Hello!

[DouglasXKR]

Hi there, just as I thought my T2 was getting better, 12 days ago I was admitted with hyperglycaemia and discharged 5 days later with T2+T1. I’m 75yrs.

I wonder whether I might ask you for some help, please?

1) they gave me a 4Sure kit and the lancing device will not penetrate my skin - it’s seen some hard work and it’s a bit leathery. The lancet was swapped for a thicker 28 gauge (0.38mm pin diameter) which worked better but still not perfect. What I plan to do is machine a 6mm diameter spacer and about 0.2mm thick and fit it into the base of the socket that holds the lancet and will cause the lancet to project 0.2mm further into my skin. I’ve duplicated the result with some cardboard engineering and it works. Does anyone else have trouble with these things and advise how they sorted it?

2) between us and we’ve been together for 50 years, over the last 6 days herself and I got the glucose readings across a whole day to 16+/-1.25 with slow insulin 22 units and 3x8 units fast insulin. It seems easy, just pull the average down by increasing the slow insulin??

Any help gratefully received! I’d also be keen to know whether the NHS covers the cost of non-medicinal items such as test strips? The ketone strips will cost me about £2 a shot which could mount up.

 

[Docb]

Hi @DouglasXKR and welcome to the forum.

On your first point, you could ask your GP/diabetes clinic to prescribe an Accucheck Fast Click lancing device. This is adjustable with the idea of being able to cope with various skins. I use one on setting 1 ( gets blood from me) and goes up to setting 6 which I've never been near but would like as not get blood from a rhino.

You should get all the test strips you need on precription if you are on medication (like insulin) which can lead to low blood glucose. Just ask your GP for them to be added to your medication list.

I'll keep out of the insulin adjustment discussion, out of my experience.

 

[EmmaL76]

Yes I’m an in between type of diabetic. If type 1 is mentioned in your medical notes then I’m pretty sure all prescriptions are free. Which means you get a meter, for some reason I get 400 strips a month (think that was a clerical error and I don’t pick that amount up ) 20 keytone testing strips (also that is above average) my libre 2 sensors. Obviously insulin if I need it, lancing devices/needles. I’m very lucky that I’ve never had to push for this stuff. Also yes there is another lady on here always saying the same that she struggles to get enough blood to test. I don’t use the lancing device because they bruise my fingers just kinda stab myself with the little needle bits. The contour next one machine only requires a tiny bit of blood but the strips are expensive and wouldn’t be on prescription I don’t think.

 

[helli]

Welcome to the forum @DouglasXKR sounds as if you have been through the ringer but gad you are getting some assistance now.

With regard to your lance not lancing deep enough, are you able to adjust your device? Typically, they have a dial on them which can be moved to make the lance go deeper.

With regard to your insulins, it sounds as if you have a fast acting which you take with meals and a slow acting one that you take once or twice a day. This is called basal/bolus regime. The basal (slow acting) is a background insulin. Throughout the day, our livers drip glucose into our blood - the basal insulin breaks down this glucose. Its purpose is to keep our levels flat in the absence of other blood glucose influencers such as food and exercise and stress. This is easiest to see overnight so if we find our levels in the morning are significantly lower than when we went to bed, it is likely that our basal dose is too high Likewise, if our levels rise throughout the night, the basal dose is likely to be too low.
The purpose of the fast acting insulin is to break down the addition glucose which typically comes form the carbohydrates that we eat. Therefore, this is usually taken with (or just before) food.

It is common to be started on fixed doses of basal and bolus insulin but, over time, it should be explained how to calculate the dose. This is especially true with the bolus dose where you may read about carb counting - we have a ratio of how many units of insulin we need for 10g of carbs.

Feel free to ask more questions - many of us have been through the same things as you.

 

[DouglasXKR]

@EmmaL76 the discharge papers have not been completed which complicates the issue. Type 1 may not be mentioned. The NHS round my way is not in a good position.

@Docb the accuchek fast clix looks promising. I’ll give it a go. Many thanks.

 

[DouglasXKR]

@Docb an M2 washer slipped under the lancet with a tiny touch of glue holding it in place works very well. It raises the lancet about 0.35mm and the device now operates at level 1

 

[everydayupsanddowns]

The contour next one machine only requires a tiny bit of blood but the strips are expensive and wouldn’t be on prescription I don’t think.

I have been using Contour Next for years - the strips definitely are available on prescription. It’s the meter that links to Medtronic pumps, but since switching to Tandem I have continued with the meters as they suit me well, and self-funding Dex means I use comparatively few strips these days.

Welcome to the forum @DouglasXKR

An ingenious solution for your finger pricker you worked out there! But I would also recommend the Accu-chek Fastclix lancing device. A class above most others IMO.

2) between us and we’ve been together for 50 years, over the last 6 days herself and I got the glucose readings across a whole day to 16+/-1.25 with slow insulin 22 units and 3x8 units fast insulin. It seems easy, just pull the average down by increasing the slow insulin??

The role of your slow insulin (also called basal or background) is to counteract the glucose that is trickled out by the liver 24/7. These glucose stores are the reason you don’t need to eat in order to run for the bus, and don’t keel over if you miss a meal. You already have some glucose stored away that can bridge the gaps. Basal insulin should ideally hold your blood glucose levels roughly steady 24 hours a day, rather than make them drop.

