# Refused Testing Strips by GP



## CHRISJK (Jul 21, 2017)

Hi, I am a "Newbie" on here and I have just received a letter from my GP stating that my Prescription for my Diabetic Testing Strips has been Cancelled, as they don't think I need them ?  I am absolutely Astounded by this..... I have been a Type 2 Diabetic for around Fifteen Years, and my GP and Nurses have Congratulated me Constantly on how well I have managed my Blood Glucose Levels and my GP has commented that if he didn't know better he would think that I didn't have Diabetes. I will now be unable to Control my Diabetes as well as I had previously and I feel that I will be in Danger of Having Hypo episodes.... I really don't know what to do ?  I Don't think that Speaking to my GP will help , because I have had Disagreements with her before about my Diabetes........ Chris


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## Bill Stewardson (Jul 21, 2017)

Hello to you Chris,

Sadly that is not an uncommon tale,

All I would suggest is writing back to appeal the decision.

Always worth exhausting their internal procedures,

Good luck with it.


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## Stitch147 (Jul 21, 2017)

Hi Chris and welcome to the forum. This isn't unusual for type 2's. Are you on any medication for your diabetes?


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## Bubbsie (Jul 21, 2017)

CHRISJK said:


> Hi, I am a "Newbie" on here and I have just received a letter from my GP stating that my Prescription for my Diabetic Testing Strips has been Cancelled, as they don't think I need them ?  I am absolutely Astounded by this..... I have been a Type 2 Diabetic for around Fifteen Years, and my GP and Nurses have Congratulated me Constantly on how well I have managed my Blood Glucose Levels and my GP has commented that if he didn't know better he would think that I didn't have Diabetes. I will now be unable to Control my Diabetes as well as I had previously and I feel that I will be in Danger of Having Hypo episodes.... I really don't know what to do ?  I Don't think that Speaking to my GP will help , because I have had Disagreements with her before about my Diabetes........ Chris


Chris...I believe you need to challenge this...particularly since you have been prescribed them for almost fifteen years...demonstrated they are a necessary part of your diabetes management/control...this has happened to several members here...either their prescription for testing stirps has been restricted...or cancelled...many simply accept that believing there is nothing they can do...part of the problem is GP practices are under pressure to reduce costs...type 2 diabetics non-dependant on hypoglycaemic medications are routinely denied testing a strips on prescription (they are easy targets)...and as demonstrated by your circumstances those that have been using them for many years...have them withdrawn...you can write to your GP...challenge the withdrawing of your prescription...ask for justification...if it is a directive from your local CCG...you can write to them and justify your need for testing strips on prescription...I have done that myself...I now have my testing strips supplied on prescription...if you want to challenge this decision...I am more than happy to help if you need it...think about it...let me know.


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## CHRISJK (Jul 21, 2017)

Bubbsie said:


> Chris...I believe you need to challenge this...particularly since you have been prescribed them for almost fifteen years...demonstrated they are a necessary part of your diabetes management/control...this has happened to several members here...either their prescription for testing stirps has been restricted...or cancelled...many simply accept that believing there is nothing they can do...part of the problem is GP practices are under pressure to reduce costs...type 2 diabetics non-dependant on hypoglycaemic medications are routinely denied testing a strips on prescription (they are easy targets)...and as demonstrated by your circumstances those that have been using them for many years...have them withdrawn...you can write to your GP...challenge the withdrawing of your prescription...ask for justification...if it is a directive from your local CCG...you can write to them and justify your need for testing strips on prescription...I have done that myself...I now have my testing strips supplied on prescription...if you want to challenge this decision...I am more than happy to help if you need it...think about it...let me know.


Hi, Thank you for your Reply....Of Course I want to Challenge This Decision.


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## CHRISJK (Jul 21, 2017)

Stitch147 said:


> Hi Chris and welcome to the forum. This isn't unusual for type 2's. Are you on any medication for your diabetes?


Yes I am on Metformin , and my GP has Reduced this. At first she wanted to Reduce my Tablets from Four to Two Tablets a Day, but after we had a "Discussion" they were Reduced to Three a Day


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## Bubbsie (Jul 21, 2017)

CHRISJK said:


> Hi, Thank you for your Reply....Of Course I want to Challenge This Decision.


Good Chris...part of the overall problem is not many of us do challenge...not sure we can...or how we do that...I suggest the first thing would be to write to your GP...point out your diabetes is well managed & under control...you test regularly to maintain that control...it is essential for you to be able to continue that...as a new member I am not sure if you are able to use the private message (PM) facility here yet...if not we could ask one of the moderators to amend that...would you be confident writing your own letter?...or do you need a hand...important if your GP is going to withdraw any essential equipment for managing your diabetes it should be done only after discussion with the patient...a couple of points...are you currently on any medication...what are your blood sugar levels now... there are other points we would need to cover (personal circumstances)...that is probably better done privately...if you need assistance with the letters happy to help...we can do that by PM.


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## Lucy Honeychurch (Jul 21, 2017)

Good luck with your appeal. I really don't understand the logic behind this, seems bonkers to me. If people can control their bgs from regularly testing and wish to do so then why deny them the ability to do so? I know many people self fund, but what about people on low incomes? Prevention is better than cure, surely


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## Vicsetter (Jul 21, 2017)

As I see it the problem lies with the 'scientific studies' that the NHS seems to use to prove that self testing does not affect the outcome of HBA1c.  The latest study in the states is amazing in it's stupidity:http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2630691
The test group was split in 3, one group didn't test, one group tested once a day and one group tested once a day with encouragement!

These so-called experts fail to understand that people do not test once a day, but use self testing to monitor and adjust the foods that affect their HBA1c.  Unofrtunately this is what NICE and your GP/DN uses as an excuse for reducing costs.
This is the argument you have to argue with your GP.

Having said that it is probably hard to justify a lot of testing if you have been doing it for a number of years.  After time you tailor your eating habits to avoid and reduce your BG levels and testing once or twice a day is probably as much as you need.

How often do you test? and when?  Will the lack of test strips affect your eating habits?


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## Mickw247 (Jul 21, 2017)

CHRISJK said:


> Hi, I am a "Newbie" on here and I have just received a letter from my GP stating that my Prescription for my Diabetic Testing Strips has been Cancelled, as they don't think I need them ?  I am absolutely Astounded by this..... I have been a Type 2 Diabetic for around Fifteen Years, and my GP and Nurses have Congratulated me Constantly on how well I have managed my Blood Glucose Levels and my GP has commented that if he didn't know better he would think that I didn't have Diabetes. I will now be unable to Control my Diabetes as well as I had previously and I feel that I will be in Danger of Having Hypo episodes.... I really don't know what to do ?  I Don't think that Speaking to my GP will help , because I have had Disagreements with her before about my Diabetes........ Chris


You could always change your GP!


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## Bubbsie (Jul 21, 2017)

Mickw247 said:


> You could always change your GP!


Whether or not he changes his GP he's likely to encounter the same problem at another practice...more to the point we should not be expected to simply accept this kind of treatment without any prior consultation...discussion or agreement...the more of us that challenge these arbitrary decisions the better...why on earth just 'roll over'  & just give in?...that's not an option any of us should consider.


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## Drummer (Jul 21, 2017)

As Metformin is not a glucose lowering medication and there is no legal requirement for testing before driving or using machinery there seems to have been a tightening up of the prescribing of testing supplies, and most newly diagnosed type 2s are being advised not to test at all.


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## Bill Stewardson (Jul 21, 2017)

Drummer said:


> As Metformin is not a glucose lowering medication and there is no legal requirement for testing before driving or using machinery there seems to have been a tightening up of the prescribing of testing supplies, and most newly diagnosed type 2s are being advised not to test at all.



Seems to me that removing/refusing strips could be false economy in that early detection of problems would be missed. Not to mention the peace of mind that they obviously give to patients.

Doing it without firstly consulting the patient suggests all sorts of dark things which do not belong in a 21st century health care organisation.


