Freestyle Libre, applicator wastage

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rebrascora said:
I really wish we had a coherent national system as regards recycling and sharps for that matter, as there is so much confusion over these things and what is and isn't accepted practice.
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I do so agree - when we lived in South Cambs we could recycle virtually everything, we had 3 wheelie bins and they took hard plastic and soft plastic together in one of them, along with all the usual stuff like tins and bottles and cardboard, with a separate tub which fitted in the top for paper. Wheelie bin for green and food waste got collected every week for free, and the recycling and landfill ones every fortnight. Sharps bins went back to pharmacy, all very easy.

Here in Cotswolds they don't take soft plastic and we end up with bags full of it in our garage, waiting on the offchance that one day we'll go to a supermarket which collects it (we normally have food delivered, especially over last couple of years). Half the time the wood mice shred it before we manage to take it anywhere, leaving bits which may be worse than just landfilling it. Hard plastic and tins go out in a canvas bag and cardboard in another canvas bag. They always smell as though cats have urinated on them in the night, so very yucky to store, and not really cleanable, unlike a wheelie bin. I always feel as though things like opened tins put out in a bag might be a threat to local wildlife as well. Glass and paper have separate tubs and food waste another one, so there are 7 different things to put out every fortnight. We have to pay if we want a green waste collection, and that's recently gone from once a week to once a fortnight, without any reduction in the price. Sharps are the only easy thing - they can go to either surgery or pharmacy.

I've had no instructions from anyone as to how to use sharps bins or which things should go in them though. I tend to err on the side of caution because of having ME (there has been some research which suggested ME might be a blood-bourne virus and people with ME have a lifelong ban on giving blood) so I put in everything which might have my blood on it. I'm not sure whether it's worse to burn it or landfill it, but it has to be one thing or the other, so I'm going for burning rather than risking anyone else getting ME.
 
Interesting discussion developing. Whether the 'needle' is inside the applicator or not, it still represents a terrible amount of waste and a burden on landfill. What is left within the applicator device after insertion of the sensor to the user's body, is the outer sheath. I suppose this could be referred to as the needle though I would suggest the actual needle is on the sensor itself, after insertion. The needle/sheath part comes in the sensor pack, the plastic tub that resembles a small juice container like the ones that used to be given in-flight on plane journeys. It seems this sensor pack/container only contains the needle/sheath. When the applicator is pushed down into the sensor pack, the needle/sheath is passed from the sensor pack to the applicator. The sensor is already inside the applicator, not the sensor pack. I am sure it could be contained within the applicator device, so as to cut out the need for the sensor pack/container. The more I look into it, the more disturbed I am about the wastage. I like what the Libre system offers but I don't like the wastage and I think a less wasteful insertion/attachment system could be developed. I'm considering going back to my test-strip-and-meter system, though that also creates waste of its own, especially with the one-use hard plastic lancets (which I would put into my sharps/clinical waste bin).
 
I can assure you that there is a steel inserter "needle" within the applicator along with a metal spring which should both be removed before taking to the tip for plastic recycling as it poses a health hazard and that needle and spring are an integral part of the applicator design. If you disassemble the applicator, you will find it, but as @mikeyB suggests, wear eye protection incase the spring "pings" out.
I absolutely agree that I too would be a lot happier if it was better designed with a reusable applicator. It would be interesting to compare the plastic from test strips and lancets if used properly (many of us reuse lancets and just change them annually on St Swithin's day, but that's another matter) over a period of 2 weeks compared to the Libre. If you include the pots as well as the test strips and all the lancets from testing say 10 times a day which is what I would need, it may be quite comparable or more possibly.
I have to say, the disposables with a pump is one of the things which turns me off from them although it is good to hear that a few have reusable cannula inserters.
 
rebrascora said:
I have to say, the disposables with a pump is one of the things which turns me off from them although it is good to hear that a few have reusable cannula inserters.
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Yes there is rather a lot of single use paraphernalia connected to diabetes. I can no longer use a reusable inserter, because my new pump only has infusion sets that have single-use serters, and I don’t get on well with pushing sets in by hand.

