Recent Posts - DAFNE Online

Jul 2, 2011

xJeanx 8 posts

Topic: General Discussion / Corrective Doses of Insulin

Hi there
When I did my DAFNE course I was taught never to 'correct' by more than 3 units of insulin. I'm sure I've read recently that it is now acceptable to 'correct' by up to 4 units. Can anyone please confirm if this is right? I have just had a search through the online DAFNE Course Handbook but I can't seem to find anything that mentions specifically about this (although it might be me that's missing it Embarassed

). If anyone could advise me I would be most grateful. Thanks in advance.
Jean Smile

Jul 2, 2011

Anil 39 posts

Topic: General Discussion / medical leave during DAFNE course

I swear under the Disability Discrimination Act, their is a clause where If a diabetic who is on Insulin medication must attend a course about insulin management, the company must pay for it, I remember reading this before I went on my DAFNE course, I would suggest ringing maybe Diabetes UK and see if they can help you, I dont think this will come out of your holiday, and you should get paid for it, (maybe at a lower rate) but you should BY LAW get paid for it,
Check out the Disability discrimination Act, for Diabetes, Im preety sure im right tho..

[Edit]: Im 50% sure im right...

Jul 1, 2011

JayBee 587 posts

Topic: General Discussion / medical leave during DAFNE course

You're welcome! Best of luck with it and you have a smashing weekend too! May we all have glorious sunshine! ^0^

Jul 1, 2011

vinod 5 posts

Topic: General Discussion / medical leave during DAFNE course

Thanks guys. I really appreciate your inputs. I'll check with my company and see what they say!
Have a lovely weekend:-)

With Regards,

Vinod Kavle

Jul 1, 2011

JayBee 587 posts

Topic: General Discussion / DAFNE Myths

I agree with Athena - It would be good to have someone explain why these statements are false because they are clearly confusing some of us.

Just to touch back on my question about correcting after hypos - if I am supposed to be able to correct within the 24 hours after a hypo like I have not been able to without having another hypo, is it reasonable to assume that I have too much background if I do hypo again, especially when I'm 100% sure the CP calculation is correct (on the basis that all my ratios are 1:1 currently that is)?

To be honest, it would suit me a lot more if I could do that to make adjustments a lot sooner than having to wait for the 24 hour period before pattern searching again - however, considering no one is defending the statements (I know some have responded to questions, like myself but I mean defending the original item itself), it is difficult to take this thread seriously.

Jul 1, 2011

derekh1965 90 posts

Topic: General Discussion / Battling Diabetes

Glad to hear it is of interest to you Athena

Derek

Jul 1, 2011

ang78 12 posts

Topic: General Discussion / medical leave during DAFNE course

I had to take paid leave from work, I dont get any sort of special leave what so ever

Jul 1, 2011

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Ketones/ Not enough Carbs

Hey,

The sick day rules are exactly what you would use in this situation, as they are only in place to deal with the lack of food being consumed..............

Ketones are normal and can be processed with insulin, just like in non diabetics, but with us they can get out of control if we dont give the insulin to deal with them..........obviously not eating is not wise if you can........

What kind of level of ketones are you talking about when you miss a meal...........? If a lot then this must be a pain when testing your background..............what are your levels like in the morning after many hours fasting?

Jul 1, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / DAFNE Myths

As long as you dont starve yourself for a good length of time, theoretically meals can be missed, but as you say, ketones will be produced if energy is not coming from the carbs, but this is OK, if there is insulin present to process them.........

Jul 1, 2011

Athena 52 posts

Topic: Questions for HCPs / Ketones/ Not enough Carbs

Hi,

I was wondering about starving for a medical procedure. I know to drop my insulin to avoid hypos, but I don't know how to handle the ketones that will result from not eating carbs for a long period of time. DAFNE hasn't sorted this for me, and I can only ever skip one carb mea, before getting ketones.
How will I manage the ketones? Will I use the protocol for " Coping when you are Ill" i.e the 20% of the TDD every couple of hours thing. Is that the correct bit in the handbook for going carb free?