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## Bubbsie (Jul 21, 2017)

Drummer said:


> As Metformin is not a glucose lowering medication and there is no legal requirement for testing before driving or using machinery there seems to have been a tightening up of the prescribing of testing supplies, and most newly diagnosed type 2s are being advised not to test at all.


Metformin does work to lower the amount of sugar produced in the  liver... it  increases the sensitivity of muscle cells to insulin...so cells are able to remove sugar from the blood... Metformin also slows the absorption of sugars from the intestines...lowering the amount of sugar in the blood...it rarely causes hypos...however that is not the issue here...if you prescribe testing strips for fifteen years then remove them without any consultation...that is manifestly wrong...for those well motivated T2's who have been testing consistently to manage/control their conditions strips & meters should be provided... never withdrawn without consultation/justification...it's not a question of 'tightening up'...more a case of type 2 diabetics being east targets for cost cutting exercises...since we rarely 'fight back' the practice continues.


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## mikeyB (Jul 21, 2017)

I completely agree with Bubbsie. Yes, the risk of hypo is reduced on Meformin, that's hardly the point. All the potential damage comes from persistently high blood glucose, so if you have no testing, you are far more likely to develop complications. I can't think of a falser economy. It's completely idiotic.


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## happydog (Jul 21, 2017)

My GP practice have been keen to not let me have any strips and the DNs are the culprits.  I have been politely persistent and it has worked.  I only get 50 bimonthly which is not many and as I have noticed some spiking recently (probably due to stress) I am going to test more for a while, so have bought less expensive meter and the strips and will use that for extra tests when it arrives..  Although I have been called "obsessive" I have found that testing has helped me with my control.  I would certainly query this refusal and see if you can get them back.  Good luck with it.


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## Vicsetter (Jul 21, 2017)

As


mikeyB said:


> I completely agree with Bubbsie. Yes, the risk of hypo is reduced on Meformin, that's hardly the point. All the potential damage comes from persistently high blood glucose, so if you have no testing, you are far more likely to develop complications. I can't think of a falser economy. It's completely idiotic.


Being devils advocate, I have said elswhere and in this thread, where is the scientific study which supports the theory that self monitoring has a positive result?  My GP reluctantly gave me a new prescription but would rather do an HBA1c test at shorted intervals than annual.


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## Bill Stewardson (Jul 21, 2017)

I think your missing the point that any D who tests is actively assisting the medical teams by continuously monitoring their BG levels which can only be good on a number of fronts.

Early detection of possible onset of various problems, teaching themselves about which foods their systems do or do not tolerate. Ingraining in themselves the multi disciplines required to adhere to strict intake regimens.

Exempting, to a large degree, the NHS from actively doing all of the above may not be quantifiable on a clinical test study, it does however deserve recognition as vital and more than necessary, indeed, all those who are self testing at their own expense deserve the thanks of the NHS and indirectly the general public.

ANYONE self testing is an example of self help at a time of worry , giving them the help they need is a fundamental responsibility of any health care provider.

Not being ridden over roughshod and treated as though they are nothing but an unnecessary irritant who should know better.

There is however always the possibility that these medical people who advocate financially penalising highly motivated D patients are in fact correct and those who self test should cease immediately.

I wonder what the financial implications for the NHS would be in about 18 months if we all did that ??


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## Ditto (Jul 22, 2017)

If I don't test I pig out for England, being a food addict. It's stupid not to give people strips. I'm still miffed that I'm not supposed to test. They're all being extremely short sighted.


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## Bubbsie (Jul 22, 2017)

happydog said:


> My GP practice have been keen to not let me have any strips and the DNs are the culprits.  I have been politely persistent and it has worked.  I only get 50 bimonthly which is not many and as I have noticed some spiking recently (probably due to stress) I am going to test more for a while, so have bought less expensive meter and the strips and will use that for extra tests when it arrives..  Although I have been called "obsessive" I have found that testing has helped me with my control.  I would certainly query this refusal and see if you can get them back.  Good luck with it.


Same here happydog...never saw a DSN for almost a year after DX...always dealt with GP for diabetes issues...saw her once... cursory foot check...she .asked about my routine..said I tested up to 6 times a day...I was told that was obsessive...pointed out according to my GP my control was 'excellent'...will continue to test...now I refuse to see her.


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## Bubbsie (Jul 22, 2017)

Vicsetter said:


> As
> 
> Being devils advocate, I have said elswhere and in this thread, where is the scientific study which supports the theory that self monitoring has a positive result?  My GP reluctantly gave me a new prescription but would rather do an HBA1c test at shorted intervals than annual.


Ralph...scientific study or not...I know testing works for me...gives me reasonable control...helps me manage my diabetes...as for the HbA1c test at short intervals...every three months...six months...once a year...hardly 'short' intervals.


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## Vicsetter (Jul 22, 2017)

Bubbsie said:


> Ralph...scientific study or not...I know testing works for me...gives me reasonable control...helps me manage my diabetes...as for the HbA1c test at short intervals...every three months...six months...once a year...hardly 'short' intervals.


Who is Ralph?


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## Bubbsie (Jul 22, 2017)

Vicsetter said:


> Who is Ralph?


Good question Vic...who is Ralph?...clearly not you...more coffee needed...this is what happens when you tackle serious issues on a weekend with only one cup of coffee behind you...more coffee brewing...will report back later!


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## Vicsetter (Jul 22, 2017)

In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels".  I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use.  I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion.  I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.


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## Bill Stewardson (Jul 22, 2017)

Vicsetter said:


> In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels".  I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use.  I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion.  I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
> Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.



Everyone who enters "combat" with a GP regarding strips deserves every Ds thanks. Thing is, why should they have to ?

Seems to me that there has been a policy implemented to trigger this move by GPs to pressure patients into not testing, even to the extent of doing it in an underhanded manner.

Even IF not testing was the sensible thing to do, why has such a move not been publicised and put out for discussion ??

So, who is behind this policy decision ? More importantly, is there a national voice that can challenge it on behalf of Ds ??

I blame Ralph.


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## john cuthbert (Jul 22, 2017)

.Hi ChrisJK,

GPS are facing pressure to cut down on 'unneccessary' prescriptions.  Ive just lost my gluten free bread which costs me about £1 per day.  Its not a 'nice to have'.

You are obviously taking care of yourself.  You dont need test strips to see that.  If you keep your weight down, eat a  a sensible diet, get some, moderate exercise. Walk if you can instead of driving you may well find life less stressfull if you do not feel the need to keep testing.  You already know which foods you should day no to. Apologies if you are already doing this.   What was your recent HBA1c?  How many test a day do you take?   What is your exercise/diet regime?  If you stop testing for 3months while doing all the other things you may find it actually better.

JohnC


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## john cuthbert (Jul 22, 2017)

Oh, and are you overweight?


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## Bubbsie (Jul 22, 2017)

Vicsetter said:


> In the words of my GP: " there is no evidence that self monitoring has any beneficial affect on blood glucose levels".  I pursuaded her that by measuring my BG before my evening meal I could adjust my carbohydrate intake and then pursuaded her that 50 strips was not enough for 2 months use.  I made an appointment solely for the purpose of putting my case after I had twice had strips removed from my prescription without any notice or discusion.  I have no doubt that at my next HBA1c test it will not have gone down and she will want to remove the test strips.
> Unfortunately there are lots of T2s that do not monitor and for whom monitoring would be a waste of time, and they are not members of this forum.


Had the same from my GP & the DSN  (who I now refuse to see)...pointed out even if that were the case...whilst no scientific evidence which quantified the benefit of testing for me...good evidence from my recent HbA1c test...which my they said indicated excellent control...so they could rely on that...will be using the same argument at my next review if the issue reoccurs.


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## Bubbsie (Jul 22, 2017)

john cuthbert said:


> .Hi ChrisJK,
> 
> GPS are facing pressure to cut down on 'unneccessary' prescriptions.  Ive just lost my gluten free bread which costs me about £1 per day.  Its not a 'nice to have'.
> 
> ...


