T2 Qualifying for CGM technology

[Leadinglights]

I also self fund Libre2.

How long do you find that they stay stuck to your skin? I’m forever having them just slide off.

Have you tried one of the Libre jazzy straps you can buy from Amazon.

 

[Susanann1955]

Yes I have informed DVLA and my insurance as I have been on Tresiba for 3 year previously.

 

[Susanann1955]

The insulin you are taking is a mixture of a slow acting insulin which is supposed to keep your glucose level in the absence of food plus a quick acting insulin (bolus) which copes with the carbohydrate in the food you eat but it is less flexible as you should eat a certain amount of carbs otherwise the insulin will either be too little and blood glucose will be high or too much and your blood glucose will be too low and you risk hypos.
A more flexible regime is to have separate insulins, one which is slow acting taken once or twice a day (basal) to cover the background release of glucose from the liver and a fast acting insulin which is taken with food or carby snacks to allow you to cope with the carbs in your meals. Those doses can be adjusted individually to suit you.
Are you taking Creon as if you you may not be digesting food properly.

Yes I take creon and have done for about 7 years now.

 

[Susanann1955]

Yes I have informed DVLA and my insurance as I have been on Tresiba for 3 year previously.

 

[Susanann1955]

As already stated in my reply to your other post no you are not type3 PEI is caused by a lack of enzyme so you take creon so you can digest food it has nothing to do with diabetes at all.

The insulin you are on is a mixed dose not basal/bolus.
Have you told the DVLA you are on insulin and your ins company? If not you need to do so.

My gastroenterologist says my insuffiency had caused my diabetes.

 

[Leadinglights]

My gastroenterologist says my insuffiency had caused my diabetes.

How did your PEI come about, it seems important to get your CREON dosage correct. Does you gastro consultant think it was caused by damage to your pancreas.

 

[ColinUK]

Have you tried one of the Libre jazzy straps you can buy from Amazon.

I can’t bear the idea of wearing a strap to hold the sensor in place. I know there are adhesive overlays for Dexcom sensors so I suppose that there must be something similar for Libre2.
This evening I was out at a drinking establishment frequented by fellow gentlemen of the homosexualist persuasion and I just felt it slip out from under my T-shirt sleeve.
I’ll call Abbott in the morning rather than use the form as they may be able advise some way to Velcro them to my arm.

 

[Susanann1955]

How did your PEI come about, it seems important to get your CREON dosage correct. Does you gastro consultant think it was caused by damage to your pancreas.

Yes he thinks it was caused by damage to my pancreas - I manage okay with the dosage of my creon. I have had it a long time so apart from an occasional flare up I manage it okay.

 

[Catbanj]

I can’t bear the idea of wearing a strap to hold the sensor in place. I know there are adhesive overlays for Dexcom sensors so I suppose that there must be something similar for Libre2.
This evening I was out at a drinking establishment frequented by fellow gentlemen of the homosexualist persuasion and I just felt it slip out from under my T-shirt sleeve.
I’ll call Abbott in the morning rather than use the form as they may be able advise some way to Velcro them to my arm.

When I had my Libre tiral I got a trial patch from https://www.diabeticsupply.co.uk/collections/libre-overpatch "Not Just a Patch". it stopped me catching it and it was completely secure for the fortnight.

 

[trophywench]

They do stick to my arms really well - but I have to say my skin everywhere is now dry rather than a bit greasy like it and my hair always were. You know the 'wipes' you used to get with Libre but they stopped supplying them? - well you can certainly buy em quite cheaply over the counter and if you try using one of them to clean wherever you're gonna stick the sensor but DO make 100% that skin is 100% dry as a bone before you press the inserter on your arm - that should help it stick better to you. Have to say I apply mine the day or night before one runs out but I deliberately don't shower or bathe the very next morning - just have a bloomin good wash everywhere except those 2 inches square! Then it just stays stuck - unless any bra straps or passing doorframes put their oar in, of course!

 

[Leadinglights]

Yes he thinks it was caused by damage to my pancreas - I manage okay with the dosage of my creon. I have had it a long time so apart from an occasional flare up I manage it okay.

If it was caused by damage to your pancreas then that could make you Type 3c and in which case you should be treated as Type 1, but I suppose it may depend on how the damage was caused.

 

[Lucyr]

I know there are adhesive overlays for Dexcom sensors so I suppose that there must be something similar for Libre2.

PM me if you want some, using dexcom now but am sure I have some libre stickers and arm band left

 

[Pumper_Sue]

Yes he thinks it was caused by damage to my pancreas - I manage okay with the dosage of my creon. I have had it a long time so apart from an occasional flare up I manage it okay.

I have PEI and it's caused by an enzyme inefficiency not a hormone inefficiency which is what happens when the pancreas is removed. Insulin is a hormone hence lack of causes diabetes.
So as you have been diagnosed with PEI it does not make you a type3 diabetic.

 

[rebrascora]

So as you have been diagnosed with PEI it does not make you a type3 diabetic.

From what I understand Type 3c diabetes is categorized by cause (the same as other types) and for Type 3c it is diabetes caused by injury, disease or trauma to the pancreas including surgery.
I don't think that @Susanann1955 is suggesting that the PEI is causing diabetes, but that whatever caused the PEI has also caused her diabetes, in which case she would be Type 3c. ie she had damage to her pancreas which is causing both PEI and diabetes and hence an inability to produce enough insuiin or digestive enzymes.

As a Type 3c she should be more easily eligible for Libre or other CGM on prescription so it would be important for her to establish that Type 3c diagnosis. I am thinking that since she doesn't mention surgery, there may be some cysts or necrotizing of tissue following pancreatitis or perhaps there is some history of physical trauma. I think I would be asking what they think has caused the PEI and asking for a scan to to assess the condition of the pancreas.... and rule out anything more worrying going on like cysts or tumours. A C-pep test might also be helpful in showing how much insulin production is left and I would definitely ask about a basal/bolus insulin regime which will give more flexibility to manage food intake and BG levels.

 

[Pumper_Sue]

don't think that @Susanann1955 is suggesting that the PEI is causing diabetes, but that whatever caused the PEI has also caused her diabetes, in which case she would be Type 3c. ie she had damage to her pancreas which is causing both PEI and diabetes and hence an inability to produce enough insuiin or digestive enzymes.

I don't think that's right.

Pancreatic Exocrine Insufficiency (PEI) and Pancreatic Enzyme Replacement Therapy (PERT)

Learn more about Pancreatic Exocrine Insufficiency (PEI) and Pancreatic Enzyme Replacement Therapy (PERT) with our patient information.

gutscharity.org.uk

Needless to say though @Susanann1955 should be prescribed the sensors due to her disability (arthritis in hands)
This is also interesting https://www.thinkpei.com/en-gb/pei-and-associated-ta/diabetes

Type 3c diabetes​

The pathophysiology of type 3c diabetes is different from that of types 1 and type 2 diabetes and makes patients particularly susceptible to postprandial hyperglycaemia. The main pathological characteristics are:1

• Deficient insulin secretion
• Deficient pancreatic polypeptide secretion (mainly from the head of the pancreas), which may prevent or reduce suppression of postprandial hepatic glucose production
• Impaired secretion of the incretin hormones, which play an important role in postprandial blood glucose regulation
• Deficiency of glucagon secretion plus PEI (malabsorption of nutrients), and intact or enhanced peripheral insulin sensitivity, predispose patients to episodes of hypoglycaemia

I would suggest OP's A1c and high levels rules out type3c.