Any info welcome. Thanks

Jul 1, 2011

Athena 52 posts

Topic: General Discussion / Battling Diabetes

derekh1965 said:

Hi

I stumbled upon this website. It is American and seems to have a lot of information. New research etc.
I haven't looked at it all but seems quite a good site.

http://www.battlediabetes.com/

Incidentally case nobody knows about stumble upon http://www.stumbleupon.com/
Discover the best of the web. You sign up free, input your interests from a long list of topics and then start stumbling.

It will find websites related to your interests.

Derek

Cheers Derek. This looks good and I will also try the stumble upon thing.

Jul 1, 2011

Athena 52 posts

Topic: General Discussion / DAFNE Myths

marke said:
On the 10th June the Annual DAFNE Collaborative was held. This is the DAFNE get-together of all educators, programme management etc. I was
fortunate enough to be there as a DAFNE User Action Group rep. One presentation that really caught my ear that I can now share with you was
about DAFNE Myths and Misconceptions. If you click here you can read the presentation in PDF form.
Remember it is being said that ALL the things in the presenation are myths. Have a read and post your views here ! Its bound to cause some controversy, which is why I'm posting it here to see what peoples views are.

This is unbelievable really, very confusing. Has she sat in on a DAFNE course or read the handbook ?
I do find some of the DAFNE things a myth though for me personally although I k now they work for other people.
THe not treating until 3.5 doesn't work for me, just turns a mild hypo into a being down at 1 hypo. Also, the being able to skip meals doesn't work. I go into ketones if I don't keep my carbs up just as I did before DAFNE.

Anyway, not sure waht is goping on with this . It would be interesting to know how people responded to the presentation.

Jul 1, 2011

JayBee 587 posts

Topic: General Discussion / medical leave during DAFNE course

I was quite lucky because my course was done right near the end of the year for the holiday turn over so, after the HR department investigated into the benefits that DAFNE would provide for them if I did it, they were happy for me to have some special leave so I could attend. However, I was also asked to use my remaining holiday (2 days if I remember correctly) to keep the special leave to a minimum.

I'm sure if you speak to your DAFNE team, they can send a letter or have a chat with your employer to clarify the benefits to the business if you do the course (because if you are more likely to be well as a result as a result, making you more likely to be a reliable employee (not that you're not already I'm sure!)).

Good luck with getting the time off you need! Smile

Jul 1, 2011

novorapidboi26 1,819 posts

Topic: General Discussion / medical leave during DAFNE course

Fortunately I was unemployed at the time of my course, but other in my class did have problems I believe, some got time off paid, others did not, its just your luck I think................but I dont think companies are obliged to do you any favours......

best to read up your contract.............

Jul 1, 2011

vinod 5 posts

Topic: General Discussion / medical leave during DAFNE course

Hello There

I have attended DAFNE course in May 2011. I had informed by company that I am attending a DAFNE course, which is for 5 days and requested them to consider this as a medical leave as my thinking was that NHS count this course is necessary for each diabetics in UK. So NHS approves this as a medical leave from work to attend the course and dont consider as a paid holiday! Am I wrong here? Do I've to use my paid holidays to attend this course? My company says they dont this policy of medical leave, so they declined to count those five days as paid leave from work. Please advice me here.

With Regards,

Vinod Kavle

Jul 1, 2011

JayBee 587 posts

Topic: Questions for HCPs / Blood Testing

AllanR said:
Only issue is new items since you've never had them before you need to see the GP to get those added. But once it's something I've had before I can easily change quantities and such just by going into Boots. As for exemption certificate when I first had the repeat system setup they asked for the card to add the number to the system, and other than a tick, a signature and a tick list of everything I tend to get to tick off quantities everything's sorted and ready on whatever date I arrange it for with Boots. Even if I run out of needles or strips I can go in and request some for next day (only a small boots here so don't always have everything in stock). But it is a great service and saves having to go to the GP unless I really have to. Not sure howit's handled behind the scenes or if Boots have to contact the GP, but if they do they've never had any issue getting anything which I've had before.