John...really... how have you come to that opinion knowing little about the individual circumstances of  this member...state he does not need to test...any well motivated diabetic who uses testing strips to manage/control their diabetes should have access to the necessary equipment...if it has been provided for a continuous period...then withdrawn without discussion...consultation...that is not acceptable...diabetes is a life long chronic condition as you know...you gain control of it...you need to maintain that control...there are times when irrespective of how well you eat...follow the same routine your blood sugar levels can rise...type 2 diabetics in particular are often denied testing strips routinely...based on the inaccurate interpretation of the NICE guidelines by GP practices & local CCG's...the guidelines say testing for type 2's non-dependant on hypoglycaemic medications should not be routinely undertaken...it does not preclude them...clearly those comments indicate.it allows room for deviation...discretion...it's not just about keeping your weight down...eating a sensible diet...or exercise...the assumption this is all it takes to manage as a type 2 diabetic not dependant on hypo causing medication...is not dissimilar to the popular media myth that type 2's are all overweight...inactive... eat the wrong food...*like you apologies if that is the wrong assumption*...however there is nothing in the posters thread that says he wants to stop testing...clearly from his comments he wants to continue testing...I very much hope he does challenge the decision to withdraw his prescription...I would offer him every assistance to do that if he wishes...  whilst we are all fighting diabetes...there are many differences between the medications/regime employed to manage our different types of diabetes... please as a type 2 managing her diabetes on a very small dose of Metformin...don't assume it is as simple as eating a healthy diet...exercising...losing weight...avoiding stress to maintain good control...consequently we have no need to test...we have  enough barriers in our way already...from those health care professionals charged with our care who express similar.. .ill informed/unfounded views such as yours.


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## Bubbsie (Jul 22, 2017)

CHRISJK said:


> Yes I am on Metformin , and my GP has Reduced this. At first she wanted to Reduce my Tablets from Four to Two Tablets a Day, but after we had a "Discussion" they were Reduced to Three a Day


Of course I should have added this to my response above...when medication is reduced...as it has been in this instance...important to continue to ensure good management/control of your diabetes is not affected by the reduced dose...by testing!


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## Drummer (Jul 22, 2017)

I am over 6 months from diagnosis have not seen a doctor to discus my results, the nurses I have seem have no training in controlling by diet, just repeat that there is no need to test, and the doctor I was called in to see last week just wanted to persuade me to take statins again. 
It is NHS policy not to supply meters or strips for testing - and things are being tightened up.
Yes it is an embuggerance, but that is the way things are at the moment.
It might prove to be a false economy at the moment but it is the coping mechanism at the moment and I'm not supposed to bother the surgery again for six months. I have reminded them twice that I have not had a thyroid check for almost two years, but that seem to be more than I am worth at the moment. Maybe next year.


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## Derek Stubbs (Jul 22, 2017)

it's strange that they are quick to prescribe drugs & tablets (things which the big pharma companies are in bed with the Government ) because the big pharma companies pay £billions to governments who then set agenda's which GP need to follow in order to get paid. Yet, if they prescribed everyone with meters & test strips so we can control it ourselves with diet (I am talking type 2 here), it would mean less need for tablets etc, & the government then loose out if the big pharma companies reduced payments as their "products" weren't being used.  Companies that produce test strips are just peanuts compared to the big drug companies. So money talks. Drugs & money, not test strips , rule this world


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## Bill Stewardson (Jul 22, 2017)

john cuthbert said:


> .Hi ChrisJK,
> 
> GPS are facing pressure to cut down on 'unneccessary' prescriptions.  Ive just lost my gluten free bread which costs me about £1 per day.  Its not a 'nice to have'.
> 
> ...



So, just exactly how do you balance a cost saving against the peace of mind the patient enjoys by testing ?

How do you then have the ability to brush aside the obvious benefits of a patient taking control of their health care on a day to day basis ?

Where does the higher position required to class strip prescriptions as unnecessary come from ?

What do you think Mr Majeed ( my pancreatic surgeon) would have to say if I just stopped monitoring my BG levels ?

How much would my not being in a position to spot problems developing potentially cost the NHS ??

In what way would the potential for Ds to be extra susceptible to infections be reduced by taking away strips ? ( and that's ignoring the underhand way it is being done).

Sorry to put you on the spot, just wanted you see how the original poster must be feeling.


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## mikeyB (Jul 22, 2017)

This thread depresses me. This is not an argument we should having among ourselves. We know that this is just money saving, and nothing to do with ideal diabetic control. 

It's something that DUK should be banging on the government's door to put right. It's a discussion that crops up regularly on the forum, members are regularly complaining. I've said before, this a false economy, and it is a backward step in diabetes management, and will cost the NHS dear.  Why this is not a priority in DUKs plans is completely beyond me. Are they making any effort at all to convince the powers that be that this is crazy? If not, who will?


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## Bill Stewardson (Jul 23, 2017)

mikeyB said:


> This thread depresses me. This is not an argument we should having among ourselves. We know that this is just money saving, and nothing to do with ideal diabetic control.
> 
> It's something that DUK should be banging on the government's door to put right. It's a discussion that crops up regularly on the forum, members are regularly complaining. I've said before, this a false economy, and it is a backward step in diabetes management, and will cost the NHS dear.  Why this is not a priority in DUKs plans is completely beyond me. Are they making any effort at all to convince the powers that be that this is crazy? If not, who will?



Understood Mike.

If anyone has any ideas as to who should be written to, I will do that.

Not much comes out of us telling each other in here, time to tell those out there, if we' don't do it nobody else will.


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## Bubbsie (Jul 23, 2017)

Bill Stewardson said:


> Understood Mike.
> 
> If anyone has any ideas as to who should be written to, I will do that.
> 
> Not much comes out of us telling each other in here, time to tell those out there, if we' don't do it nobody else will.


Bill...please please please don't assume *nothing comes out of us telling each other here*...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they  are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.


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## CHRISJK (Jul 23, 2017)

Bubbsie said:


> Bill...please please please don't assume *nothing comes out of us telling each other here*...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they  are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.


Hi , Sorry I havn't been on here for a while but I am on Holiday for a few days, but when I get back I will write to my GP regarding this. Any help with this will be appreciated . Thank You all for the replies...... Chris


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## Bubbsie (Jul 24, 2017)

CHRISJK said:


> Hi , Sorry I havn't been on here for a while but I am on Holiday for a few days, but when I get back I will write to my GP regarding this. Any help with this will be appreciated . Thank You all for the replies...... Chris


Enjoy your break Chris...when you get back...will be happy to provide some information for you...let me now when you're ready


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## Bill Stewardson (Jul 24, 2017)

Bubbsie said:


> Bill...please please please don't assume *nothing comes out of us telling each other here*...I have said this before...there are members taking action...working quietly behind the scenes...writing to their GP's...local CCG's...MP's...councillors and other agencies...then passing on that information to other members...sharing so they can do similar...I have done that several times...not publicly on the forum...by private message...unfortunately Diabetes care does not warrant a great deal of public attention...it's not a popular media issue (unless they  are looking for a convenient whipping boy)...the DUK testing campaign did nothing to forward the issue of testing equipment for type 2's in our circumstances...we were largely ignored...however...until that changes...until this issue is taken seriously by those in a position to change that perspective...we can have a 'quiet revolution'...encourage other members take direct action...challenge decisions...read the NICE guidelines (not as difficult as many think)...write to their GP practices...CCG's...chip away at the stereotype image of the fat lazy sloth like type2 diabetic...who has brought this on themselves...we all know that to be inaccurate...lets be positive & encouraging...not dismissive and 'accept our lot.



There is no assumption here that individuals taking issue is of no value, more that dealing with the policy makers may carry more value, if it turns out not to, at least that tactic can be crossed off the list.

It is disappointing that a different plan being  put forward is classed as being dismissive. We are all in this together.


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## Bubbsie (Jul 24, 2017)

Bill Stewardson said:


> There is no assumption here that individuals taking issue is of no value, more that dealing with the policy makers may carry more value, if it turns out not to, at least that tactic can be crossed off the list.
> 
> It is disappointing that a different plan being  put forward is classed as being dismissive. We are all in this together.


