GP forcing change to Dexcom from Libre!

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Eternal422

Eternal422

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Type 1
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Just had this text from my GP Health Centre :

The Practice has reviewed the Continuous Glucose Monitor (CGM) we prescribe for our patients and has decided that Dexcom ONE will be our preferred CGM. To support this change, full training will be provided on Dexcom One at the Practice. Please book your preferred time on the booking link attached to this message. Please download the Dexcom One & Dexcom Clarity app before your appointment. If your phone is not compatible, you will be provided with a hand-held receiver device, free of charge


I am shocked and as I am under care of my hospital team who have said nothing about this I can’t see they can do this! As we are away for another 3 weeks this will have to wait until we’re back home when I shall contact the hospital team.

Has anyone else had this happen to them and if so how did it go if you don’t want to change?
 
I don’t see any issues with that?
 
I’m not sure I want to change, the Dexcom sensor is a different size/shape for one thing and also the hospital team use LibreView to review my results and advise on changes to insulin etc. Although I guess they can do the same with Dexcom, it just seems odd the GP are driving the change when it should be the hospital team I would have thought?
 
Eternal422 said:
I’m not sure I want to change, the Dexcom sensor is a different size/shape for one thing and also the hospital team use LibreView to review my results and advise on changes to insulin etc. Although I guess they can do the same with Dexcom, it just seems odd the GP are driving the change when it should be the hospital team I would have thought?
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Why is a different shape a problem? The hospital will just use dexcom clarity to see results, they’ll have other patients on dexcom already.

If there’s an actual functional reason that dexcom doesn’t work for you then your GP will be able to change you back to libre or keep you on it, but I don’t think “I don’t like the shape” would cut it?
 
Have heard nothing from my Gp as yet, hopefully I won’t since it is the size of Libre sensor that is appealing.
 
I have had a real wobble week just changing from the Libre reader to the phone app. I think the algorithm may be slightly different plus I had a couple of hypos, one nocturnal, where I could not manage to work the app and got myself into a right pickle because all my focus was taken with trying to cancel the screeching alarm instead of dealing with the hypo. In the morning when I looked at the log, I had 14 entries in the space of 20 mins at 4.30am when I was trying to log that I had eaten 5g carbs in an attempt to stop the alarm, and because I was groggy and hypo brain, I didn't actually eat the jelly babies until right at the end when I realised but I was in a total panic. I clearly don't cope well with technology change as I am normally so relaxed with nocturnal hypos with my reader, that I am back to sleep in a couple of minutes. I hate to think how I would cope with a completely different system and I would definitely challenge the decision based on my issue with nocturnal hypos, if I was in your shoes. It was really scary as I was trapped in a mental loop trying to deal with the app instead of dealing with the hypo, because the alarm was making me panic.
I hope you are able to get it sorted out. It is clearly a cost cutting exercise and they have no doubt negotiated a deal with the Dexcom rep, but I think you will be entitled to a CGM which works best for you.
 
Satan’s little helper said:
The Libre comes as one unit. The Dexcom comes as a sensor+ transmitter. Dexcom is a trusted sensor but they are not without thier own “limitations.” Have you used a Dexcom?
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Yes, I know they’re different shapes. I don’t see why the shape is a reason to refuse. Have used dexcom when I self funded and when another member here donated to me.
 
Lucyr said:
Yes, I know they’re different shapes. I don’t see why the shape is a reason to refuse. Have used dexcom when I self funded and when another member here donated to me.
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I don’t see the shape as a “reason.” The design in the sense the transmitter could & can disconnect & the 10 day probe life on the changeover cycle could be. 🙂 As opposed to 14 on a Libre.
 
I agree that the shape is not a reason as such, however personal preference and my own feelings are important. I guess it is a cost cutting exercise, but coming out of the blue without anything from the hospital DSN is strange.
 
@Eternal422 maybe worth checking your phone is compatible with the Dexcom app. Their app is supported on far fewer phone models than LibreLink and, if not supported it will not run (rather than run but maybe have a few gremlins like LibreLink).
 
No @Lucyr, it's not just a question of "shape". Out of curiosity, when Libre did not seem to be giving me great results, I had a free trial of Dexcom G6. The results were frankly no more "accurate" than Libre, but what bugged me most was the faff of having to deal with a bulky two-part system and the way more obtrusive nature of Dexcom - not just a sensor + transmitter but a largish "sticking plaster" to surround it which was not just way more obvious but was actually filthy by the end of the 10 days due to picking up fluff from my clothes. Not for me at all. In the event, the improvements to Libre and its reincarnation as a CGM have convinced me that this is my way to go and I would resist any attempt to move me onto Dexcom or anything else on cost grounds, to the extent that I would pay for Libre again if I had to. (I have already done this in relation to my BG meter and strips - the only one my ICB will approve is a cheap Chinese model which I found wildly inaccurate and 6 of the originally supplied 10 test strips were wasted due to error messages.)

