# Hello all



## Sam Matthews (May 2, 2017)

Hello everyone. I'm a new Diabetes Specialist Nurse in Watford. Looking forward to following forums, getting involved in debate and most importantly, improving the care of people with diabetes. Please say hello/drop me a message if you're from Watford or the vicinity. Thanks. 

Sam


----------



## Ditto (May 2, 2017)

I'm not from Watford but hello anyway.


----------



## stephknits (May 2, 2017)

Hello Sam, welcome to the forum.


----------



## Steff (May 2, 2017)

Hi Sam a warm welcome to the forum.Not in Watford either but hi


----------



## RobK (May 2, 2017)

Welcome Sam, Also not from Watford


----------



## grovesy (May 2, 2017)

Welcome.


----------



## Matt Cycle (May 2, 2017)

Hi Sam (again) and welcome to the forum.   (For everyone else - I met Sam last year on my DAFNE style carb counting course in Stoke.  We all just rolled up each Friday but Sam had just finished working long hours and still managed to stay awake and contribute!  Very dedicated and knowledgeable like most of our NHS staff and I'm sure will be a great DSN.)


----------



## sunny sanghera (May 2, 2017)

Welcome to the forum Sam


----------



## Northerner (May 2, 2017)

Hi Sam, welcome to the forum  Please feel free to ask any questions you may have


----------



## mikeyB (May 2, 2017)

Hi Sam. Welcome. I know Watford quite well. Strange place, like a Northern town with terraced houses and the footie ground in the middle of town. Mrs B's family originated from there, but moved up in the world.


----------



## Amigo (May 2, 2017)

Hi Sam, welcome to the forum and thanks for wanting to contribute. I'm not from Watford either I'm afraid but once had a good night out there (must be the similarity to a northern town!)


----------



## SB2015 (May 2, 2017)

Hi Sam.  A warm welcome to the forum.


----------



## TheClockworkDodo (May 2, 2017)

Hello Sam, and welcome


----------



## Greyhound Gal (May 3, 2017)

Hi Sam welcome. Always good to know new DSNs are being trained, especially if they are so proactive as you in wanting to join a fantastic forum like this.
Sorry, but not from Watford either!


----------



## Stitch147 (May 3, 2017)

Hi Sam and welcome to the forum. Im not from Watford.


----------



## Pumper_Sue (May 3, 2017)

Hi Sam and welcome to the forum.


----------



## Amigo (May 3, 2017)

Be very interested (at some future point) on your views towards type 2's being prescribed testing strips for home testing Sam. 

A very hotly debated issue on here and I'd be interested to know if DSN's are being advised to dissuade it.

You may not wish to however without a hard hat!


----------



## Mini-Vicki (May 3, 2017)

Welcome to the forum Sam


----------



## Kaylz (May 3, 2017)

Welcome to the forum Sam  x


----------



## Wirrallass (May 3, 2017)

Hello Sam I'm not from Watford either but just want to welcome you to our very friendly & helpful forum  - a breath of fresh air - this is by no means any disrespect to our amazing forum members  - I'm thinking you are going to be unindated with many questions so be prepared for the onslaught   Hope you have all or most of the answers for those who wish learn more about diabetes and all that it unfortunately brings - and similarly hope you will glean much knowledge here too, good luck & take care.
WL

Dx T2 April 2016
Metformin withdrawn 
Diet control and exercise only


----------



## Bubbsie (May 4, 2017)

Amigo said:


> Be very interested (at some future point) on your views towards type 2's being prescribed testing strips for home testing Sam.
> 
> A very hotly debated issue on here and I'd be interested to know if DSN's are being advised to dissuade it.
> 
> You may not wish to however without a hard hat!


Ooh good question Amigo.


----------



## Grannylorraine (May 4, 2017)

Welcome


----------



## Barbara W (May 4, 2017)

Welcome, not from Watford but I know it's good for shopping been there many times and it has a great football stadium.


----------



## Davo (May 4, 2017)

Welcome to the forum


----------



## Diabetes UK (May 5, 2017)

Welcome to the forum Sam, it's really great to see a DSN joining us and getting involved


----------



## Carolg (May 6, 2017)

Not from Watford but hi


----------



## HOBIE (May 7, 2017)

Sam Matthews said:


> Hello everyone. I'm a new Diabetes Specialist Nurse in Watford. Looking forward to following forums, getting involved in debate and most importantly, improving the care of people with diabetes. Please say hello/drop me a message if you're from Watford or the vicinity. Thanks.
> 
> Sam


Welcome Sam !  From someone who has been T1 for more than 50yrs & still in full time employed. Good luck with your work.