Bill...I've made my position clear on this issue...you deal with your management your way...I deal with my diabetes my way...anything...anything at all we do to challenge unfair inequitable decisions is of value...whether that be policy makers or any others involved in diabetes management *at any level in the NHS...*if my GP refuses me testing strips/medication I will ask him why...similarly if the DSN were to adopt the same approach...I would ask her why...the policy makers set the policy (NICE)...the policy most often is misinterpreted...misapplied by our surgeries...the local CCG committees...that's where the problem begins...there is every point in 'us' talking to each other about this...sharing information...we have to change the views of those we deal with directly...those that actually say 'No'...point to the guidelines...give a critique if necessary (lord knows most GP's DSN's need one)...your plan is not dismissed...whatever action you decide to pursue is a matter for you...as for your disappointment...many of us here have faced disappointment struggling to get what we need...for me a hard fought/won concession from my local CCG that my GP can prescribe testing strips & a meter proved invaluable...for me and others here I have shared that with...I wish you good luck with your battle....I sincerely hope it comes to fruition.


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## everydayupsanddowns (Jul 24, 2017)

Part of the challenge for motivated T2s who can and do successfully use self monitoring of blood glucose (SMBG) to improve their blood glucose management through adjusting their diet and exercise patterns (ie most members here who choose to self monitor) is that they need to be seen as the exception, rather than the rule of the T2 population.

There are significant studies into SMBG in T2 which are interpreted to show that 'It Does Not Work' (Farmer et al etc) and the NICE guidance is clear that self monitoring should not be *routinely* offered in T2 unless you are taking something more likely to cause hypos than Metformin.



> 1.6.13 Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:
> 
> the person is on insulin *or*
> 
> ...


https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#blood-glucose-management-2

The old Farmer study (and a subsequent follow-up) conclude that self monitoring has no positive effect and actually causes people distress. It costs money, and it not only doesn't help - it actually makes people feel worse. And this I am sure we find very confusing. But it is evidence of these and similar studies that form the basis of the NICE guidance not to offer strips to T2s.

Of course, if some of our T2s look at the way that study was conducted, they will immediately see that _of course it wasn't going to work if that was what they were doing! _Because if I remember right, part of the initial study setup was to ensure that they kept eating what had initially been agreed and did not deviate. Rather than using their individual results to adjust their diet for better BG outcomes.

I find this paper from Australia really interesting in that regard - https://www.mja.com.au/journal/2015...sely-when-it-comes-monitoring-type-2-diabetes

Because it again demonstrates that you can't necessarily improve T2 outcomes just by spraying test strips around to people who really aren't interested in them (or people who have been given inappropriate advice on how to use the results). Again it shows that just testing alone is unlikely to confer benefit, and may cause problems. What really works is the test-review-adjust style approach that T2s here advocate.

For SMBG to be effective in people on D&E/metformin the people involved need to learn, or be shown what to DO with the information, how to adjust their diet and exercise in response to the results they see 1 and 2 hours after eating vs before the meal. How long they need to commit to the tiresome business of intensive self-monitoring while building up their understanding of how different foods affect them _as an individual_, before they can drop back to a more relaxed, occasional 'maintenance level' and give their fingers a rest. All this takes effort, and commitment. And it is not necessarily an approach that everyone will want to take.

My opinion is that people who are motivated to use self-monitoring to improve their BG outcomes need to convince their clinic/GP that they are unusual. That they are the exceptions to the rule. That they understand that SMBG doesn;t generally work for people in their position, but how it will work for them, and improve their long-term health/reduce complication risk.

My guess is that many Drs and Practice nurses are not purely doing this to save money (though I am sure some are). They are doing it because there is substantial scientific evidence that it doesn't 'work'.

You need to demonstrate that you are one of the cases in which self monitoring offers real benefit.


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## Radders (Jul 24, 2017)

everydayupsanddowns said:


> Part of the challenge for motivated T2s who can and do successfully use self monitoring of blood glucose (SMBG) to improve their blood glucose management through adjusting their diet and exercise patterns (ie most members here who choose to self monitor) is that they need to be seen as the exception, rather than the rule of the T2 population.
> 
> There are significant studies into SMBG in T2 which are interpreted to show that 'It Does Not Work' (Farmer et al etc) and the NICE guidance is clear that self monitoring should not be *routinely* offered in T2 unless you are taking something more likely to cause hypos than Metformin.
> 
> ...


Brilliant explanation, I love this!


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## Bill Stewardson (Jul 24, 2017)

everydayupsanddowns said:


> Part of the challenge for motivated T2s who can and do successfully use self monitoring of blood glucose (SMBG) to improve their blood glucose management through adjusting their diet and exercise patterns (ie most members here who choose to self monitor) is that they need to be seen as the exception, rather than the rule of the T2 population.
> 
> There are significant studies into SMBG in T2 which are interpreted to show that 'It Does Not Work' (Farmer et al etc) and the NICE guidance is clear that self monitoring should not be *routinely* offered in T2 unless you are taking something more likely to cause hypos than Metformin.
> 
> ...



Absolutely spot on. Therefore, any patient who puts their hand up and requests the necessary equipment to self test has already shown that they are motivated enough to WANT to assist the clinicians by working towards the correct food intake. Your/my healthy food plate may not be same as the next persons.
No one is/should be under the impression that testing cures anything by itself, however there is a very good chance that it will assist the staving off of all kinds of future problems and definitely improve the patients quality of life on an ongoing basis, if only by improving confidence, and we all know the amplified effect stress has on blood sugars.
Financial considerations do have to be considered, again, I see that "prevention is better than cure" being an extension of the above.
A blanket refusal across the country is not acceptable, never mind the underhanded way it is currently being operated.
Me or you buying strips at the chemist are very likely paying a lot more per strip than the NHS would be, I would assume the same applies to meters.
Are unwaged people currently being refused ??
Does DUK support the pro or anti position ??

Then ofcourse there is the possibility that It is pointless, personally I doubt that.


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## Stefan Diabetes UK (Jul 24, 2017)

CHRISJK said:


> Hi, I am a "Newbie" on here and I have just received a letter from my GP stating that my Prescription for my Diabetic Testing Strips has been Cancelled, as they don't think I need them ?  I am absolutely Astounded by this..... I have been a Type 2 Diabetic for around Fifteen Years, and my GP and Nurses have Congratulated me Constantly on how well I have managed my Blood Glucose Levels and my GP has commented that if he didn't know better he would think that I didn't have Diabetes. I will now be unable to Control my Diabetes as well as I had previously and I feel that I will be in Danger of Having Hypo episodes.... I really don't know what to do ?  I Don't think that Speaking to my GP will help , because I have had Disagreements with her before about my Diabetes........ Chris



Hi @CHRISJK sorry to hear about the problems you've been having getting the test strips you need. You might find the Diabetes UK Testing Times campaign tools useful here. There's a free advocacy pack which sets out the current rules around test strips and gives you tips on how to make the case that test strips help you manage your diabetes.

We also have a tool to help you write to your local health care authority to challenge the decision, if you don't get anywhere with your GP. It gives you a template letter which you can then add the details of your own experience too.

Our research showed that 1 in 4 people living with diabetes had faced some sort of restrictions, so we started the Testing Times campaign on this issue earlier this year. There's more details on our website.

As you'll have seen quite a few people on the forum have faced similar issues and I'm sure will also be able to offer very helpful advice.


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## Bill Stewardson (Jul 24, 2017)

Stefan Diabetes UK said:


> Hi @CHRISJK sorry to hear about the problems you've been having getting the test strips you need. You might find the Diabetes UK Testing Times campaign tools useful here. There's a free advocacy pack which sets out the current rules around test strips and gives you tips on how to make the case that test strips help you manage your diabetes.
> 
> We also have a tool to help you write to your local health care authority to challenge the decision, if you don't get anywhere with your GP. It gives you a template letter which you can then add the details of your own experience too.
> 
> ...



Brilliant stuff.

I would definitely suggest anyone with problems in this area reads the above or gives Bubbsie a tug,, if only we could get DNs to think the same way.


