GPs will make diabetes decisions in best interests of individual patients, says RCGP

Publication date: 06 April 2017

Dr Stephen Lawrence, Clinical Lead for Diabetes for the Royal College of GP, has responded to a new report by charity Diabetes UK today on the availability of self-monitoring kits for patients from the NHS.

He said: “GPs are highly trained and skilled professionals who will always make the best decision for the individual patient in front of us.

“But at the same time, £24m of the scarce NHS budget is spent on diabetes care every day and it would be irresponsible not to make the most appropriate use of limited resources.

“The benefits of self-monitoring blood glucose levels in patients with Type 2 diabetes is unclear and the latest guidance from NICE specifies that the majority of patients do not need to self test.

“Therefore it would be inappropriate to issue self test strips as a ‘one size fits all’, especially when advances in medical treatment and technology are constantly emerging, particularly with newer forms of oral medications that do not cause hypoglycaemia.

“GPs in Tower Hamlets recently managed to dramatically reduce inappropriate use of blood glucose self-monitoring kits among patients with Type 2 diabetes without negatively affecting their health. If this  was applied nationally, it is estimated that we could safely and responsibly prevent unnecessary testing in 340,000 people, as well as saving £21.8m of the NHS budget.

“Instead, GPs will perform HbA1c tests at set points throughout the year to measure their patient’s blood glucose level and once these levels have stabilised, the monitoring frequency will be reduced and GPs will then usually offer diet and lifestyle advice to help patients maintain this safe level.

“For those with Type 1 diabetes, self-monitoring is needed to ensure good control of blood glucose levels and help avoid hypoglycaemic episodes. But the frequency of such monitoring will depend on the patient’s individual circumstances and testing should never be done for the sake of it.

“The GP consultation is the opportunity for a two-way discussion with the patient about finding the most appropriate treatment for ensuring their diabetes is well controlled so patients should never feel that they are 'challenging’ their family doctor.

“We urge NHS England to deliver on the pledges made in its GP Forward View for greater investment in general practice – including more GPs – so that we can give more time to all our patients, including those with diabetes.”

Further Information

RCGP Press office: 020 3188 7574/7575/7633
Out of hours: 0203 188 7659

Notes to editor

The Royal College of General Practitioners is a network of more than 52,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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