It does sound like that instead of you having to request quantity change at your GP, you do it at your pharmacy instead so it saves you a trip to your GP on top. This won't neccessarily work for me considering my doctors change my quanities without even asking me first and I'm having to go back to my GP more than once to sort it out again.

Jul 1, 2011

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Blood Testing

I think most people dont have a problem going into get strips and the like, its having to go in say every week because your doctor is not giving you enough tubs of strips with each prescription.......

I get issued two pots of strips each time, which is 100 strips, 10 tests a day max, so about 3 weeks my strips last, which for me is fine.........

Jun 30, 2011

AllanR 15 posts

Topic: General Discussion / Thoughts of biking with a pump?

Cheers, will have a looksee. Smile

Jun 30, 2011

AllanR 15 posts

Topic: Questions for HCPs / Blood Testing

JWo said:
I had no idea that that sort of service was avaliable... always thought that you had to go through your GP to get a prescription only...
Can you still use your medical exemption certificate when you use that route? If I was to go this way, how does the GP respond?
Will they "freak out" like they did about a simple Levemir / Detemir naming, especially if I wanted to add something or change it?

That'll be wonderful if all this hassle was cut down considering I don't have much faith left in my GP surgery (which unfortunately was one that I moved to within the past year because it was more convient - I can't move back to my previous doctors because for years they've not been accepting new patients).

Only issue is new items since you've never had them before you need to see the GP to get those added. But once it's something I've had before I can easily change quantities and such just by going into Boots. As for exemption certificate when I first had the repeat system setup they asked for the card to add the number to the system, and other than a tick, a signature and a tick list of everything I tend to get to tick off quantities everything's sorted and ready on whatever date I arrange it for with Boots. Even if I run out of needles or strips I can go in and request some for next day (only a small boots here so don't always have everything in stock). But it is a great service and saves having to go to the GP unless I really have to. Not sure howit's handled behind the scenes or if Boots have to contact the GP, but if they do they've never had any issue getting anything which I've had before.

Jun 30, 2011

ang78 12 posts

Topic: Questions for HCPs / Blood Testing

All my prescriptions are sent to my chosen pharmacy, I just email the surgery and 2 days later pick it up from the chemist. However I'm pretty sure my chemist CAN't change my prescription, it has to be done by the GP. Be handy if they could though!!

Jun 30, 2011

JayBee 587 posts

Topic: Questions for HCPs / Blood Testing

novorapidboi26 said:
I actually email the doctors surgery with the items I need, and then sometimes the next day even I go into my local pharmacy and pick it up, so I dont actually know how much involvement the GP has with issuing the prescription, if any at all, they might just email the pharmacy directly with my request......

The service might be available near you, its definitely much easier than going into the surgery and dropping off your script, saves paper too............

Unfortunately, this GP surgery can even get the email service right so I avoid it. That was something I was looking forward to using when I first moved to them. Sad

Carolin said:
JWo said:
Edit: Is it true that Levemir is an insulin used by some Type 2s? Maybe this is causing the confusion (for me anyway)?

Sadly in my experience, many GPs and practice nurses get confused with insulins (although not all!)

The are around 20 different insulins available in the NHS, granted some of them are just different 'brands' of essentially the same stuff. However any of these insulins may be prescribed in both Type 1 and Type 2 diabetes.

Historically, insulin therapy has been initiated and managed in secondary care (hospital) diabetes services by doctors and nurses who are specialised and highly experienced in diabetes. This does mean that most primary care staff either never get the experience of prescribing / altering insulins, or do it so infrequently they don't build up the necessary skills.