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## Bubbsie (Jul 24, 2017)

everydayupsanddowns said:


> Part of the challenge for motivated T2s who can and do successfully use self monitoring of blood glucose (SMBG) to improve their blood glucose management through adjusting their diet and exercise patterns (ie most members here who choose to self monitor) is that they need to be seen as the exception, rather than the rule of the T2 population.
> 
> There are significant studies into SMBG in T2 which are interpreted to show that 'It Does Not Work' (Farmer et al etc) and the NICE guidance is clear that self monitoring should not be *routinely* offered in T2 unless you are taking something more likely to cause hypos than Metformin.
> 
> ...


What absolute nonsense Mike...first you make the point the NICE guidelines do not say not to offer strips to T2s...but 'do not routinely offer testing strips/meters'...yet later state the NICE guidelines say not to offer test strips to T 2's...conflicting information?...or can you just not make up your mind...secondly you refer to significant studies...which based on your own view...*'if some of our T2s look at the way that study was conducted, they will immediately see that of course it wasn't going to work if that was what they were doing! Because if I remember right, part of the initial study setup was to ensure that they kept eating what had initially been agreed and did not deviate. Rather than using their individual results to adjust their diet for better BG outcomes'..*given those circumstances that study was designed to fail from the outset...where is the science/objectivity in that?...I find the rest of your comments unbelievable...patronising...ill-informed...as a type 2 diabetic using Metformin only...I do not want to be seen as an exception to the rule...what is the rule...who would...I do not want to hear the standard NHS mantra  paraded continually by DUK or their staff...I live with my diabetes daily...I manage/control my condition... know what I need in order to maintain that control...I do not find *'the business of intensive self-monitoring tiresome'...*I find it liberating...invaluable...I am not unusual in that...I do not agree that SMBG does not work for people in my position...give type 2's the opportunity to demonstrate that...your opinion is subjective...unfounded (given the scientific data you quote...I use the term scientific loosely)...many/most type 2's are not given the option to test...strongly advised against it...deterred on the flimsiest of pretexts....where is the substantial evidence you refer to?...not contained in any of the references you make above...it does work...many of our members here have demonstrated that...many of our members have testing strips withdrawn...restricted...Mike there are many differences between the management of our respective conditions...I speak from personal experience here...I am tired of the constant distinctions 'subtly'  inferred/drawn between type 1 & 2 diabetics...from the medical profession...failed non-scientific studies...but most of all DUK (just wondering why I have never seen a type 2 moderator... or member of staff feature prominently  here...are there  any)...the recent DUK campaign on testing strips was type 1 & 2 centric...focused on those dependant on hypoglycaemic medications...there was nothing there for me...or other members in similar circumstances...we are very much left to our devices...please don't make it harder by telling us SMBG doesn't work...*'we need to prove we are the exception to the rule'...'we need to convince our GP's/Nurses we are unusual'*...I couldn't believe I was reading that...type 2 diabetics reliant on Metformin or diet & exercise only appear to be 'the poor relations' of the diabetes world (my opinion only)..until that attitude changes...particularly within those organisations that are presumed to be our 'Voices'...Primarily DUK...Please do not seek to justify the vacuous excuses given to deny type 2's the equipment many of them need to control their diabetes...we are not unusual...not the exception to the rule (given most of us are denied the opportunity to prove otherwise routinely)...we are not uninformed...we are diabetic too.


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## Bubbsie (Jul 24, 2017)

Stefan Diabetes UK said:


> Hi @CHRISJK sorry to hear about the problems you've been having getting the test strips you need. You might find the Diabetes UK Testing Times campaign tools useful here. There's a free advocacy pack which sets out the current rules around test strips and gives you tips on how to make the case that test strips help you manage your diabetes.
> 
> We also have a tool to help you write to your local health care authority to challenge the decision, if you don't get anywhere with your GP. It gives you a template letter which you can then add the details of your own experience too.
> 
> ...


Stefan...this campaign was type 1 focused...extended to type 2's on hypoglycaemic medication...there is/was little in for type 2's dependant on Metformin or diet & exercise only.


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## mikeyB (Jul 24, 2017)

Aye, Bubbsie, which is why your personal campaign is a valuable example for others to follow. I still think it shouldn't be so hard for motivated folk to get test strips.


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## Bill Stewardson (Jul 24, 2017)

I was hoping this would not become an "Us and Them" scenario.


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## Bubbsie (Jul 24, 2017)

mikeyB said:


> Aye, Bubbsie, which is why your personal campaign is a valuable example for others to follow. I still think it shouldn't be so hard for motivated folk to get test strips.


Mike I have said this before...many member here have done exactly the same as I have ...albeit more discreetly...less directly...it  is more than a personal campaign...there are a growing number of new diabetics joining the forum...with certainly more knowledge & insight than I had when I first arrived here...reading...researching...challenging the advice they are given...testing however strongly they are advised not to...all those actions are positive...thank you for your confidence in me...however I think you give me too much credit for it being MY campaign...I have used the advice...information & support given by other members on the forum...to challenge my GP's refusal to provide what I need on prescription...to challenge the CCG...I am very grateful for their input...I hope that small...limited success... will encourage many more here to adopt the same approach.


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## Bubbsie (Jul 24, 2017)

Bill Stewardson said:


> I was hoping this would not become an "Us and Them" scenario.


Bill diversity of opinion is not an 'us and Them' scenario...it leads to discussion...debate...new perspectives...learning...this is a forum...what it's all about


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## everydayupsanddowns (Jul 24, 2017)

@Bubbsie - I feel you are attacking me and calling me ill informed and patronising and that my opinions are unfounded. All I was trying to do was to explain to others reading this thread WHY their doctor says that an A1c is enough and that they do not need to test.

I am NOT saying that 'it doesn't work'. I firmly believe that it does - for the right people with the right support and knowledge. We see that on the forum all the time. We always suggest meters and self-monitoring for new arrivals here.



Bubbsie said:


> What absolute nonsense Mike...first you make the point the NICE guidelines do not say not to offer strips to T2s...but 'do not routinely offer testing strips/meters'...yet later you say the NICE guidelines say not to offer test strips to T 2's...conflicting information?...or can you just not make up your mind...secondly you refer to significant studies...which based on your own view...



I'm afraid I never said that NICE _doesn't_ say not to offer test strips - because that's exactly what they DO say. How else can one interpret "*Do not routinely offer*"

I also never said that testing does not work for someone in your position.

What I said is that the evidence that NICE use to make their recommendations says that 'it doesn't work'.

The trials are published, reviewed, randomised controlled studies. As individuals, we may have concerns over the structure and study method, but these studies from part of the literature on which NICE guidance etc is based.

The conclusion of the 2009 Farmer study:


> While the data do not exclude the possibility of a clinically important benefit for specific subgroups of patients in initiating good glycaemic control, SMBG by non-insulin-treated patients, with or without instruction in incorporating findings into self-care, did not lead to a significant improvement in glycaemic control compared with usual care monitored by HbA1c levels. There was no convincing evidence to support a recommendation for routine self-monitoring of all patients and no evidence of improved glycaemic control in predefined subgroups of patients.



You will see that there IS wiggle room there for an individual to go to their doctor to make a case for strips ('specific subgroups'). That was why I suggested forum members position themselves as 'exceptions to the rule'. This was not intended to cause offence to you as an individual.

I was trying to be on your side. But I'm afraid you have just made it feel like I am being attacked and shouted down for trying to explain why we are where we are.

That's not what I expect from the forum to be honest.

Incidentally you might be interested to know that we did have a respected T2 moderator for many years. They still visit the forum though are not as frequent a poster as they were.