Your mealtime doses are an insulin that works over 4-5 hours, with a peak of activity around the 1-2hour mark, and are intended to cover the carbohydrate content in your meals (which more often than not will be absorbed over the same sort of period).

As you become more experienced, your clinic will help you understand how to adjust your meal doses to match the carbohydrate content of the meals and snacks you are eating.

You might find the book Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas to be a very helpful reference guide. Ignore the title, it is suitable for any age, but perhaps just skip the chapter on going to school!

 

[DouglasXKR]

@everydayupsanddowns
The accu-check fast clix ad seemed a) to describe the product’s capability as if that was an aspiration which is typical of Chinese knock-offs and b), most damning, it spelt Roche as first Roch and then described the product as of “Roche quality” and in both cases omitted the Roche symbol.

Anyway cash changed hands and one is on its way to me!!

 

[rebrascora]

I have hardened thick skin on my fingers and tend to use the highest setting... 5 on my current device I believe. Using the sides of the pads is important rather than the middle of the pad both from a comfort and thickness of skin issue and rather than pressing the lancing device hard against the finger, I find just touching it to the side of the finger and depressing the button allows the lancet to penetrate and bounce back much quicker and easier and results in a good blood sample and no bruising. I just use bog standard lancing devices and that technique works well for me. Also ring and little fingers tend to be the least thick skinned and therefore the easiest to get blood from.

 

[Robin]

@everydayupsanddowns
The accu-check fast clix ad seemed a) to describe the product’s capability as if that was an aspiration which is typical of Chinese knock-offs and b), most damning, it spelt Roche as first Roch and then described the product as of “Roche quality” and in both cases omitted the Roche symbol.

Anyway cash changed hands and one is on its way to me!!

That sounds alarming, did you buy it from a reputable site? Boots and Amazon, just for example, sell them, and spell everything correctly.

 

[grovesy]

Boots sometimes have them on offer.

 

[EmmaL76]

I have been using Contour Next for years - the strips definitely are available on prescription.

So I’m talking rubbish as usual 😳

 

[Robin]

So I’m talking rubbish as usual 😳

Not necessarily! There are different grades of things in the various formularies for each commissioning group. Here in Oxfordshire, cheaper testing strips are 'Green' and can be prescribed by any GP. Some more expensive strips are on the 'Brown' list, and aren’t normally prescribed but can be if there are special reasons (my Abbot strips for example, because they fit the Libre reader), or can only be prescribed in a hospital clinic setting.

 

[NotPink]

Hi @DouglasXKR and welcome to the forum.

On your first point, you could ask your GP/diabetes clinic to prescribe an Accucheck Fast Click lancing device. This is adjustable with the idea of being able to cope with various skins. I use one on setting 1 ( gets blood from me) and goes up to setting 6 which I've never been near but would like as not get blood from a rhino.

You should get all the test strips you need on precription if you are on medication (like insulin) which can lead to low blood glucose. Just ask your GP for them to be added to your medication list.

I'll keep out of the insulin adjustment discussion, out of my experience.

I too have an accucheck and use setting 5 which makes me a rhino? Anything less does not draw blood.

 

[NotPink]

I have hardened thick skin on my fingers and tend to use the highest setting... 5 on my current device I believe. Using the sides of the pads is important rather than the middle of the pad both from a comfort and thickness of skin issue and rather than pressing the lancing device hard against the finger, I find just touching it to the side of the finger and depressing the button allows the lancet to penetrate and bounce back much quicker and easier and results in a good blood sample and no bruising. I just use bog standard lancing devices and that technique works well for me. Also ring and little fingers tend to be the least thick skinned and therefore the easiest to get blood from.

Some folk on here suggest you warm your fingers first. Maybe dipping them in warm water first?

 

[Leadinglights]

Some folk on here suggest you warm your fingers first. Maybe dipping them in warm water first?

Also massage your finger towards the end before you prick.

 

[Docb]

I too have an accucheck and use setting 5 which makes me a rhino? Anything less does not draw blood.

Oops, 😡

 

[everydayupsanddowns]

So I’m talking rubbish as usual 😳

Not really, we’ve had lots of members over the years who have been switched from their meter of choice and given a cheaper alternative. Some a bit of a struggle to get their preferred meter back. Seems to be a bit of a postcode lottery unfortunately.

The guidelines for T1 are that the should have access to a meter that is clinically appropriate and meets their needs and preferences - but some still get caught up in blanket changes across whole areas, so I can see why you might have heard that Contour XT meters weren’t available on prescription 🙂

 

[Jenny105]

I use a Glaucomen areo - blood sugars I guess. This won't penetrate the skin on any setting. I have removed the cap, ; set the pen; hold the lancet spike against my finger ; press the button . That works for me. When I hear from my nurse or doc I'll ask for something different

 

[Leadinglights]

We used to use those sort of lancing devices when I worked at the university and they were notoriously unreliable in actually firing, they were tricky to set and probably failed at least 25% of the time.
Due to Health and Safety, blood getting on the outside of the device, we moved to single use devices which were much more satisfactory as no sharp bit was ever visible.