So in primary care, they will have lots of experience of managing Type 2 diabetes and prescribing tablets to treat that, but will usually refer patients on to a specialist team (some of whom are based in primary care settings now) when it comes to insulin for either Type 1s or Type 2s.

So, unless your GP or practice nurse has been through one of the DAFNE training programmes (DEP - DAFNE Educator Programme; DDP - DAFNE Doctor Programme; DAP - DAFNE Adviser Programme), it is unlikely that they will have even the slightest idea about the DAFNE system and the importance of BG monitoring to enable your insulin adjustments.

I got the impression from the doctor that I did see about putting my insulins back on that he didn't really understand my condition generally (advising that I fast, I shouldn't be testing as much as I have (well, I had been ill as well at the time), being reluctant to put my insulins back on for a Type 1... stuff like that)... I almost always expect GPs to not know of DAFNE because I know it's still being rolled out and it takes time. There is one nurse there though, that Jean from my hospital DAFNE team has spoken to that is aware of DAFNE, but this doesn't neccessarily straighten out the problem. Sad

It was quite sad really when I had my first GP appointment and the GP (I have yet to have the same doctor twice!) was very dismissive of DAFNE. That doctor is no longer at the surgery because they can't seem to keep hold of staff.

On that note, I really must update Jean on progress...

Edit: Does any one know fully the "avoid the GP" system that AllanR was speaking about? I don't understand how they can get a prescription without getting it signed by a doctor... does Boots really do everything including give the okay or are we talking about the free collection repeat prescription service?

I've been having a search for more information about it online - espeically regarding Exemption Certificate use, but no sources have been clear.

Jun 30, 2011

Carolin 83 posts

Topic: Questions for HCPs / Blood Testing

JWo said:
Edit: Is it true that Levemir is an insulin used by some Type 2s? Maybe this is causing the confusion (for me anyway)?

Sadly in my experience, many GPs and practice nurses get confused with insulins (although not all!)

The are around 20 different insulins available in the NHS, granted some of them are just different 'brands' of essentially the same stuff. However any of these insulins may be prescribed in both Type 1 and Type 2 diabetes.

Historically, insulin therapy has been initiated and managed in secondary care (hospital) diabetes services by doctors and nurses who are specialised and highly experienced in diabetes. This does mean that most primary care staff either never get the experience of prescribing / altering insulins, or do it so infrequently they don't build up the necessary skills.

So in primary care, they will have lots of experience of managing Type 2 diabetes and prescribing tablets to treat that, but will usually refer patients on to a specialist team (some of whom are based in primary care settings now) when it comes to insulin for either Type 1s or Type 2s.

So, unless your GP or practice nurse has been through one of the DAFNE training programmes (DEP - DAFNE Educator Programme; DDP - DAFNE Doctor Programme; DAP - DAFNE Adviser Programme), it is unlikely that they will have even the slightest idea about the DAFNE system and the importance of BG monitoring to enable your insulin adjustments.

Jun 30, 2011

novorapidboi26 1,819 posts

Topic: Questions for HCPs / Blood Testing

I actually email the doctors surgery with the items I need, and then sometimes the next day even I go into my local pharmacy and pick it up, so I dont actually know how much involvement the GP has with issuing the prescription, if any at all, they might just email the pharmacy directly with my request......

The service might be available near you, its definitely much easier than going into the surgery and dropping off your script, saves paper too............ Very Happy

Jun 30, 2011

JayBee 587 posts

Topic: Questions for HCPs / Blood Testing

I had no idea that that sort of service was avaliable... always thought that you had to go through your GP to get a prescription only... Sad

Can you still use your medical exemption certificate when you use that route? If I was to go this way, how does the GP respond?
Will they "freak out" like they did about a simple Levemir / Detemir naming, especially if I wanted to add something or change it?