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## Vicsetter (Jul 24, 2017)

Bubbsie said:


> What absolute nonsense Mike...first you make the point the NICE guidelines do not say not to offer strips to T2s...but 'do not routinely offer testing strips/meters'...yet later you say the NICE guidelines say not to offer test strips to T 2's...conflicting information?...or can you just not make up your mind...secondly you refer to significant studies...which based on your own view...*'if some of our T2s look at the way that study was conducted, they will immediately see that of course it wasn't going to work if that was what they were doing! Because if I remember right, part of the initial study setup was to ensure that they kept eating what had initially been agreed and did not deviate. Rather than using their individual results to adjust their diet for better BG outcomes'..*given those circumstances that study was designed to fail from the outset...where is the science/objectivity in that?...I find the rest of your comments unbelievable...patronising...ill-informed...as a type 2 diabetic using Metformin only...I do not want to be seen as an exception to the rule...who would...I do not want to hear the standard NHS mantra  paraded continually by DUK or their staff...I live with my diabetes daily...I manage/control my condition... know what I need in order to maintain that control...I do not find *'the business of intensive self-monitoring tiresome'...*I find it liberating...invaluable...I am not unusual...I do not agree that SMBG does not work for people in my position...your opinion is subjective...unfounded (given the scientific data you quote...I use the term scientific loosely)...many/most type 2's are not given the option to test...strongly advised against it...deterred on the flimsiest of pretexts....where is the substantial evidence you refer to?...not contained in any of the references you make above...it does work...many of our members here have demonstrated that...many of our members have testing strips withdrawn...restricted...Mike there are many differences between the management of our respective conditions...I speak from personal experience here...I am tired of the constant distinctions 'subtly'  inferred/drawn between type 1 & 2 diabetics...from the medical profession...failed non-scientific studies...but most of all DUK (just wondering why I have never seen a type 2 moderator... or member of staff feature prominently  here...are there  any)...the recent DUK campaign on testing strips was type 1 & 2 centric...focused on those dependant on hypoglycaemic medications...there was nothing there for me...or other members in similar circumstances...we are very much left to our devices...please don't make it harder by telling us it doesn't work...we need to prove we are the exception to the rule...we need to convince our GP's/Nurses we are unusual...I couldn't believe I was reading that...type 2 diabetics reliant on Metformin I diet & exercise only appear to be 'the poor relations' of the diabetes world (my opinion only)..until that attitude changes...particularly within those organisations that presumed to be our 'Voices'...Primarily DUK...Please do not seek to justify the vacuous excuses given to deny type 2's the equipment many of them need to control their diabetes...we are not unusual...not the exception to the rule (given most of us are denied the opportunity to prove otherwise routinely)...we are not uninformed...we are diabetic.



Unbelievable, you have obviously done lots of studies into the behaviour of T2 diabetics!  I would be willing to bet that you are the exception to the rule, but unlike you I do not attack Mike who has only put forward the facts.  If T2s were to be concerned about self testing then there would be a lot more members on this forum.

The NHS can only base it's guidlines, (under increasing pressure of rising costs) upon the scientific evidence that exists. I have posted at least twice asking if anyone knows of a study that proves SBMG is beneficial - and got no reply.  NICE are not going to change their rules upon your experience. The weight of the evidence is that the supply of test strips has no affect on HBA1c.
The studies I have seen, including the latest from the USA was incredible in expecting 1 BG test a day to have any affect at all.

I had a friend who was T2 on Byetta and then Bydureon, who would test and then say " oh less than 10 thats good" and tuck into a piece of cake, he wouldn't take any advice and certainly wouldn't join this forum.
You are an exception and perhaps that is because of your mental attitude to YOUR diabetes.  

T2s have problems in that the only control they have (unless on insulin) is to regulate their diet or potentially increase their exercise.  I have never exercised and given blood pressure/circulatory problems and not going to start now.  It takes an enormous amount of willpower (I would say from experience more willpower than giving up smoking) to radically change your diet, especially as there is no perceived benefit (except maybe weight loss).


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## Bubbsie (Jul 24, 2017)

everydayupsanddowns said:


> @Bubbsie - I feel you are attacking me and calling me ill informed and patronising and that my opinions are unfounded. All I was trying to do was to explain to others reading this thread is WHY their doctor says that an A1c is enough and that they do not need to test.
> 
> 
> 
> ...


I'm sorry attacking you...really...since you ask 'do not routinely offer' means just that do not routinely offer clearly indicating there is room for discretion...deviation...it is not an absolute no...if you are unhappy with my comments...is it appropriate to say I am attacking you because I do not agree with your comments/opinion?..am able to justify that....is that the way forward?


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## Bubbsie (Jul 24, 2017)

Vicsetter said:


> Unbelievable, you have obviously done lots of studies into the behaviour of T2 diabetics!  I would be willing to bet that you are the exception to the rule, but unlike you I do not attack Mike who has only put forward the facts.  If T2s were to be concerned about self testing then there would be a lot more members on this forum.
> 
> The NHS can only base it's guidlines, (under increasing pressure of rising costs) upon the scientific evidence that exists. I have posted at least twice asking if anyone knows of a study that proves SBMG is beneficial - and got no reply.  NICE are not going to change their rules upon your experience. The weight of the evidence is that the supply of test strips has no affect on HBA1c.
> The studies I have seen, including the latest from the USA was incredible in expecting 1 BG test a day to have any affect at all.
> ...


Vic I am entitled to my opinion...there will be diversity here...that's the point of the forum...you are entitled to yours...Mike is entitled to his...why the forum is here...if Mike believes this is a personal attack...he can report it to the moderating staff...that's what they are here for.


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## Juzzy1972 (Jul 24, 2017)

Hi all sorry this is my 1st post and what a post my blood strips and needles have been taken off my repeat prescription without telling me  after seeing my GP this morning who told me it's a government issue that they have been told they can't give the strips and bit out and quote " you have to fund them yourself sorry " I have made another appointment to see the diabetic nurse as in her words keep and eye on your bloods as I have got problems with kidneys and liver so will see what she says.
Let doctors and went next door to chemist asked the price of strips just under £20 pharmacies overheard and said no you don't pay your had them on prescription so repeated what GP said off she went to have a word with drs 10 mins came back and apologised and said she couldn't believe it neither myself I said.
Any advice would be nice ?

I'm type 2 diabetic on metformin oh and really fun part my bloods have only been high when diagnosed never had a hypo my bloods go low and lowest recorded 1.2 so fun time ahead of guessing I suppose sorry for blabbing on it just me lol cheers Justin


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## Vicsetter (Jul 24, 2017)

Bubbsie said:


> Vic I am entitled to my opinion...there will be diversity here...that's the point of the forum...you are entitled to yours...Mike is entitled to his...why the forum is here...if Mike believes this is a personal attack...he can report it to the moderating staff...that's what they are here for.


Mike is a moderator!


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## Bubbsie (Jul 24, 2017)

Vicsetter said:


> Mike is a moderator!


And?


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## Vicsetter (Jul 24, 2017)

Bubbsie said:


> Vic I am entitled to my opinion...there will be diversity here...that's the point of the forum...you are entitled to yours...Mike is entitled to his...why the forum is here...if Mike believes this is a personal attack...he can report it to the moderating staff...that's what they are here for.


Starting off your post with 





> What absolute nonsense Mike


 struck me as attacking.  
I would like to see you justify your opinion with some facts (other than, it works for me)


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## everydayupsanddowns (Jul 24, 2017)

Bubbsie said:


> Vic I am entitled to my opinion...there will be diversity here...that's the point of the forum...you are entitled to yours...Mike is entitled to his...why the forum is here...if Mike believes this is a personal attack...he can report it to the moderating staff...that's what they are here for.



I've now mentally reported the post to myself, to see whether I thought I was feeling attacked. I think I probably *did* feel attacked. That was why I said "I feel that you are attacking me". I suppose I hoped that it would show that I was feeling attacked. Sorry I wasn't more clear about that.


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## Vicsetter (Jul 24, 2017)

Bubbsie said:


> And?


SO he has to report himself to himself!