Out of the sensors I’ve used only Medtronic had a reusable inserter.

Libre is the easiest to dismantle. The Dexcom G6 I pop open to landfill the outer hard plastic/metal combo but the inner needle holding section is fiendishly complicated, so more of that has to go in sharps.

We may see some movement on this over the coming years, but to be honest I think this is pretty niche in terms of the overall picture (proportion of the total number of sensor users in terms of the entire global population). I suspect device manufacturers are more focussed on making sensor insertion as foolproof, straightforward and reliable as possible?

Like many things, I think that until product manufacturers are obligated to deal with (or pay for) the waste and/or recycling of their products themselves, there will be quite slow progress.

The amount of single use plastic involved in diabetes management is still something I repeatedly hear being raised with device manufacturers though. So we as consumers can continue to keep up the pressure.
 
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everydayupsanddowns said:
The amount of single use plastic involved in diabetes management is still something I repeatedly hear being raised with device manufacturers though. So we as consumers can continue to keep up the pressure.
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Totally agree Mike. Add to what you have listed are single use disposable insulin pens.

However, the whole pharmaceutical industry is responsible for huge amounts of plastic waste. I take 5 different prescribed medications, which come in plastic foil backed strips. No way of recycling them as you cannot detach the foil from the plastic. Think of the number of people taking prescription meds... far more than those of us with diabetes. In the “olden days” pills came in little glass bottles that you returned to the chemist for refilling.
 
Pattidevans said:
I take 5 different prescribed medications, which come in plastic foil backed strips. No way of recycling them as you cannot detach the foil from the plastic.
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Interestingly recently a local pharmacy (Savers?) has begun collecting plastic pill packets for recycling as part of a fundraiser for a cancer charity. I’m not sure how they go about the recycling part - but presumably if it is *only* pill blister packs then there is a way of separating things out, rather than it being mixed in with the general plastic recycling.
 
I wish more did it Mike!
 
I changed my pump and inserted a new Libre sensor today.
With both, I recycle as much as I can but would like to recycle more.
It was interesting to see the two waste piles next to each other - the Libre applicator pile was considerably larger in volume by about five or six times.

My pump manufacturer recently contacted me to ask my opinion on a recycling scheme.
They mentioned "We know another patch pump manufacturer say they offer this, but on closer inspection their recycling scheme is a collection and incineration scheme."
I don't know how true this is but it is an interesting thought in terms of how much is done for the environment and how much for marketing.
 
It's a great idea, but not very useful to those of us who can't leave the house - or who even when they could leave the house, couldn't go into a Superdrug! And this will be true of a lot of disabled and elderly people, who are the very ones who are using a lot of the medicines.

I've looked at Terracycle recycling initiatives before - they also have one for used water filters, among other things - and they tend to require you to go to a location which you may not be able to reach or which will mean burning up a lot of petrol and so causing a lot of pollution to get there.

It would be lovely if the councils collected these things, or even if they had dedicated collection areas in the waste recycling centres so people only had to make one trip with all their items.
 
I have 2 Superdrug stores in my City but niether have Pharmacies!
 
The Libre applicator engineering is pretty good. It fulfils a number of important functions in a minimum of space.
1. Joining the two parts together connects the battery and places the needle and filament
2. Pressing it against your skin performs 2 functions:
2.1 Using the needle that surrounds the filament to penetrate the skin
2.2 a powerful spring then retracts the needle into the applicator, leaving the filament inserted
From taking it apart, think this is how it works. Happy to be corrected

If you take it apart, you could recycle the spring (metal) and sharpsafe the actual needle
 
TheClockworkDodo said:
I took my first lot of applicators into the surgery and told the nurse they contained sharps, and she put the whole applicators into a 7 litre sharps bin - and then gave me my own 7 litre sharps bin, so I've been putting the applicators in there ever since (it's now full - I've asked the surgery if I can have another one, but I suspect I shouldn't have been given one in the first place and they'll say no). The plastic lids of the applicators go in our hard plastic recycling.
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I am delighted to say that for once my surgery and pharmacy have got their acts together and I have another 7 litre sharps bin 🙂