That'll be wonderful if all this hassle was cut down considering I don't have much faith left in my GP surgery (which unfortunately was one that I moved to within the past year because it was more convient - I can't move back to my previous doctors because for years they've not been accepting new patients). Sad

Jul 2, 2011 xJeanx 8 posts	Topic: General Discussion / Corrective Doses of Insulin Hi there When I did my DAFNE course I was taught never to 'correct' by more than 3 units of insulin. I'm sure I've read recently that it is now acceptable to 'correct' by up to 4 units. Can anyone please confirm if this is right? I have just had a search through the online DAFNE Course Handbook but I can't seem to find anything that mentions specifically about this (although it might be me that's missing it ). If anyone could advise me I would be most grateful. Thanks in advance. Jean

Jul 2, 2011 Anil 39 posts	Topic: General Discussion / medical leave during DAFNE course I swear under the Disability Discrimination Act, their is a clause where If a diabetic who is on Insulin medication must attend a course about insulin management, the company must pay for it, I remember reading this before I went on my DAFNE course, I would suggest ringing maybe Diabetes UK and see if they can help you, I dont think this will come out of your holiday, and you should get paid for it, (maybe at a lower rate) but you should BY LAW get paid for it, Check out the Disability discrimination Act, for Diabetes, Im preety sure im right tho.. [Edit]: Im 50% sure im right...

Jul 1, 2011 JayBee 587 posts	Topic: General Discussion / medical leave during DAFNE course You're welcome! Best of luck with it and you have a smashing weekend too! May we all have glorious sunshine! ^0^

Jul 1, 2011 vinod 5 posts	Topic: General Discussion / medical leave during DAFNE course Thanks guys. I really appreciate your inputs. I'll check with my company and see what they say! Have a lovely weekend:-) With Regards, Vinod Kavle

Jul 1, 2011 JayBee 587 posts	Topic: General Discussion / DAFNE Myths I agree with Athena - It would be good to have someone explain why these statements are false because they are clearly confusing some of us. Just to touch back on my question about correcting after hypos - if I am supposed to be able to correct within the 24 hours after a hypo like I have not been able to without having another hypo, is it reasonable to assume that I have too much background if I do hypo again, especially when I'm 100% sure the CP calculation is correct (on the basis that all my ratios are 1:1 currently that is)? To be honest, it would suit me a lot more if I could do that to make adjustments a lot sooner than having to wait for the 24 hour period before pattern searching again - however, considering no one is defending the statements (I know some have responded to questions, like myself but I mean defending the original item itself), it is difficult to take this thread seriously.

Jul 1, 2011 derekh1965 90 posts	Topic: General Discussion / Battling Diabetes Glad to hear it is of interest to you Athena Derek

Jul 1, 2011 ang78 12 posts	Topic: General Discussion / medical leave during DAFNE course I had to take paid leave from work, I dont get any sort of special leave what so ever

Jul 1, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Ketones/ Not enough Carbs Hey, The sick day rules are exactly what you would use in this situation, as they are only in place to deal with the lack of food being consumed.............. Ketones are normal and can be processed with insulin, just like in non diabetics, but with us they can get out of control if we dont give the insulin to deal with them..........obviously not eating is not wise if you can........ What kind of level of ketones are you talking about when you miss a meal...........? If a lot then this must be a pain when testing your background..............what are your levels like in the morning after many hours fasting?

Jul 1, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / DAFNE Myths As long as you dont starve yourself for a good length of time, theoretically meals can be missed, but as you say, ketones will be produced if energy is not coming from the carbs, but this is OK, if there is insulin present to process them.........

