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Is anyone using a standalone (not with a pump) continuous glucose monitor finding they are being switched to a different cgm without any discussion?
- Thread starter BadaBing
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rebrascora
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We had a post a few months back about this. I think the member was being changed to a Dexcom One from Libre 2 without any discussion, but if I remember rightly they got the matter resolved. I would certainly push back against any change as I absolutely love Libre and what I have found is that even any very small change in technology can have a very significant impact on my diabetes management. For instance, I use the reader with Libre. I have twice moved over to using the phone app and each time I have given it at least a couple of months, but my TIR dropped by as much as 10% using the phone app and came back up as soon as I reverted to the reader. More over I felt really confused and frustrated with the phone app particularly when I was hypo which is when familiarity with the system is probably most important and there were a couple of times when I was so confused (and frightened) trying to deal with a hypo that I burst into tears. I have been using the reader for 4 years and had lots of hypos in that time but never had that problem of feeling out of control. So for me a change of system completely to another brand would be a massive issue and would almost certainly mean a huge loss of confidence for me and I would fight it tooth and nail. I think with the Dexcom, there are only a limited number of phones that it is compatible with compared to Libre, so that might be an angle to argue your point.
I think there are some Dexcom reps trying to do deals with GP practices to supply their sensors at a more competitive price to get a bigger share of the market, so I suspect that we may see more of this happening.
I would just like to say that I am not knocking the Dexcom system at all and I am sure that it works well for some people and it may even work well for me in the long run, but the change would cause me significant upheaval and when Libre works really well for me I would not be prepared to undergo months of upheaval for no obvious gain and potential loss of confidence in managing my diabetes.
I think there are some Dexcom reps trying to do deals with GP practices to supply their sensors at a more competitive price to get a bigger share of the market, so I suspect that we may see more of this happening.
I would just like to say that I am not knocking the Dexcom system at all and I am sure that it works well for some people and it may even work well for me in the long run, but the change would cause me significant upheaval and when Libre works really well for me I would not be prepared to undergo months of upheaval for no obvious gain and potential loss of confidence in managing my diabetes.
Inka
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I thought of that thread too @rebrascora This one?:
@BadaBing Just put your foot down politely. I find that usually works (although sometimes it’s a struggle to be polite with my GP surgery who like to randomly ‘tidy’ my prescription by removing crucial meds or changing them for no reason 🙄 )
@BadaBing Just put your foot down politely. I find that usually works (although sometimes it’s a struggle to be polite with my GP surgery who like to randomly ‘tidy’ my prescription by removing crucial meds or changing them for no reason 🙄 )
rebrascora
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What is the significance of not having a pump?
Many of us with pumps have a CGM that is not being used for HCL.
Thank you @rebrascora
I wasn't aware of the earlier thread. I've been alerted to this happening by some people posting on another forum elsewhere.
My DSN told me that some local health authorities are managing to obtain significant discounts from Dexcom for Dexcom sensors (including the very new Dexcom One Plus cgm) even lower than NHS England has managed to obtain when negotiating with Dexcom centrally.
So I understand why the natural inclination is for local health authorities to instruct GPs in their area to switch patients to an alternative cgm if it is less expensive than what they are using at present and if it "performs the same essential functions" as their current cgm (on one of the other forums someone who works at an integrated care system has indicated that their rules say is all ICSs need to consider to justify directing GPs to switch patients to an alternative cgm).
It also doesn't help that apparently all ICSs in England were mandated by the previous government to save 20% off their budgets generally this financial year. Of course, the new government may reverse this mandate over coming months. But diabetes is 10% of the entire NHS budget so it is going to be looked at if they are trimming costs.
I live in an local heath authority that is super active in cutting costs. As a taxpayer I understand the pressures they are under. But as a patient I know that the Libre cgms work very well for me with my body chemistry. And, I, too, have grown familiar with the Libreview app (its clunkiness and room for improvement notwithstanding). I'm not averse to learning something new, but if given a choice, would rather stay with what I have.
I don't particularly relish having to change sensors every 10 days instead of twice a month.
As a taxpayer for many decades I am starting to become "worn down" by the fact that we are having to butt heads with "the system" simply to be given some meaningful sort of choice of what works best for us clinically on a "day-to-day" basis, when there is choice available.
Don't feel excluded! I didn't have "pump users with CGMs who aren't using them as hybrid closed loops" when I framed my question. That particular cohort might also have been told to switch their cgm without discussion.
So far I am only cognisant of this happening to people using a CGM as a standalone device.
Your answer has confused me.
Can you clarify the purpose of your question?
- Are you asking for assistance with your situation?
- Are you trying to find out how big the problem is?
Neither of these reasons would need you to distinguish between those of us using a CGM "stand alone" with a pump and those of us using a CGM "stand alone" with insulin pens. From my experience (only a sample of one) , pumpers are also likely to become "victims" of limited choice through cost cutting.
Don't worry, I do not feel exclude, just curious.