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## everydayupsanddowns (Jul 24, 2017)

Juzzy1972 said:


> Hi all sorry this is my 1st post and what a post my blood strips and needles have been taken off my repeat prescription without telling me  after seeing my GP this morning who told me it's a government issue that they have been told they can't give the strips and bit out and quote " you have to fund them yourself sorry " I have made another appointment to see the diabetic nurse as in her words keep and eye on your bloods as I have got problems with kidneys and liver so will see what she says.
> Let doctors and went next door to chemist asked the price of strips just under £20 pharmacies overheard and said no you don't pay your had them on prescription so repeated what GP said off she went to have a word with drs 10 mins came back and apologised and said she couldn't believe it neither myself I said.
> Any advice would be nice ?
> 
> I'm type 2 diabetic on metformin oh and really fun part my bloods have only been high when diagnosed never had a hypo my bloods go low and lowest recorded 1.2 so fun time ahead of guessing I suppose sorry for blabbing on it just me lol cheers Justin



Hello Juzzy!

Welcome to the forum. Sorry you've had your test strips removed without consultation - do take a look at the links in Stefan's post which might give you some hep in appealing the decision.

Regrettably some of our members do find they need to self-fund test strips, because their GP surgery will not budge on the issue. I believe the SD codefree meter is one of the better cheaper ones if that applies to you.


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## Robin (Jul 24, 2017)

Juzzy1972 said:


> Hi all sorry this is my 1st post and what a post my blood strips and needles have been taken off my repeat prescription without telling me  after seeing my GP this morning who told me it's a government issue that they have been told they can't give the strips and bit out and quote " you have to fund them yourself sorry " I have made another appointment to see the diabetic nurse as in her words keep and eye on your bloods as I have got problems with kidneys and liver so will see what she says.
> Let doctors and went next door to chemist asked the price of strips just under £20 pharmacies overheard and said no you don't pay your had them on prescription so repeated what GP said off she went to have a word with drs 10 mins came back and apologised and said she couldn't believe it neither myself I said.
> Any advice would be nice ?
> 
> I'm type 2 diabetic on metformin oh and really fun part my bloods have only been high when diagnosed never had a hypo my bloods go low and lowest recorded 1.2 so fun time ahead of guessing I suppose sorry for blabbing on it just me lol cheers Justin


Hello, Justin, and welcome to the forum. As you can see from this thread, test strips are a hot topic! Hopefully, you can get these reinstated when you see your DSN, but if not, the cheapest meter and strips that we've found is the Codefree, which is inexpensive, and around £8 a pot for strips, I think. Have a look on the thread pinned to the top of the 'Newbies' section, I think there's a link to where you can buy it ( Amazon, or direct from the manufacturer, Home health) and details of what you need to order.
Edit: Mike types faster than I do and got there before me with the same info!


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## New-journey (Jul 24, 2017)

I think it is important all diabetics have choice and part of the choice is knowing that testing can make a difference. It is information, I believe vital information which then can be used to improve levels. We can never make people change but we can make it more likely they will, and surely every type two knowing they can use testing as a tool is a good thing?
The fact that the scientific research is so weak is just part of the difficulties type two's face. I do believe type 2's deserve more, they in my mind are demonised, the general thinking that they will all just eat cake even after they have tested as Vic says, but they are all individual and we need to make sure they all have what they need.


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## Bubbsie (Jul 24, 2017)

Vicsetter said:


> SO he has to report himself to himself!


However improbable that suggestion seems Vic...apparently you were absolutely correct...that is exactly what he has done...see his response.


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## Bill Stewardson (Jul 24, 2017)

everydayupsanddowns said:


> I've now mentally reported the post to myself, to see whether I thought I was feeling attacked. I think I probably *did* feel attacked. That was why I said "I feel that you are attacking me". I suppose I hoped that it would show that I was feeling attacked. Sorry I wasn't more clear about that.



Cue Monty Python music,,

All I said was " that piece of halibut was fit for Jehova"


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## Angela123 (Jul 24, 2017)

Interesting to read this thread. I am very new to this and would probably have been easily fobbed off with the no need for a monitor trend. I shall do my best to get one.


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## Bill Stewardson (Jul 24, 2017)

Angela123 said:


> Interesting to read this thread. I am very new to this and would probably have been easily fobbed off with the no need for a monitor trend. I shall do my best to get one.



 Which makes the whole thing worthwhile.


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## Bubbsie (Jul 24, 2017)

Angela123 said:


> Interesting to read this thread. I am very new to this and would probably have been easily fobbed off with the no need for a monitor trend. I shall do my best to get one.


Good to hear that Angela...I feel very strongly about this issue...if you need any help whatsoever...I would be more than happy to offer some...good luck...please let me know how you fare...and if you do need a hand.


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## everydayupsanddowns (Jul 24, 2017)

Angela123 said:


> Interesting to read this thread. I am very new to this and would probably have been easily fobbed off with the no need for a monitor trend. I shall do my best to get one.



AlanS's Test Review Adjust post is well thought of by our members.
http://loraldiabetes.blogspot.co.uk/2006/10/test-review-adjust.html

As is his 'testing on a budget' approach if you find yourself in the position where you must fund your own strips and the costs become difficult. Progress can be made on just one check a day (though it will obviously take longer to fine tune your diet)
http://loraldiabetes.blogspot.co.uk/2007/04/teting-on-budget.html


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## Bubbsie (Jul 24, 2017)

Juzzy1972 said:


> Hi all sorry this is my 1st post and what a post my blood strips and needles have been taken off my repeat prescription without telling me  after seeing my GP this morning who told me it's a government issue that they have been told they can't give the strips and bit out and quote " you have to fund them yourself sorry " I have made another appointment to see the diabetic nurse as in her words keep and eye on your bloods as I have got problems with kidneys and liver so will see what she says.
> Let doctors and went next door to chemist asked the price of strips just under £20 pharmacies overheard and said no you don't pay your had them on prescription so repeated what GP said off she went to have a word with drs 10 mins came back and apologised and said she couldn't believe it neither myself I said.
> Any advice would be nice ?
> 
> I'm type 2 diabetic on metformin oh and really fun part my bloods have only been high when diagnosed never had a hypo my bloods go low and lowest recorded 1.2 so fun time ahead of guessing I suppose sorry for blabbing on it just me lol cheers Justin


Juzzy you can challenge this...several members have done so successfully...I have no idea what document your GP was quoting...you could ask for a copy...be interested to read it...as far as I am aware this issue is covered by the NICE guidelines...NICE are the National Institute For Health & Care guidance...who advise on quality standards and information for public health & social care...their guidelines do not preclude the provision of testing strips for type 2 diabetics...so NICE do not say NO outright...possibly your GP is quoting a directive from your local clinical commissioning group...who in my opinion interpret the guidelines narrowly & inaccurately...since you previously had been prescribed strips...were you given any explanation for the withdrawal apart from the quote s/he read out...it is possible to write to your GP justify your need for the strips to be reinstated on your prescription...let me know if you would like to challenge this decision.


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## everydayupsanddowns (Jul 24, 2017)

A guide to NICE-speak for the uninitiated (not official, but this is my understanding during conversations with NICE people about drafting guidance):

*Offer*
This works and/or represents best practice. Even if it is very expensive, it's worth it.

*Consider*
The scientific evidence here is mixed. Some studies show that it can work in certain circumstances, either the evidence is not very clear, or the outcomes are not very significant. It might be worth giving this a go. 'Consider' is often used in conjunction with the circumstances that suggest better chances of success. "Consider xxxxxx where xxxx". It should be noted that the more expensive a thing is the better evidence it needs to be 'offer' rather than 'consider'.

*Do not routinely offer*
The evidence is pretty clear that this does not work for the general population affected by whatever the guidance relates to and/or is simply too expensive. There may be individual cases where this will work, but the evidence suggests it is likely that the costs outweigh the benefits for general use.

*Do not offer*
The majority of the evidence shows that this either doesn't work or is actually harmful.


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## Angela123 (Jul 24, 2017)

Bubbsie said:


> Good to hear that Angela...I feel very strongly about this issue...if you need any help whatsoever...I would be more than happy to offer some...good luck...please let me know how you fare...and if you do need a hand.


Thank you, I appreciate that.