Jul 1, 2011 Athena 52 posts	Topic: Questions for HCPs / Ketones/ Not enough Carbs Hi, I was wondering about starving for a medical procedure. I know to drop my insulin to avoid hypos, but I don't know how to handle the ketones that will result from not eating carbs for a long period of time. DAFNE hasn't sorted this for me, and I can only ever skip one carb mea, before getting ketones. How will I manage the ketones? Will I use the protocol for " Coping when you are Ill" i.e the 20% of the TDD every couple of hours thing. Is that the correct bit in the handbook for going carb free? Any info welcome. Thanks

Jul 1, 2011 Athena 52 posts	Topic: General Discussion / Battling Diabetes derekh1965 said: Hi I stumbled upon this website. It is American and seems to have a lot of information. New research etc. I haven't looked at it all but seems quite a good site. http://www.battlediabetes.com/ Incidentally case nobody knows about stumble upon http://www.stumbleupon.com/ Discover the best of the web. You sign up free, input your interests from a long list of topics and then start stumbling. It will find websites related to your interests. Derek Cheers Derek. This looks good and I will also try the stumble upon thing.

Jul 1, 2011 Athena 52 posts	Topic: General Discussion / DAFNE Myths marke said: On the 10th June the Annual DAFNE Collaborative was held. This is the DAFNE get-together of all educators, programme management etc. I was fortunate enough to be there as a DAFNE User Action Group rep. One presentation that really caught my ear that I can now share with you was about DAFNE Myths and Misconceptions. If you click here you can read the presentation in PDF form. Remember it is being said that ALL the things in the presenation are myths. Have a read and post your views here ! Its bound to cause some controversy, which is why I'm posting it here to see what peoples views are. This is unbelievable really, very confusing. Has she sat in on a DAFNE course or read the handbook ? I do find some of the DAFNE things a myth though for me personally although I k now they work for other people. THe not treating until 3.5 doesn't work for me, just turns a mild hypo into a being down at 1 hypo. Also, the being able to skip meals doesn't work. I go into ketones if I don't keep my carbs up just as I did before DAFNE. Anyway, not sure waht is goping on with this . It would be interesting to know how people responded to the presentation.

Jul 1, 2011 JayBee 587 posts	Topic: General Discussion / medical leave during DAFNE course I was quite lucky because my course was done right near the end of the year for the holiday turn over so, after the HR department investigated into the benefits that DAFNE would provide for them if I did it, they were happy for me to have some special leave so I could attend. However, I was also asked to use my remaining holiday (2 days if I remember correctly) to keep the special leave to a minimum. I'm sure if you speak to your DAFNE team, they can send a letter or have a chat with your employer to clarify the benefits to the business if you do the course (because if you are more likely to be well as a result as a result, making you more likely to be a reliable employee (not that you're not already I'm sure!)). Good luck with getting the time off you need!

Jul 1, 2011 novorapidboi26 1,819 posts	Topic: General Discussion / medical leave during DAFNE course Fortunately I was unemployed at the time of my course, but other in my class did have problems I believe, some got time off paid, others did not, its just your luck I think................but I dont think companies are obliged to do you any favours...... best to read up your contract.............

Jul 1, 2011 vinod 5 posts	Topic: General Discussion / medical leave during DAFNE course Hello There I have attended DAFNE course in May 2011. I had informed by company that I am attending a DAFNE course, which is for 5 days and requested them to consider this as a medical leave as my thinking was that NHS count this course is necessary for each diabetics in UK. So NHS approves this as a medical leave from work to attend the course and dont consider as a paid holiday! Am I wrong here? Do I've to use my paid holidays to attend this course? My company says they dont this policy of medical leave, so they declined to count those five days as paid leave from work. Please advice me here. With Regards, Vinod Kavle

Jul 1, 2011 JayBee 587 posts	Topic: Questions for HCPs / Blood Testing AllanR said: Only issue is new items since you've never had them before you need to see the GP to get those added. But once it's something I've had before I can easily change quantities and such just by going into Boots. As for exemption certificate when I first had the repeat system setup they asked for the card to add the number to the system, and other than a tick, a signature and a tick list of everything I tend to get to tick off quantities everything's sorted and ready on whatever date I arrange it for with Boots. Even if I run out of needles or strips I can go in and request some for next day (only a small boots here so don't always have everything in stock). But it is a great service and saves having to go to the GP unless I really have to. Not sure howit's handled behind the scenes or if Boots have to contact the GP, but if they do they've never had any issue getting anything which I've had before. It does sound like that instead of you having to request quantity change at your GP, you do it at your pharmacy instead so it saves you a trip to your GP on top. This won't neccessarily work for me considering my doctors change my quanities without even asking me first and I'm having to go back to my GP more than once to sort it out again.

