NHS De registering as Diabetic

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has anyone experienced this or come across any information about the policy to de register diabetics if their hba1c levels do not fall within the diabetic range 6.5 and above - from what i understand it excludes you from the annual screening programs that are routinely offered

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  • robert65ferguson
    robert65ferguson Posts: 390 Member
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    Sorry, haven't heard about that. I have noticed a trend to suggest HBA1c tests at 6 moths instead of the usual 3 months. I tend to ignore these nudges and request the tests as normal as per the guidlines listed in Diabetes.UK.com.
  • NineteenSixty5
    NineteenSixty5 Posts: 13 Member
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    Thanks for replying I was unaware that there was a need to request these tests and thought that the care plan scheduled the frequency of reviews and tests. However, I am wondering if the process of de registering a diabetic due to the trend on their HBA1c being downward and outside of the 'diabetic' limits is discretionary rather than a uniform policy. Do you think maybe you could make an inquiry at your next review ? I am wondering what else.
  • robert65ferguson
    robert65ferguson Posts: 390 Member
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    Thanks for replying I was unaware that there was a need to request these tests and thought that the care plan scheduled the frequency of reviews and tests. However, I am wondering if the process of de registering a diabetic due to the trend on their HBA1c being downward and outside of the 'diabetic' limits is discretionary rather than a uniform policy. Do you think maybe you could make an inquiry at your next review ? I am wondering what else.

    Hi, I just noticed that the link I suggested, ie Diabetes .uk was not what I should have quoted. The correct link should have been Diabetes.co.uk. It is easy to sign up to and the regular updates keep those of us in the Diabetic community informed. There is also a very useful forum where you can get lots of tips. While it may be the practice at your surgery to de-register those below 6.5 HBa1c I would not be happy with this approach. My last HBa1c was 6.1. While this seemed to please the practice nurse I knew it was a regression from my previous result of 5.7. Try booking the tests as normal and see what happens. At the end of the day it is us in the diabetic community who have to live with any complications which may develop. The other tip I would give is to get a blood glucose meter and keep a check on the effects of certain things in your diet. What causes a spike for me may not cause a spike for you. It is the sugar spikes with the resulting insulin spikes which cause the damage. I use a code free meter which I got from Home Health. www.homehealth.uk.com. Do not let your practice put you off by suggesting the worried well approach. NICE recommendations are to involve the patient in the management of their diabetes. Doing home testing to identify foods which cause our personal spikes and having regular checks demonstrate that you are taking your diabetes seriously and deserve the support of your local practice.
  • robert65ferguson
    robert65ferguson Posts: 390 Member
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    Thanks for replying I was unaware that there was a need to request these tests and thought that the care plan scheduled the frequency of reviews and tests. However, I am wondering if the process of de registering a diabetic due to the trend on their HBA1c being downward and outside of the 'diabetic' limits is discretionary rather than a uniform policy. Do you think maybe you could make an inquiry at your next review ? I am wondering what else.

    One further thought which occured to me. If you have not yet been offered a Diabetic education course you should follow this up and request it from your surgery. Be cautious about their dietary advice. The recent articles in the Daily Mail about the fallacy of a low fat higher carb approach should be required reading for every diabetic in my opinion. If you want to do some background reading; Blood Sugar 101 by Jenny Ruhl or Dr Bernsteins Diabetic Solution would be a great place to start. If you're more into audio/visual there is some really enlightening stuff on youtube by people like Dr Phinney, Bernstein, Eldsfelt and others. One of our greatest self protection weapons is self education because there is a lot of advice being given by health care ' professionals' which is highly questionable as even a cursory glance at the Diabetes.co.uk forums will demonstrate. If you do nothing else, get the Jenny Ruhl book and you will be better equipped to challenge questionable advice.
  • NineteenSixty5
    NineteenSixty5 Posts: 13 Member
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    Thansk for the guidance regarding the info - i have attended the education course and will have a look at the BS 101 you mentioned. I agree that there is a lot of variability in the information given and am now skeptical as to the motivations behind some practices especially when they are run as business entities. Sadly I see no point in challenging anything as there is no where else to go.
  • AarchAngel
    AarchAngel Posts: 20 Member
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    The website you posted, is that info for every one or primarily for the UK? I live in Colorado is there a similar site for US?
    Sorry, haven't heard about that. I have noticed a trend to suggest HBA1c tests at 6 moths instead of the usual 3 months. I tend to ignore these nudges and request the tests as normal as per the guidlines listed in Diabetes.UK.com.

    The website you posted, is that info for every one or primarily for the UK? I live in Colorado is there a similar site for US?
  • robert65ferguson
    robert65ferguson Posts: 390 Member
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    AarchAngel wrote: »
    The website you posted, is that info for every one or primarily for the UK? I live in Colorado is there a similar site for US?
    Sorry, haven't heard about that. I have noticed a trend to suggest HBA1c tests at 6 moths instead of the usual 3 months. I tend to ignore these nudges and request the tests as normal as per the guidlines listed in Diabetes.UK.com.

    The website you posted, is that info for every one or primarily for the UK? I live in Colorado is there a similar site for US?

    Hi Aaarch, Diabetes.co.uk is aimed primarily at diabetics in the UK. The National Health System NHS is obviously different from the States but the issues faced in the UK are much the same. I don't know if there is a comparable organisation in the US but you try logging on to Diabetes.co.uk and see if there is a link. You may not be able to ask questions but you should be able to follow the forum threads. In the UK we measure blood sugars using DCCT system which a recent change to mmol/l which most of us still refer to. To convert from mmol/l to mg/dl you need to multiply by approx 18. Hope this helps.
  • robert65ferguson
    robert65ferguson Posts: 390 Member
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    Thansk for the guidance regarding the info - i have attended the education course and will have a look at the BS 101 you mentioned. I agree that there is a lot of variability in the information given and am now skeptical as to the motivations behind some practices especially when they are run as business entities. Sadly I see no point in challenging anything as there is no where else to go.

    You have nothing to lose by not challenging except your health. If push came to shove you could change to a more supportive practice. In the meantime take every possible step to learn as much as you can. Your are then better equipped to seek the support that you need and deserve.
  • cw106
    cw106 Posts: 952 Member
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    has anyone experienced this or come across any information about the policy to de register diabetics if their hba1c levels do not fall within the diabetic range 6.5 and above - from what i understand it excludes you from the annual screening programs that are routinely offered
    not at all.
    had annual review today, hbac at 36mmol,down from 40mmol 6 months ago.
    now considered "well controlled diabetic" is the official nhs term.
    was hoping to be considered pre- diabetic and drop metformin altogether.
    no chance of that ,period.