----------



## Sam Matthews (May 8, 2017)

Thank you for everyone's kind messages. On the subject of testing strips for T2s, It think that if you have diet controlled T2DM or are well controlled on metformin or other agents then there's no need to test unless you feel unwell or are changing your diet or lifestyle drastically. Same goes if you're well controlled on lower dose sulphonylureas. However for older people on sulphonylureas, higher dose sulphonyureas or T2s on insulin, more frequent testing may be required. For the latter groups, should be left to the individual (or carer) to decide on testing frequency with guidance from us of course!


----------



## Sam Matthews (May 8, 2017)

I like these sorts of questions - keep them coming. Some don't have easy answers!


----------



## Ljc (May 8, 2017)

Hi Welcome.


----------



## Bubbsie (May 8, 2017)

Sam Matthews said:


> Thank you for everyone's kind messages. On the subject of testing strips for T2s, It think that if you have diet controlled T2DM or are well controlled on metformin or other agents then there's no need to test unless you feel unwell or are changing your diet or lifestyle drastically. Same goes if you're well controlled on lower dose sulphonylureas. However for older people on sulphonylureas, higher dose sulphonyureas or T2s on insulin, more frequent testing may be required. For the latter groups, should be left to the individual (or carer) to decide on testing frequency with guidance from us of course!


Sam...interesting to hear your point of view...however...puzzled by your justification for not testing if not dependant on medication that may cause hypoglycaemia...you say 'no need to test unless you feel unwell or are changing you diet or lifestyle drastically'...since all of us whether dependant on insulin or sulphonylureas... or not... need to change our diet & lifestyle drastically if we are to manage/control our diabetes?...curious how you would expect T2's on Metformin...or diet & exercise only to manage their diabetes without testing...I have changed my diet...increased my activity...test regularly to see how the different foods I eat will affect my blood sugar...I've discovered that what one T2 .tolerates well...will 'spike' my BG levels...my diet & lifestyle have changed dramatically...my GP now tells me I have excellent control...I self funded for nine months...now after a lengthy battle with him & the local CCG finally my testing strips/lancets are provided on prescription...disappointing to hear another health care professional issuing what seems to be the standard 'mantra' of the NHS...'No need to test'...despite many T'2 demonstrating good control of their conditions by testing regularly...with the results of testing enabling them to adjust their diet & lifestyle accordingly...delaying/avoiding complications...which of course is extremely beneficial for them...and...saves the cash starved NHS a great deal of time...effort...and money...be interested to hear your point of view on this.


----------



## SB2015 (May 8, 2017)

The best description I read on here about just relying on HbA1c for those not on insulin is relating life to driving to Glasgow (or anywhere else you fancy) the HbA1c is the test done at Glasgow.  With no testing in between it is like driving to Glasgow with a blindfold on and just hoping that you get there in one piece.  You wouldn't do it.  You need to see what is happening on the way.


----------



## Robin (May 8, 2017)

SB2015 said:


> The best description I read on here about just relying on HbA1c for those not on insulin is relating life to driving to Glasgow (or anywhere else you fancy) the HbA1c is the test done at Glasgow.  With no testing in between it is like driving to Glasgow with a blindfold on and just hoping that you get there in one piece.  You wouldn't do it.  You need to see what is happening on the way.


Well, we wouldn't do it, but I think by virtue of the fact that we have all bothered to join the forum, we are probably a bunch of highly motivated people. I just wonder how many patients the average DSN sees who have no intention of changing a thing, and who would test and not act. Don't get me wrong, I think everyone should be offered a meter, and support to test, but I suspect there are a fair few who won't bother to use it, or won't act on the results. I remember going into my first appointment with my surgery nurse, and her saying ( with a nod to the door where her last patient had just departed) 'well at least you're doing everything you're supposed to!


----------



## SB2015 (May 8, 2017)

Robin said:


> Well, we wouldn't do it, but I think by virtue of the fact that we have all bothered to join the forum, we are probably a bunch of highly motivated people. I just wonder how many patients the average DSN sees who have no intention of changing a thing, and who would test and not act. Don't get me wrong, I think everyone should be offered a meter, and support to test, but I suspect there are a fair few who won't bother to use it, or won't act on the results. I remember going into my first appointment with my surgery nurse, and her saying ( with a nod to the door where her last patient had just departed) 'well at least you're doing everything you're supposed to!