Jul 1, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Blood Testing I think most people dont have a problem going into get strips and the like, its having to go in say every week because your doctor is not giving you enough tubs of strips with each prescription....... I get issued two pots of strips each time, which is 100 strips, 10 tests a day max, so about 3 weeks my strips last, which for me is fine.........

Jun 30, 2011 AllanR 15 posts	Topic: General Discussion / Thoughts of biking with a pump? Cheers, will have a looksee.

Jun 30, 2011 AllanR 15 posts	Topic: Questions for HCPs / Blood Testing JWo said: I had no idea that that sort of service was avaliable... always thought that you had to go through your GP to get a prescription only... Can you still use your medical exemption certificate when you use that route? If I was to go this way, how does the GP respond? Will they "freak out" like they did about a simple Levemir / Detemir naming, especially if I wanted to add something or change it? That'll be wonderful if all this hassle was cut down considering I don't have much faith left in my GP surgery (which unfortunately was one that I moved to within the past year because it was more convient - I can't move back to my previous doctors because for years they've not been accepting new patients). Only issue is new items since you've never had them before you need to see the GP to get those added. But once it's something I've had before I can easily change quantities and such just by going into Boots. As for exemption certificate when I first had the repeat system setup they asked for the card to add the number to the system, and other than a tick, a signature and a tick list of everything I tend to get to tick off quantities everything's sorted and ready on whatever date I arrange it for with Boots. Even if I run out of needles or strips I can go in and request some for next day (only a small boots here so don't always have everything in stock). But it is a great service and saves having to go to the GP unless I really have to. Not sure howit's handled behind the scenes or if Boots have to contact the GP, but if they do they've never had any issue getting anything which I've had before.

Jun 30, 2011 ang78 12 posts	Topic: Questions for HCPs / Blood Testing All my prescriptions are sent to my chosen pharmacy, I just email the surgery and 2 days later pick it up from the chemist. However I'm pretty sure my chemist CAN't change my prescription, it has to be done by the GP. Be handy if they could though!!

