Issues obtaining the 3x25gram squeeze tubes twist top Glucose Gel

[Lilly]

I am having repeated problems asking my GP Practice ordering "Emergency Hypo Treatment"

Problem has been going on months just need any Glucose gel 25g by 3 twist top tube. but, being sent 80gramme large bottle Glucose gel which is no good unable to carry in running belt, and I cannot do with an additional 80gramme bottle.

Unable to open any other Glucose tube when your numbers are 2.3 going down. And while already carrying the 150 gramme MiniMed 780g, a 180 gramme Accu-check finger-stick monitor pack; so already 330 gramms to be carried umbilically connected, 24/7 by a 47kg 70yrs+ woman and while blood sugar is dropping to the point where logical and dextrous actions are no longer possible.


This is from 'SNOMED browser', the 'Children' refers to the sub-packs from each Pharma company -
Children (8)
AACE Gluco 40% gel (Essential-Healthcare Ltd) 75 gram 3 x 25g (product)
AddGluco 40% gel (TriOn Pharma Ltd) 75 gram 3 x 25g (product)
Dextrogel 40% gel (Neoceuticals Ltd) 75 gram 3 x 25g (product)
GlucoBoost 40% gel (Ennogen Healthcare International Ltd) 75 gram 3 x 25g (product)
GlucoGel 40% gel (British Biocell International) 75 gram 3 x 25g (product)
GlucoGel 40% gel berry (BBI Healthcare Ltd) 75 gram 3 x 25g (product)
Rapilose 40% gel (Penlan Healthcare Ltd) 75 gram 3 x 25g tubes (product)

Last attempt I asked for 'Rapilose Gel' not because I care which squeeze tube I get, but because Penlan Healthcare Ltd don't have an 80g pack. The GP clicking on their formulary list presume from Tees Formulary, and I cannot see what surgery or (CCG Pharmacist) has to click on, but the script says " Glucose 40% Gel 75g" and no mention of what is actually required.

Anyway I have just returned the 80g bottle of GlucoGel (BBI Healthcare) who also are listed for the 75g pack, an the non specificity and lack of availability of correct product has become very hard to bear. I feel like I'm between a rock and an immoveable object.

Note also I cannot open the tear sachets from "YourGLUCO 40% gel (Your Products Ltd) 75 gram 3 x 25g (product)"
Neither can my husband nor my doctor, so these are useless as an 'emergency' measure in a hypo condition.

My local Pharmacist is telling me when they order as script, they have to issue what is sent, and they have no control over what the supplier gets. He is asking that the GP prescribe by brand name and that "Gluco Boost" is currently available to order

There has to be a solution to this as to me the situation is untenable.

@everydayupsanddowns

 

[helli]

My GP will not fund any hypo treatments.
I have to buy them myself.

However, whenever I have something on my prescription which is wrong or too generic, I find my surgery's prescribing pharmacist is the person to make the corrections. Once they have made the correction, the dispensing pharmacist is able to dispense the appropriate items.

 

[Inka]

I don’t know anyone who gets hypo treatments on prescription now @Lilly Mine stopped many years ago (15 years or more).You might just have to consider buying them and choose what suits you best. You can usually buy multi-packs of things that are cheaper.

I saw that you mentioned your pump and meter but didn’t mention a CGM. I’m presuming you have one? If so, set your Low Alarm higher so you have better warning to treat any drops before you get to “the point where logical and dextrous actions are no longer possible”. I appreciate exercise makes things a little trickier because blood sugar can change quicker, but, depending on what CGM you have, a few tweaks might help.

There are a number of runners here, so maybe you could ask what they use.

 

[Lilly]

I have to buy them myself.

Good for you, that could save the NHS an ambulance journey or two.
The point here really is that you shouldny be going out for any distance without that emergency glucose, and the best way to ensure that is if you carry it in the same belt as the pump umbilically attached which is a pain in itself, and I definately don't appreciate extra weight 24/7 round the clock. I'm sure I wouldn't be carrying anything bigger around all the time, and If you get caught short it would cost them more than 25 grammes

 

[Lilly]

I don’t know anyone who gets hypo treatments on prescription now @Lilly Mine stopped many years ago (15 years or more).You might just have to consider buying them and choose what suits you best. You can usually buy multi-packs of things that are cheaper.

I saw that you mentioned your pump and meter but didn’t mention a CGM. I’m presuming you have one? If so, set your Low Alarm higher so you have better warning to treat any drops before you get to “the point where logical and dextrous actions are no longer possible”. I appreciate exercise makes things a little trickier because blood sugar can change quicker, but, depending on what CGM you have, a few tweaks might help.

There are a number of runners here, so maybe you could ask what they use.

well yes mention of 'finger-stick monitor pack' = Accu-check Guide etc. and yes I did adjust the low alarm but you don't want them too early either.