We have the right to the treatment that works for us and I believe that should go for technology as well. I have every sympathy with the OP and I certainly would not stand by and meekly accept whatever the bean-counters decide is best!
 
I moved over to dexcom, the g6, and think its a lot better. But that was my choice. I think i'd me a bit taken aback if it had been dropped on me like it has op..
But why not give it a go? You may prefer it.
If your phones not compatible, and you really like using your phone for the app, you may be able to use the 'build your own app' available via reddit. (Well, for g6...i bet they have a version for One too)

The dexcom has an advantage for overnight hypos as the alarm will repeat, unlike the libre...on g6, at least.

Why not give it a spin?
 
Kol said:
Considerate as that may be can’t say I’d relish the thought of more to carry.
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The receiver is pretty tiny
 
I’m calming down a bit about this, luckily I have an appointment with my hospital DSN when we get back home from our Australian trip so I’ll not respond to the GP until after I’ve spoken to them. I’m still not happy about a decision being thrust on me without any consultation, but certainly won’t be accepting it without a discussion. I do feel it may be a cost cutting exercise, even though I had read that both Dexcom and Libre are roughly the same price to the NHS?

I have become used to the Libre and the Dexcom in comparison looks to be more intrusive, I.e. a large “plaster” patch surrounding it instead of the neat circle of the Libre. I guess it shouldn’t matter to me, but it does. I also definitely do not want to have to carry around a separate receiver - it looks like the version of iOS I am running is not compatible with the Dexcom app according to their website.

I’ve not used a Dexcom before, so not able to say exactly how I would get on with it or whether I would like it. I was starting to get hopeful that the new Libre 2+ expected from June may be a stepping stone to HCL eventually when they broaden the categories to put people onto HCL and that I could therefore remain with Libre.

Thanks everyone for your comments and thoughts, I’ll update here after my hospital DSN appointment in the first week of May.
 
We used to have issues like this when GPs arbitrarily changed things like test strips or needles (usually to a cheaper, lower quality alternative). GPs should not make changes of this nature without consulting you first, but often they spam the changes out to everyone then try and deal with any complaints. It may be an administrative change to them, but for some things I think they do not realise the impact it can have on our day to day management of what is, after all, a pretty complex and demanding condition :(

My understanding has always been that the hospital should be able to override the GP's decisions. I've never used Dexcom, but they have had a good reputation for many years, long befre Libre came along to challenge them. It can't seem to be a decision based on cost as, in the past at least, Dexcom was always much more expensive than Libre - maybe competition has equalised that?

Definitely discuss your concerns with your DSN. This sort of change announced out of the blue can be unsettling, I know how I would feel if, for example, my insulin was changed on the basis that they are all the same 😱 :( Life with T1D is hard enough, and change for change's sake when you have a set up that you are happy with adds unnecessary stress.

I hope you can get things sorted soon on your return 🙂
 
Thanks @Northerner - that really helps me and given me more strength to challenge this. As you rightly say, T1D is tough enough and relentless to live with that any arbitrary change is added unnecessary stress.
 
JJay said:
a cheap Chinese model which I found wildly inaccurate and 6 of the originally supplied 10 test strips were wasted due to error messages.)
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For years i had been supplied with a great meter, can't remember name though!, but it was in a pu leather wallet style with tear off testing strips in foil, really quite streamlined as far as these things go, very happy with that one and was sorry to see it go (funny how you get attatched to things!)

Then fabric pouch style and the plastic pots for strips, instantly far more bulky items, but along came the worst one so far, bigger still, certainly not easily pocketable, but no doubt a cheaper and lower quality, i suspect this had issues though as it wasn't prescribed for long from the surgery.

Now they supply the CareSens Dual which is ok, bit of a happy medium and does test ketones so hopefully they won't change that one again soon as i buy a spare for home, one for the car and one to leave at work.
 
I would resist the surgery change. It's OK for new patients but a real hassle otherwise. No one has mentioned CGM adhesive? Dexcoms have a reputation for adhesive allergy. I'm allergic to many plaster types but not at all with Libre 2. I would worry about moving to Dexcom One just in case.
 
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