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## Angela123 (Jul 24, 2017)

everydayupsanddowns said:


> AlanS's Test Review Adjust post is well thought of by our members.
> http://loraldiabetes.blogspot.co.uk/2006/10/test-review-adjust.html
> 
> As is his 'testing on a budget' approach if you find yourself in the position where you must fund your own strips and the costs become difficult. Progress can be made on just one check a day (though it will obviously take longer to fine tune your diet)
> http://loraldiabetes.blogspot.co.uk/2007/04/teting-on-budget.html


Thank you, I have a friend who was diagnosed two years ago and she set about eating porridge for breakfast (as is recommended) and had readings sky high. She now has weetabix and if fine. Don't want to fall into that trap only to discover in three months time I need meds.


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## everydayupsanddowns (Jul 24, 2017)

Angela123 said:


> Thank you, I have a friend who was diagnosed two years ago and she set about eating porridge for breakfast (as is recommended) and had readings sky high. She now has weetabix and if fine. Don't want to fall into that trap only to discover in three months time I need meds.



This is what frustrates so many members here who are denied strips @Angela123  - it is so important to get clear, immediate feedback on how different foods affect you - this is information that a 3-monthly HbA1c simply cannot provide. And neither can your Dr offer advice with any certainty for you as an individual*. Once you have found out how you respond then you'll have a range of 'safe' choices that you can rely on.

It is simply impossible to know whether your body can cope with porridge/weetabix/toast/whatever-form-of-carbs for breakfast without checking. Likewise lunches and evening meals. All carbs have the potential to send your BGs sky high. It's a question of finding the ones (and the portion sizes) your body can cope with best and then mixing it up with other alternatives.


* As an example, it might be OK for your friend, but Weetabix (along with all breakfast cereals) is a complete nightmare for me, even with the benefit of injected rapid acting insulin. That't the crazy thing - the same thing affects different people differently!


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## Angela123 (Jul 24, 2017)

everydayupsanddowns said:


> This is what frustrates so many members here who are denied strips @Angela123  - it is so important to get clear, immediate feedback on how different foods affect you - this is information that a 3-monthly HbA1c simply cannot provide. And neither can your Dr offer advice with any certainty for you as an individual*. Once you have found out how you respond then you'll have a range of 'safe' choices that you can rely on.
> 
> It is simply impossible to know whether your body can cope with porridge/weetabix/toast/whatever-form-of-carbs for breakfast without checking. Likewise lunches and evening meals. All carbs have the potential to send your BGs sky high. It's a question of finding the ones (and the portion sizes) your body can cope with best and then mixing it up with other alternatives.
> 
> ...


Exactly and that is why I will have a blood  monitor and will buy one myself if that is how it has to be...would be crazy not to!


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## Bubbsie (Jul 24, 2017)

Angela123 said:


> Thank you, I appreciate that.


Okay Angela...let me know when you/how you want to approach this...what the response from your GP is...then if necessary we can do some work on it.


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## Derek Stubbs (Jul 24, 2017)

it is rather poor by doctors, they seem to be happy that your average over three months is fine, irrespective if you are going high then low as a consequence of certain foods, this is why doctors need to understand the need to test as high's & lows are dangerous even though the end result is a nice average, no good having a good average if you have a hypo & end up in hospital.


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## Martin Canty (Jul 24, 2017)

Don't get me wrong, there is a lot wrong with the US healthcare system, but I walked out of the Dr.'s after diagnosis with prescriptions for Metformin, test kit & 2 strips/day. I assumed this would be SOP for all newly minted diabetics until I joined this board. I know of pre-D's who have had testing supplies on prescription. (Over here) I have never once heard of the notion that testing is bad and it worries people unnecessarily.
What we should eat is another thing.... When I see the Practice Nurse I tend to gloss over my diet; just editing it down to "Low Carb". However they can see by my numbers that something is working so if it 'aint broke don't fix it!


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## CHRISJK (Aug 2, 2017)

Bubbsie said:


> Juzzy you can challenge this...several members have done so successfully...I have no idea what document your GP was quoting...you could ask for a copy...be interested to read it...as far as I am aware this issue is covered by the NICE guidelines...NICE are the National Institute For Health & Care guidance...who advise on quality standards and information for public health & social care...their guidelines do not preclude the provision of testing strips for type 2 diabetics...so NICE do not say NO outright...possibly your GP is quoting a directive from your local clinical commissioning group...who in my opinion interpret the guidelines narrowly & inaccurately...since you previously had been prescribed strips...were you given any explanation for the withdrawal apart from the quote s/he read out...it is possible to write to your GP justify your need for the strips to be reinstated on your prescription...let me know if you would like to challenge this decision.


Hi, I am back off Holiday and ready to challenge my GP about her withdrawing my test strips on prescription, and I would like to take you up on your kind offer to help. I really don't think my Letter writing skills are up to scratch, so as I said any help would be greatly appreciated.  Thanks....... Chris


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## Bubbsie (Aug 3, 2017)

CHRISJK said:


> Hi, I am back off Holiday and ready to challenge my GP about her withdrawing my test strips on prescription, and I would like to take you up on your kind offer to help. I really don't think my Letter writing skills are up to scratch, so as I said any help would be greatly appreciated.  Thanks....... Chris


Hi Chris...hope you enjoyed the holiday...good to hear you want to challenge the decision...writing the letter is not as difficult as many think...off to work relatively early this morning...will be in touch later...may have to ask for some personal information...do you have access to the private message facility yet?...probably best done by PM...not sure if as a new member you can use that yet...if not one of the moderators could arrange that...will be in touch later.


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## AndyG1961 (Aug 3, 2017)

I was initially refused a meter/strips so I bought my own codefree, I told my GP I had done so but was finding it quite expensive as being newly diagnosed I was testing a lot to discover what foods spiked my levels and what I could tolerate etc, he gave me a diary to fill in and said bring that back next time and let me see. When I returned for next check up (4 weeks later) he looked through diary and said I was doing very well and gave me a meter and has since given me 100 strips and lancets every 28 days. I don't test as much now as I have sussed most of the stuff I eat however there are odd times I just feel yucky and my vision goes blurry so I test to make sure levels are ok


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## Bubbsie (Aug 3, 2017)

AndyG1961 said:


> I was initially refused a meter/strips so I bought my own codefree, I told my GP I had done so but was finding it quite expensive as being newly diagnosed I was testing a lot to discover what foods spiked my levels and what I could tolerate etc, he gave me a diary to fill in and said bring that back next time and let me see. When I returned for next check up (4 weeks later) he looked through diary and said I was doing very well and gave me a meter and has since given me 100 strips and lancets every 28 days. I don't test as much now as I have sussed most of the stuff I eat however there are odd times I just feel yucky and my vision goes blurry so I test to make sure levels are ok


Well done Andy...your GP sounds enlightened...if only more were like that.


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## CHRISJK (Aug 3, 2017)

Bubbsie said:


> Hi Chris...hope you enjoyed the holiday...good to hear you want to challenge the decision...writing the letter is not as difficult as many think...off to work relatively early this morning...will be in touch later...may have to ask for some personal information...do you have access to the private message facility yet?...probably best done by PM...not sure if as a new member you can use that yet...if not one of the moderators could arrange that...will be in touch later.


Hi Bubbsie, No I cant do PM's yet and I am not sure how to get in touch with the Moderators.    Regards..... Chris


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## everydayupsanddowns (Aug 3, 2017)

CHRISJK said:


> Hi Bubbsie, No I cant do PM's yet and I am not sure how to get in touch with the Moderators.    Regards..... Chris


Make a few more posts Chris - that should do the trick.


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## Northerner (Aug 3, 2017)

CHRISJK said:


> Hi Bubbsie, No I cant do PM's yet and I am not sure how to get in touch with the Moderators.    Regards..... Chris


You should be able to use the PMs (Conversations) now Chris  Let me know if you have any problems.


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## Bubbsie (Aug 3, 2017)

Chris I think the problem should be solved now...sent you a pm...let me know if you've received it.


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## Bubbsie (Aug 3, 2017)

Bubbsie said:


> Chris I think the problem should be solved now...sent you a pm...let me know if you've received it.


Chris information sent by PM...hoping you have it...please reply by PM if you do...then we can start working on things.


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