Yes, I am trying to establish how big the problem is.
Have already told you I didn't have pumpers in mind when I posed the question.
But why not?
Without HCL, a CGM used with a pump is no different to a CGM with injections. I still need to check my BG on the CGM and then use it to calculate my bolus dose.
I do not understand why you are limiting your sample when trying to find out how big the problem is - we are equally part of the problem.
Or do you consider those of us with a pump as already spending "enough" NHS money?
Bruce Stephens
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Someone on a pump with a connected CGM would, I hope, have a good argument for not switching CGMs to one that doesn't connect. (Whether the connection is for HCL or for some weaker kind of automation.) For CGMs that aren't connected, I agree there's no particular difference.
Yeah, I am asking about those of us with pumps that are not connected to their pump which is the case for most people pumping and using Libre 2 which I believe is still the most common CGM.
I really do not have the time - nor the energy frankly today - to do this.
I have already indicated that as far as getting an idea of how significant the issue is, pumpers should feel free to chip in.
Satan’s little helper
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I hear you on this point. I calculate for me it would be 3 changes a month, two of which during the week. The last thing I need on top of getting through a working day. If it ain’t broke, don’t fix it.
Bruce Stephens
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It would, yes. I guess the argument is that that offers greater accuracy, but my guess is it's just some difference in technology (with Libre being a bit newer than G6 (thought to be closely related to the One)). I'm sure I've heard that Dexcom is aggressively pricing their offerings making it significantly cheaper than Abbott's, and I presume that's the main pressure.
Satan’s little helper
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It’s my understanding the Ypsomed HCL system works with the Libre 3. So I can understand @BadaBing ’s question regarding the structure of. For the record. I’ve recently had a check up. Pleased with the results alround & no one has attempted to change my prescription. 🙂
Proud to be erratic
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I,n mid April, after I'd had some blips with my G7 and been given 3 replacement sensors, I was asked to take a phone call from:
All fine, and a useful discussion came out of that. INCLUDING the breaking news that a new Dexcom One+ was about to be launched; a 10 day disposable small sensor that was in one piece (ie akin to a scaled back G7). It was specifically going to be standalone and not intended to be used with pumps or other tech; I got the sense that it's price point should also widen it's utility and availability to non-insulin dependent folk.
So I guess we're now seeing / hearing the consequences of this push to promote Dexcom One+. I like my G7 and find Dexcom a decent supplier, but have 4 broad concerns about them:
Kym Fearn
Supervisor Patient Care Specialist Team UK/IRE (RGN/DSN) | Dexcom
T: 07826395558 | Kym.Fearn@Dexcom.com
Building 3, Watchmoor Park, Camberley, GU15 3YL
All fine, and a useful discussion came out of that. INCLUDING the breaking news that a new Dexcom One+ was about to be launched; a 10 day disposable small sensor that was in one piece (ie akin to a scaled back G7). It was specifically going to be standalone and not intended to be used with pumps or other tech; I got the sense that it's price point should also widen it's utility and availability to non-insulin dependent folk.
So I guess we're now seeing / hearing the consequences of this push to promote Dexcom One+. I like my G7 and find Dexcom a decent supplier, but have 4 broad concerns about them:
The 10 day sensors are unquestionably more of a nuisance than the 14 or 15 day sensors, causing sensor changes on any day of the week. Hardcover set up a routine.
The Dexcom app on my android phone is far less helpful than the Libre app in respect of the lack of reports being held immediately accessible on my phone, without needing to go to Dexcom's web based Clarity I can't even look back at yesterday - the app only carries the last 24 hours of data.
The app contains far too many reminders about basic helpful hints etc, as if I were a new user; these prevent me proceeding with what I want to see/do until I've confirmed "I understand" the messages. On the few occasions I've had to reinstall there are no short cuts to progressing to the end without tediously scrolling through reams of stuff that I already know as an existing user.
The app does not permit screen shots for "security" reasons. This has proved to be deceptively unhelpful forcvarious reasons; if I'm having a challwnging day and knowing the basic screen report is poor in relation to Libre, I can't even keep a screenshot to help me review tomorrow what happened today, never mind share that with anyone else!
I currently don't have a PC or tablet, so accessing Clarity from my phone is in itself a hassle and elevates my stress levels big time. I know that I'm fortunate and now have Hospital funded G7. I also have tried Libre 2, the original 2 part Dex One as well as G7. My preference would be the reliability and consistency of G7 sensors, with the breadth of reports from LibreLink.
Tdm
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I find it dead easy to get to clarity with g6, just click on the clarity link in the dexcom app...sure it goes to a different app but the transition is seamless, may as well be another page of the main app.
You can use the 'build your own dexcom app' if you want to screen shot. It also allows you to skip warm up...
You can use the 'build your own dexcom app' if you want to screen shot. It also allows you to skip warm up...
Lucyr
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Yes have heard of it happening, but if there’s a reason it isn’t suitable for you to change just explain to your GP
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