And that reminds me, I have been meaning to ask - you know the warning on your sharps bin which says "do not fill above the line"? - how many people actually do not fill above the line, and how many fill it completely until no more sharps will fit into it? I presume the "do not fill above the line" thing is to prevent medical professionals using sharps bins from spiking their fingers on other people's sharps, but if our sharps bins only contain our own sharps and we're careful when putting them in, does it matter if we fill them above the line?
 
I don't think it does matter really. After all, at our pharmacy they are allowed to put patients full sharps boxes into the GP surgery 'sharps skip' which is a huge bright yellow one kept in a locked wooden structure outside the building so one assumes eg Biffa collect such skips from them and other GP surgeries and empty the skips into their vehicle then transport all the 'locked' bins to wherever the incinerator happens to be and since they require the dispensing label to be removed before they accept them from the patient nobody knows if it was mine, yours or the Queen of Shebas bin which was over full!
 
trophywench said:
I don't think it does matter really. After all, at our pharmacy they are allowed to put patients full sharps boxes into the GP surgery 'sharps skip' which is a huge bright yellow one kept in a locked wooden structure outside the building so one assumes eg Biffa collect such skips from them and other GP surgeries and empty the skips into their vehicle then transport all the 'locked' bins to wherever the incinerator happens to be and since they require the dispensing label to be removed before they accept them from the patient nobody knows if it was mine, yours or the Queen of Shebas bin which was over full!
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I’m intrigued by your comment of removing the dispensing label?? They won’t accept my filled sharps bins unless they have a sticker containing my full name, full postal address, GP practice, date opened, date closed, life history, etc. No one has ever been able to tell me why they need this personal data or what they do with it.
 
Well my pharmacy isn't in Poole and clearly yours isn't in Coventry and if my GP was actually where I live in Bedworth, I'd have to make different arrangements and get the Council to collect them from outside my front door - so different places have different ways of doing the same things!
 
Lucyr said:
I’m intrigued by your comment of removing the dispensing label?? They won’t accept my filled sharps bins unless they have a sticker containing my full name, full postal address, GP practice, date opened, date closed, life history, etc. No one has ever been able to tell me why they need this personal data or what they do with it.
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We have to do the 'date opened' 'date closed' and sign it. Receptionist at the surgery once tried to tick me off for not having initialled the 'date opened' box, til I pointed out that her colleague had assembled and opened it for me. It’s a bit meaningless, because they’d never decipher my signature anyway.
 
I drop mine off at the GP’s for disposal. Got one receptionist once who told me off for not filling the dates in, so I did so but as it takes us over a year to fill a tub I had to take a pure guess at when it was opened. Normally they don’t even look at it, and to be honest if all you’re going to do is incinerate it, what difference does it make when it was opened and closed? I can’t understand why anyone would care!
I don’t take the dispensing label off either, if anyone happens to see that someone with my daughter’s name has filled a sharps bin I have no idea what they could do with the information, if anyone knows her it’s no secret that she has diabetes.
 
This thread has gone for a wander from the original topic so forgive me for shoving it further off course. In these sorts of discussions I wonder if people derive comfort from showing concern about small things (like the throwaway applicator) because it provides a distraction and thereby avoiding having to deal with much, much bigger things.

Next time you go to the supermarket in your car it might be instructive to reflect on the idea that the diesel or petrol burned to get there might have done less environmental harm if the oil from which it had been derived been turned into libre applicators. I often look at supermarket trolleys and am bemused by the notion that much of the volume of the goods in them will finish up in the rubbish bin. Even more bemused when the stuff is loaded into an enormous vehicle carrying one person a few miles.

There are bigger things than Libre applicators when it comes to environmental impact me thinks.

Yes and I know that every little helps, but it takes an awful lot of littles to get anywhere near one of the bigs.
 
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