Very true, but it is a shame that the motivated ones are blanketed with others and have to work so hard to get test strips.


----------



## Bubbsie (May 8, 2017)

SB2015 said:


> Very true, but it is a shame that the motivated ones are blanketed with others and have to work so hard to get test strips.


Agree absolutely SB...we shouldn't all be tarred with the same brush...my initial experience was so negative...just take the script...off you go...had I not come here...read...researched...just relied on the advice given to me by my GP & DSN.. not to test...or just test once/twice a day....believed it...then no doubt...I may have been classed as one of those who despite being given a meter...just didn't bother...no point in providing a meter/strips...if it comes with the wrong advice...no advice...or limited advice..


----------



## Hazel (May 8, 2017)

Sam, good luck to you in your job.     A very worthwhile, under staffed profession


----------



## mikeyB (May 8, 2017)

In a perfect world, everyone with diabetes of any type or treatment would test regularly if they had the opportunity. But as has been pointed out, folk on this forum are a self selected minority. The majority of Type 2s simply wouldn't bother, and rely instead on a bollocking or praise from their doctor at HbA1c checks. This was certainly my experience as a GP before the days of NICE and CCGs. So it would be a waste of public money giving everyone testing kits. It is also my experience that it's a waste of public money with some Type 1s getting testing kits, because they ignore the readings and carry on regardless.  

That said, there shouldn't be a fight when a Type 2 wants to test because they are genuinely interested in which foods cause a spike and which don't. But having learned that, and treatment is stable, the frequency of testing can drop considerably - it would just be boring. Obviously, during intercurrent illness that changes, but again, only in those motivated to test in the first place.


----------



## Johnny Baker (May 8, 2017)

Hi, Sam, I'm a 47-year-old Type 2. I also have an autism spectrum condition and Major Depressive Disorder. My type of diabetes 2 is insulin-resistant and I take 20 mcg of Lyxumia every morning and 1 g of metformin in the morning. My blood sugar today was 4.9. I live in Stockwell, South West London but I've heard of Watford, it's near Barnet, where I was born in Victoria Maternity Hospital, Wood Street, Barnet, Herts. All the best, Johnny B.


----------



## mikeyB (May 8, 2017)

I should say, on reflection , that my last paragraph above is more or less what Sam said in his post about T2 testing, so sorry for plagiarism


----------



## Ditto (May 9, 2017)

I don't agree.  I think everybody should get a meter and strips automatically and a course and an appointment with a diabetic nurse. The surgery would see if a person was looking after themselves if they order more strips rather than just shoving the lot in a drawer like my sister and ending up with injecting insulin after a heart attack. My sister said "Do you think you know more than the experts?!" after I advised her not to eat a sticky bun. I said "Yes."


----------



## mikeyB (May 9, 2017)

You make my point exactly Ditto.

I think this thread has been rather hi jacked. Wonder if the mods have an opinion.?


----------



## Sam Matthews (May 11, 2017)

Bubbsie said:


> Sam...interesting to hear your point of view...however...puzzled by your justification for not testing if not dependant on medication that may cause hypoglycaemia...you say 'no need to test unless you feel unwell or are changing you diet or lifestyle drastically'...since all of us whether dependant on insulin or sulphonylureas... or not... need to change our diet & lifestyle drastically if we are to manage/control our diabetes?...curious how you would expect T2's on Metformin...or diet & exercise only to manage their diabetes without testing...I have changed my diet...increased my activity...test regularly to see how the different foods I eat will affect my blood sugar...I've discovered that what one T2 .tolerates well...will 'spike' my BG levels...my diet & lifestyle have changed dramatically...my GP now tells me I have excellent control...I self funded for nine months...now after a lengthy battle with him & the local CCG finally my testing strips/lancets are provided on prescription...disappointing to hear another health care professional issuing what seems to be the standard 'mantra' of the NHS...'No need to test'...despite many T'2 demonstrating good control of their conditions by testing regularly...with the results of testing enabling them to adjust their diet & lifestyle accordingly...delaying/avoiding complications...which of course is extremely beneficial for them...and...saves the cash starved NHS a great deal of time...effort...and money...be interested to hear your point of view on this.


Hi Bubbsie. I certainly wouldn't class myself as an expert. I'm just someone learning who wants to help people. All of my work is done on an individual, case-by-case basis. You sound like an extremely motivated individual who wants to live well and prevent complications. I certainly wouldn't stand in your way of BG self-monitoring.


----------

