[LarryTango]

i just got a generic letter from doctor saying that after a review they have decided not to give blood glucose test strips to people not taking insulin, stating that it can infact make my results worse (i really dunno how).

i have did well with my diet and my a1c was 5.2 (which the doctor hasnt even talked to me about yet .. i had to get the receptionist to tell me after i specificly asked for it!!) but this is largely due to the fact that i test myself alot without the test tellin me how high i am etc i would just eat and eat lol

can the doctor stop me getting strips now? i live in the uk and it is / was on my repeat prescription

im on 4 x 500mg metformin a day

[Lulika]

Hi Larry...that doesnt sound right at all! I am from the UK but havent lived there for a long time, are you talking about an NHS doctor? I really dont understand how a doctor can withold strips from you.As you say, you need to test to keep good control. Sorry I cant help more but I will be interested to see what others have to say. Nice to meet you anyway!

[LarryTango]

yeah NHS doctor , im very surprised at this letter,

i dont understand how blood glucose monitoring may increase the likelihood of hypoglycemia ?

[Lulika]

I have no idea.There are some smart, more experienced folk here, I am sure they will have some ideas for you soon

[davef]

Larry,

That's incredible, you are taking control of your diabetes, you have gotten your A1c down to a great level and your doctor rewards you by taking away the most important tool!

I really can't see (but I'm only a newbie) how monitoring is likely to increase the chance of going hypo, to me, logically the opposite would be the case. As the possibility now exists that you could be watching your carbs and eat too little which could cause a hypo and you would not know!

There was a post here a little while ago from a member in the UK (sorry can't remember the member's name) who was having a problem getting a prescription for enough strips, I believe the Doctor cited funding problem within the NHS had lead to the doctor not being allowed prescribe more that a certain number.

Personally, I tell the Doctor how many times a day I want to test and he writes the prescription accordingly so that it's covered by the Irish Health System.

Could you perhaps, respond in writting and explain that your much improved results are largely due to the fact that you test (5 times a day is not outrageous) and that without the ability to test you fear that you will not be able to control your BG levels. Putting it in writing may cause them to rethink as they won't want it "on the record" that you raised the matter, should your levels increase.

Is there any chance of checking with a diabetes nurse or another Doctor to see if this is a new NHS policy?

[LarryTango]

my doctors surgary is hopeless to be honest, never see the same doctor, the nurse told me incorrect infomation and i have even been given the wrong prescription dose b4, so i keep meaning to change docs. after i had a1c i tryed to make an appointment to talk to a doctor about the results (and find what it was etc) and was told that i would have to wait at least 3 weeks .. it seems this is the final straw *looks for a new doc* i just hope its not a new nhs policy or somthing

[fgummett]

If that is new NHS policy then there is something seriously wrong with the system and you need to make as much noise as you can about it... newspapers, Member of Parliament etc...
If you are on Metformin for Diabetes you need to be testing at least once a day (preferably more)... no "ifs ands or buts" about it! How can you or your doctor monitor your progress without BS results. A1c is not enough... someone who is high every morning and low every afternoon can still have a good A1c because it's more like an average.
Please find out it if is a National policy and please do find another GP if you can... and also try to get a referral to an Endocrinologist or at least a specialist in internal medicine.
Good luck and please keep us posted.

[UpNorth]

Insulin or not, a diabetic needs to check bloodsugar at least every once in a while to know what's going on! And with oral medication, there IS a risk for going hypo, so people on oral medication needs to check bloodsugar even more than people just on diet and exercise. This is friggin ridiculous!

[Tazmara]

You have been given great advice so far Larry. I would definitely become a squeeky wheel on this one and look for a different doctor... as you have probably heard, the squeeky wheel gets the grease, right?? So, in this case, it would be you getting your test strips. When i was first diagnosed, I was not even told to get a monitor. I was told to lose weight, exercise, and see my regular doctor within the next 2 or 3 weeks. My regular doctor had made the arrangements for me to see this second doctor for a re-test of my blood sugars due to a high fasting blood sugar result while she was away on holidays. The pharmacist was the one that arranged for me to get my monitor, test strips, and lancets. Here in Manitoba, Canada, it is different, and all supplies can be obtained through the pharmacy. I don't even need a prescription for the strips, as they will just type up an official receipt so that I can request reimbursement through my medical insurance through work. Now, I don't know if they have a certain amount that they will allow me to purchase before they cut me off. I'm sure that they will notify me of this once I have reached that level.

