free service from here:

    https://static.diabetesaustralia.co...alia/f973794b-69d8-4cca-b9c5-23b55cde2f62.pdf

    Read and follow the instructions carefully on the application form.

    When you have joined and got your membership card and info pack (takes a couple of weeks). Download the application form for the test strips from here. Bookmark this link as you will need again:

    https://static.diabetesaustralia.co...alia/14bee3f6-6933-45bc-8853-c7ef030586d2.pdf

    Once you have filled it in and got your GP to sign off on it, you will get subsidised strips for six months. After that rinse and repeat the process
     
  2. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    I get mine free with the Insulin too, and always have done, so nothing has changed for me,
     
  3. Oldvatr

    Oldvatr Type 2 · Expert

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    According to my CCG, and also Bolton CCG, they are expecting NICE to update their guidelines soon. There is a NICE CG committee set up to discuss the GMMMB study imminent. Apart from the Vanguard CCG's most others are hanging fire until NICE makes a move.

    It is (so far) a matter for each local CCG to decide how they interpret the GMMMB study data. Some appear to cut their overall budget in a way so that only T2D will be affected, some like mine appear to be applying it to all D: patients in their care. Also some CCG's offer meters that are not on the GMMMB Approved list

    So it is becoming a Postcode lottery. The cake is being reduced, but portion size is variable. It is not a Government initiative, purely an NHS internal matter.
     
  4. tim2000s

    tim2000s Type 1 · Expert
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    What's the GMMMB study? I can't find any references to it.

    As I've said previously, it would be a real surprise for NICE to update the Type 1 guideline to reduce the amount of testing required, given that the guideline is completely evidence based and all the evidence shown shows that more testing has better outcomes for T1.

    I'm not sure on the T2 stuff. Given the last update was December 2015, they may make a small update, but given that NICE advice for the majority of T2s is not to offer SMBG, it hardly seems like there's a significant change there?
     
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  5. Cookie 81

    Cookie 81 Type 1 · Active Member

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    Aww that's a shame... the Gluco RX meter I was given was terrible. I find the accu-chek mobile is really good with having the 6 lancets in a drum and the test strips as a cassette it's so much easier when out & about. Wonder where my "obsolete meter" came on the list, that was also a really good meter can't for the life of me remember the name of it... was a little chunky white one sure I got it free off a link I clicked.
     
  6. ukuleleplayer

    ukuleleplayer Type 2 · Active Member

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    The meters could well be free on the back of on-going test strip sales...not an unusual marketing move.
     
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  7. Oldvatr

    Oldvatr Type 2 · Expert

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    Think a typo is indicated. It used to be GMMMG
    http://gmmmg.nhs.uk/docs/gmmmg_meetings/GMMMG-Agenda-17th-december-2015.pdf

    I think the thread here is basically discussing restrictions on test strip costs, and associated meters. I have not seen any evidence for any restriction on test frequency or for restricting the number of strips supplied in a scrip.

    My local CCG is estimating to save £1m this year by implementing this policy.
     
  8. ukuleleplayer

    ukuleleplayer Type 2 · Active Member

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    Agree on both points.
    My SD Codefree reads higher than my Contour Next. Odd thing is, when I convert my last HbA1c and compare with previous month's average mmol/l it seems the SD readings tally more. I know such conversions aren't great and Contour readings reflect my feelings better but odd, nonetheless. Suppose the next move is to get a third meter and see which that agrees with?

    The test strips on NHS is a CCG issue, no doubt under guidance from NHS England. Probably not appropriate for Mrs May to intervene?
     
  9. Oldvatr

    Oldvatr Type 2 · Expert

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    Accuchek decided not to take part in the study, so were totally excluded. None of their meters made the initial list. I suspect they also fell at the cost/strip hurdle.

    It depends on what your local CCG decides as regards implementing the policy, and you will have a local flavour set of guidelines. There may well be wriggle room to keep your current meter, but you may need to justify it in terms of essential features that none of the 'approved' meters does. It will be up to your GP or DSN to prescribe.

    I suspect most insulin users will have stronger argument for that, especially since in my area, none of the approved meters has ketone capability.
     
  10. tim2000s

    tim2000s Type 1 · Expert
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    Thanks for that @Oldvatr . I hadn't realised that it was a Greater Manchester group looking at it. What I note is that in their guidance, they state:

    So, for example, if you are a T1 using a meter that has a bolus calculator, whilst a justification would be needed, it's unlikely that they'd change it away. I suspect that one of the reasons the CodeFree didn't pass is that they don't give the meter away for free....

    I think there's perhaps less need to worry with regard to the UK than is being made out.