 

[helli]

the best way to ensure that is if you carry it in the same belt as the pump umbilically attached which is a pain in itself, and I definately don't appreciate extra weight 24/7 round the clock.

You are assuming we all have an "umbilically attached pump".
Many people are still on MDi and some of us with pumps have patch pumps.
We have no belts to store "emergency glucose".
That said, thankfully, in over 20 years, I have had no need for emergency glucose. I have good hypo awareness which ensure I am able to treat a hypo before it reaches that level and have been doing so for many years before I had a CGM with alarms.
I too find exercise can cause my BG to fall quickly but as this was the justification for me to have a pump, I have made it my mission to learn how different types of exercise require different basal patterns and when to start them.

How often do you need your emergency glucose?
Have you discussed this with your DSN to identify techniques to reduce the need?
Whilst I appreciate emergency glucose is cheaper than calling an ambulance, etc. minimising these hypos as much as possible will save the NHS even more.
And, if they occur very rarely, it is cheaper for you to fund the emergency glucose you desire.

If you need the emergency glucose while you learn (and get support from your DSN), I have explained above that I have been able to change items on my prescription by contacting the prescribing pharmacist at my GP surgery.
Have you tried this?

 

[Inka]

well yes mention of 'finger-stick monitor pack' = Accu-check Guide etc. and yes I did adjust the low alarm but you don't want them too early either.

No, not too early but I find setting them a little higher than needed allows me to ward off any lows almost completely. It’s also allowed me to keep my hypo awareness sharp, so a double bonus 🙂

So are you looping with your pump?

 

[everydayupsanddowns]

Sorry to hear about the frustrating time you have been having getting hold of hypo treatments that suit you @Lilly

I’m not sure I can help really, as in my 30+ years with T1 I have never been offered hypo treatments on prescription. I wasn’t even sure that still happened, with the possible exception of very small children.

Some members here find gluco tabs are a reliably fast-acting hypo treatment. When I need faster acting glucose I use ‘original recipe’ Coke which is just about the only full-sugar carbonated drink still worth having. Though that might not suit you weight-wise.

The severity and suddenness of hypos you are describing do make it sound like you may be able to make some small tweaks to your pump settings, in order to get earlier warnings, and give yourself a little more time?

Are you using the MM780G as a hybrid loop? You could try using Exercise mode, or setting the Smartguard target to 6.7?

My low alert is set to 4.8, so I almost always have time to act and take on some glucose if my levels are dropping, and before my thinking gets muddled.

My personal pocket treatments are currently mini-bags of Haribo and Squashies. It used to be the mini bags of Skittles, because our local Supermarket has decided to charge more than double for those!

 

[gail2]

i get hypo treatments on prescription once in a blue moon mind you and i have to ask the right gp at the practise Mind u im a t2 on insulin

 

[Lucyr]

Unable to open any other Glucose tube when your numbers are 2.3 going down.

Sounds like it would be worth prioritising improving hypo awareness and using alarms more effectively so that you aren’t in this situation. If you’re not noticing hypos till the point that you can’t open hypo treatments then that would I suspect need reporting to the DVLA as hypo unawareness.

My GP doesn’t fund hypo treatments and I wouldn’t expect them to. There are various gels or tubes etc you can get that are designed to be easily opened whilst exercising.

 

[Lilly]

If you’re not noticing hypos till the point that you can’t open hypo treatments then that would I suspect need reporting to the DVLA as hypo unawareness.

The tear sachets are impossible to open under any circumstances and neither my husband, nor my GP could tear the pack either. So how would anyone be able to tear one if they also needed to take hypo treatment. The point its carried all the time for emergency use.

 

[Lucyr]

The tear sachets are impossible to open under any circumstances and neither my husband, nor my GP could tear the pack either. So how would anyone be able to tear one if they also needed to take hypo treatment. The point its carried all the time for emergency use.

You seem fairly obsessed with emergencies, first off every single tear off tube won’t be impossible for anyone to open or they wouldn’t sell them. Secondly, hypos where you can’t chew glucose tablets or jelly babies or whatever simply shouldn’t be happening regularly enough that this is even a question.

So shall we start with the basics? What are your cgm alarms set to? Have you spoken to your diabetes team about your hypo unawareness? Have you tried running high to regain it? How often are you having hypos so severe that you need these emergency gels?

 

[Pumper_Sue]

Unable to open any other Glucose tube when your numbers are 2.3 going down. And while already carrying the 150 gramme MiniMed 780g, a 180 gramme Accu-check finger-stick monitor pack; so already 330 gramms to be carried umbilically connected, 24/7 by a 47kg 70yrs+ woman and while blood sugar is dropping to the point where logical and dextrous actions are no longer possible.

Try setting your sensor to alarm a lot sooner if you are prone to drops like that.
As to the glucose problem go buy some tubes of cake icing. Or some liquid glucose. All available in a supermarket at very little cost.
It might be a good idea to review your pump settings as well if you are dropping that low.