[HelenM]

There may be some helpful information in this thread
Test strip provisions in the UK

[HelenM]

Too late to edit I also found this govenment reply to a petition

There is no Government policy restricting the supply of blood glucose testing strips to people with diabetes. It is for the patient's doctor to decide whether or not a patient receives a particular treatment, and such a decision should be made on clinical grounds. This means that where a GP sees a clear clinical need for a particular drug or treatment he or she should prescribe it. Under their terms of service, GPs are allowed to prescribe any product that they consider necessary for the treatment of their patients under the NHS. GPs must, however, be prepared to justify any challenges to their prescribing by their Primary Care Trust (PCT.................A message reinforcing this advice was circulated through the Medical Directors, Chief Nursing Officers and GP Bulletins in February 2005.

Any PCT which is automatically discouraging the prescription of blood glucose testing strips is not acting in accordance with NICE's advice that self-monitoring may prove useful to people in their overall approach to self-care.

If you have concerns about your own treatment, you should speak to your GP. You can also contact the Patient Advice and Liaison Service (PALS) at your local PCT. This can provide information and advice about NHS services, including information on how to make a complaint. Contact details are available at 'Authorities and Trusts'.

You can find the detail here: T2Diabetes - epetition response

[REDLAN]

This is part of the NICE guidelines, where they have reviewed several aspects of diabetes care in the UK (one of them is pumps and they have significantly adjusted the guidelines).

The evidence (from clinical trials) shows that people with type 2 do not get better control if they test their blood sugar regularly. The key factor the panel concluded was willingness to comply with diet and lifestyle modifications. And willingness to test really acted as a proxy for willingness to comply with a treatment regime.

The NICE guidelines did not conclude that people with type 2 should not test their BG, only that they would only recommend BG testing for someone on insulin.

The crux is that testing for it's own sake is pointless, and very costly. You only need to test if you are going to use the results to make changes to your regime.

Hi, LarryTango, some questions.

Do you drive? Do you experience hypoglycemia from taking Metformin?

These 2 issues alone may be enough to convince your doctor that you need to continue testing.

Another strategy you could adopt is to explain how you use your testing to control your diabetes. For instance do you use testing to adjust metformin dose? Do you use testing to adjust your food intake? Do you use testing to assess the impact of a new food?

If you are doing any of the above then these are good reasons for your doctor to reinstate your prescription.

[Kim_in_TN]

That sounds insane to me .... hope you can figure out a different route and find yourself a permanent and competent doctor!

[birdyland]

That is insanely silly. Good luck finding a new doc, and let us know!

I agree with all that testing is important to help us find the foods that effect us most and least.

When my sister was diagnosed, her plan only allowed her two tests per day. With my encouragement, she is now testing whenever she wants, but had to push to get her strip allotment raised.

Testing = personal control.

[jerryn]

Originally Posted by LarryTango

i just got a generic letter from doctor saying that after a review they have decided not to give blood glucose test strips to people not taking insulin, stating that it can infact make my results worse (i really dunno how).

i have did well with my diet and my a1c was 5.2 (which the doctor hasnt even talked to me about yet .. i had to get the receptionist to tell me after i specificly asked for it!!) but this is largely due to the fact that i test myself alot without the test tellin me how high i am etc i would just eat and eat lol

can the doctor stop me getting strips now? i live in the uk and it is / was on my repeat prescription

im on 4 x 500mg metformin a day

Let the Dr. and nurse know that you test to see how foods and excercise effect your glucose levels. If they still give you a hard time, mention that if you don't get test strips then you'll be forced the find a new Dr. that will. I don't take insulin.. but I test regularly. I test at wake up, on the weekends I test 2hrs after breakfast too. I test before supper, and 2 hrs after supper.

it's needed.
By testing like this I found if I have to eat fast food, Wendy's
Chilli won't spike me. Also I found if I work out well, I get a good reading like 117 or so. If I work out hard, past the point of feeling the burn, I actually spike to 220. weird.

Testing is important.