    And if you read the BGTS report, here: http://gmmmg.nhs.uk/docs/guidance/160421-BGTS-Evaluation-Report-Update-April-2016-v4-1.pdf most of the meteres you'd expect are there.

    BG Tests.JPG
     
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  11. Oldvatr

    Oldvatr Type 2 · Expert

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    Two nights ago I had a hypo, and the luxury of 3 meters. But the SD and the new meter both gave readings above 5 mmol/l, and so majority rule would dictate my hypo did not exist. Can't win! Who tests the tester?
     
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    #31 Oldvatr, Jan 10, 2017 at 12:05 PM
    Last edited: Jan 10, 2017
  12. ukuleleplayer

    ukuleleplayer Type 2 · Active Member

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    Of course, value of meters is in trying to identify what caused the hypo rather than how low you went.
    Whilst I try (like everyone here) to maintain mid-range b/g levels, I also try to identify which foods (and activities) cause biggest variations between before & after readings. If the differences are consistent between meters maybe we can reset our own tolerance levels e.g. know that 5 or below is dangerous instead of, say, 4mmol/l.
    Just a thought.
     
  13. Oldvatr

    Oldvatr Type 2 · Expert

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    I was aware of the contents of this report, and others like it, but I refrained from posting it here since it contains commercially sensitive information which should not be published on a public forum. This may be a breach of confidentiality agreements.

    Edit to add: This table does not apply the other selection criteria being applied by CCG's I think many listed here fail that next step. The final CCG selection comes down to around 22 and most well known brands do not make it.
     
    #33 Oldvatr, Jan 10, 2017 at 12:44 PM
    Last edited: Jan 10, 2017
  14. tim2000s

    tim2000s Type 1 · Expert
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    If this particular report is confidential it should not be publicly available on the web. The data shown on the page is the NHS Drugs Tariff price for the test strips, and the evaluation criteria don't reveal any further details.
     
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  15. Oldvatr

    Oldvatr Type 2 · Expert

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    Yes I will have to apply a correction of -12% to each reading, but I note that the guidance ranges given out on this site and others like DVLA seem to still be the whole blood values. But no one has confirmed this either way, so we are currently totally in the mire if we are hypo unaware

    So the hypo level declared by @daisy1 at 3.9 mmol.l perhaps should read 4.368 mmol/l (or rounded up to 4.4 to match the meter resolution). Since new meters are coming out as plasma equivalent, then maybe this needs resolving soon
     
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  16. Oldvatr

    Oldvatr Type 2 · Expert

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    Since it is likely that there may be legal fights for compensation by some of the excluded manufacturers, I would still be careful about broadcasting this info.

    True, the decision process is applied at CCG level, so this report is simply a data collation exercise,
     
  17. tim2000s

    tim2000s Type 1 · Expert
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    I'm not sure how that would work. Once a provider is on the NHS Drug Tariff, it's not as though there is a contract between the NHS and them to always supply, only that they will supply at x cost, indeed, as we know, the CCGs are at liberty to do what they want as part of their own procurement process. As the manufacturers are operating in a commercial environment in this case, if a procurement process excludes them, whether it's the NHS or somebody private, they're not really in a position to demand compensation. Especially as what has happened is new entrants to the market at lower prices causing disruption.
     
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  18. Oldvatr

    Oldvatr Type 2 · Expert

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    As you say, the price info is in the BNF which is open access, so it is the selection process and criteria that could be disputed. Anyway, the report is not marked as commercial-in-confidence.
    I concede on this point.
     
  19. JohnEGreen

    JohnEGreen Other · Master

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    I bought a MyLife Pura the other day for £5 mainly for the test trips that came with it. Not relevant may be but just saying.
     
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  20. phoenix

    phoenix Type 1 · Expert

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    why should you apply this? They all use whole blood for testing but they should all now report the results with plasma calibration, It was relevant some years ago, when there was still a mix in the UK with some meters reporting whole blood values and others plasma. This is what I wrote in my blog at the time
    "In the UK, the manufacturers have been changing over the years and now according to DUK they all use plasma except for for those made by of of the largest manufacturers Roche ie Accu chek meters. DUK says that ‘ Roche is in the process of adjusting their meters to give results as plasma values, which they hope will be completed before the end of 2009"
    Accuchek were, as said the last to change, they didn't change the meter, they changed the strips.(as stated at the end of 2009)
    I note though that one of the criteria in the report was that they provided 'plasma calibrated readings' so perhaps some of the newer meters from smaller manufacturers don't have this calibration.
    If your meter is by chance whole blood calibrated then you shouldn't be subtracting 12% you should be adding it. The figures used for hypo when I was diagnosed(in France so in mg/dl)) were for a whole blood calibrated meter and were lower than what my doctor would use today
    upload_2017-1-10_20-25-38.png
     
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