Jun 30, 2011 JayBee 587 posts	Topic: Questions for HCPs / Blood Testing novorapidboi26 said: I actually email the doctors surgery with the items I need, and then sometimes the next day even I go into my local pharmacy and pick it up, so I dont actually know how much involvement the GP has with issuing the prescription, if any at all, they might just email the pharmacy directly with my request...... The service might be available near you, its definitely much easier than going into the surgery and dropping off your script, saves paper too............ Unfortunately, this GP surgery can even get the email service right so I avoid it. That was something I was looking forward to using when I first moved to them. Carolin said: JWo said: Edit: Is it true that Levemir is an insulin used by some Type 2s? Maybe this is causing the confusion (for me anyway)? Sadly in my experience, many GPs and practice nurses get confused with insulins (although not all!) The are around 20 different insulins available in the NHS, granted some of them are just different 'brands' of essentially the same stuff. However any of these insulins may be prescribed in both Type 1 and Type 2 diabetes. Historically, insulin therapy has been initiated and managed in secondary care (hospital) diabetes services by doctors and nurses who are specialised and highly experienced in diabetes. This does mean that most primary care staff either never get the experience of prescribing / altering insulins, or do it so infrequently they don't build up the necessary skills. So in primary care, they will have lots of experience of managing Type 2 diabetes and prescribing tablets to treat that, but will usually refer patients on to a specialist team (some of whom are based in primary care settings now) when it comes to insulin for either Type 1s or Type 2s. So, unless your GP or practice nurse has been through one of the DAFNE training programmes (DEP - DAFNE Educator Programme; DDP - DAFNE Doctor Programme; DAP - DAFNE Adviser Programme), it is unlikely that they will have even the slightest idea about the DAFNE system and the importance of BG monitoring to enable your insulin adjustments. I got the impression from the doctor that I did see about putting my insulins back on that he didn't really understand my condition generally (advising that I fast, I shouldn't be testing as much as I have (well, I had been ill as well at the time), being reluctant to put my insulins back on for a Type 1... stuff like that)... I almost always expect GPs to not know of DAFNE because I know it's still being rolled out and it takes time. There is one nurse there though, that Jean from my hospital DAFNE team has spoken to that is aware of DAFNE, but this doesn't neccessarily straighten out the problem. It was quite sad really when I had my first GP appointment and the GP (I have yet to have the same doctor twice!) was very dismissive of DAFNE. That doctor is no longer at the surgery because they can't seem to keep hold of staff. On that note, I really must update Jean on progress... Edit: Does any one know fully the "avoid the GP" system that AllanR was speaking about? I don't understand how they can get a prescription without getting it signed by a doctor... does Boots really do everything including give the okay or are we talking about the free collection repeat prescription service? I've been having a search for more information about it online - espeically regarding Exemption Certificate use, but no sources have been clear.

Jun 30, 2011 Carolin 83 posts	Topic: Questions for HCPs / Blood Testing JWo said: Edit: Is it true that Levemir is an insulin used by some Type 2s? Maybe this is causing the confusion (for me anyway)? Sadly in my experience, many GPs and practice nurses get confused with insulins (although not all!) The are around 20 different insulins available in the NHS, granted some of them are just different 'brands' of essentially the same stuff. However any of these insulins may be prescribed in both Type 1 and Type 2 diabetes. Historically, insulin therapy has been initiated and managed in secondary care (hospital) diabetes services by doctors and nurses who are specialised and highly experienced in diabetes. This does mean that most primary care staff either never get the experience of prescribing / altering insulins, or do it so infrequently they don't build up the necessary skills. So in primary care, they will have lots of experience of managing Type 2 diabetes and prescribing tablets to treat that, but will usually refer patients on to a specialist team (some of whom are based in primary care settings now) when it comes to insulin for either Type 1s or Type 2s. So, unless your GP or practice nurse has been through one of the DAFNE training programmes (DEP - DAFNE Educator Programme; DDP - DAFNE Doctor Programme; DAP - DAFNE Adviser Programme), it is unlikely that they will have even the slightest idea about the DAFNE system and the importance of BG monitoring to enable your insulin adjustments.

Jun 30, 2011 novorapidboi26 1,819 posts	Topic: Questions for HCPs / Blood Testing I actually email the doctors surgery with the items I need, and then sometimes the next day even I go into my local pharmacy and pick it up, so I dont actually know how much involvement the GP has with issuing the prescription, if any at all, they might just email the pharmacy directly with my request...... The service might be available near you, its definitely much easier than going into the surgery and dropping off your script, saves paper too............

Jun 30, 2011 JayBee 587 posts	Topic: Questions for HCPs / Blood Testing I had no idea that that sort of service was avaliable... always thought that you had to go through your GP to get a prescription only... Can you still use your medical exemption certificate when you use that route? If I was to go this way, how does the GP respond? Will they "freak out" like they did about a simple Levemir / Detemir naming, especially if I wanted to add something or change it? That'll be wonderful if all this hassle was cut down considering I don't have much faith left in my GP surgery (which unfortunately was one that I moved to within the past year because it was more convient - I can't move back to my previous doctors because for years they've not been accepting new patients).