Technology and Diabetes

[leonS]

A few years ago now I was told by a young doctor that I had significant damage caused by poorly controlled diabetes. I responded with the question "What did you expect? I have been on insulin for 40 years (then) and damage is both cumulative and irreversible."

His response was that there was no reason why any damage should occur, and good control was perfectly possible.

I should have liked to have seen his efforts given the equipment that was available to me in the ten years or so following diagnosis. It was not possible to do a BG test in less that four hours, and urine testing produced only the vaguest indication of how one was responding to treatment. Close control? An impossible dream.

I can test my BG now in seconds, in just the time it takes to get the Libre reader out and switch it on. Could I manage without the technology? - yes! I could go around like an itinerant chemist with test tube and dangerous chemicals, and achieve very poor control, but I certainly would not wish to do so.

 

[climbing mil]

I have recently changed from Libre to Dexcom on advice from my specialist nurse.
Whilst the technology is advanced I regret to say that I have found the sensor reliability to be very poor. Apart from those that fail early in life several have failed to work beyond 7 days when the manufacturer claims 10 days life.
To protect against reliability issues one must carry a traditional meter and test strips especially if you are travelling. Had to go back to my GP to get some test strips recently. He would not give me the strips I used for my Freestyle meter and insisted on giving me a new One Touch meter and strips. This apparently reduces NHS costs BUT I have had many strips that have failed to work. They need a lot more blood than my previous strips and bearing this in mind the failure rate in my case makes them a false economy.
My old Freestyle strips were far more reliable than those I am now being given and my Libre sensors were ultra reliable.
So I have significant reservations about the technology and its cost to both self funding and NHS patients.
These advances are only satisfactory if they are reliable, and sadly my recent experience has not been good. Yes my faulty sensors are replaced free of charge but I am fed up with calling the manufacturer and requesting replacements.

Hi, I have Dexcom G6, and have had one sensor not work on initiation and that was replaced quickly. Otherwise O have found it pretty reliable and liberating. Until you have CGM you really have no idea what your blood sugars behave...

 

[trophywench]

It was around 40 years ago (late 70s) that one could first purchase 'home use' BG meters, so I treated myself to one with savings and birthday money. The hospital had been using one at clinics for 2 or 3 years by then. Bit smaller than the first mobile phones as only the approx. size of HALF a housebrick! LOL

These kids have NO idea, have they? How many times have they boiled up a glass syringe or ditto their pee?

 

[Bruce Stephens]

How many times have they boiled up a glass syringe

Or been just about to inject only to remember "oh, wait, this one's 40 strength insulin, not 20 strength".

 

[trophywench]

Or been just about to inject only to remember "oh, wait, this one's 40 strength insulin, not 20 strength".

I never had that problem - I was on Ultralente (80u/ml) only once a day - 11 Exchanges. I can still hardly believe our lives had to be so damned controlled - I was more than ready for a change when it became possible.

 

[leonS]

All problems solved, well the technological ones are sorted.

I foolishly assumed that as I wanted to transfer data from a reader to a lap-top, a distance of half a meter, it would go directly there along a special wire.

This is NOT the case. The data must first be sent to the "cloud" then downloaded back from where ever that might be to my desk. To actually do this I have to log on to the Abbott site and run a program there. The hospital nurses have a special code which I put into Abbott's set-up and then they too get the results.

One must be careful to use the correct site (URL) or it starts asking "which country are you in?" and attempts to set-up a new user account.

I found the manual very useful. It is printed on white paper and when placed on the bedside table with the reader on top (it is just the right size), it makes the black reader much easier to spot in the half-light.

 

[Bruce Stephens]

This is NOT the case. The data must first be sent to the "cloud" then downloaded back from where ever that might be to my desk. To actually do this I have to log on to the Abbott site and run a program there.

But to get it there (from a Reader) you do have to connect the Reader to a laptop with a cable (not a special one, particularly, just the one you use to charge it). I think that doesn't require the usual bit of software, but a special driver of some sort which works with your web browser in some magic way. (At least, that's the case with macOS.)

And yes, your local diabetes team will have given you a code which (with less than half an hour's searching) most people will find a place to use.

(I still suspect most people will find a smartphone with the app more straightforward, though it is a little more awkward to find the right spot with the NFC antenna.)

 

[leonS]

One of the dictionary meanings of the word "special" is "designed for a particular purpose". The cable is designed to connect two USB ports together, so is special in that sense. As USB provides a power source of 5 volts this cable is also used to charge the reader. A suitable cable is provided with the reader in Abbott's kit.

Yes, you do have to install "Drivers" to use the system, as I described. I just did not expect to have to use them with a web site, and had imagined that I could take data from reader to computer directly. I do not see why the data should be sent by such a circumlocutory route.

In fact I had to set-up a cloud account, before I could do anything. Putting in the code for the hospital, was the simple.

As I have no need of a mobile 'phone, smart or otherwise, I am reluctant to go down that route. Were I to get one I should not be able to use it as I would not be able to see the icons.

At the moment all that I need is to send data to the SDN every two weeks, and I can now do that.

 

[Bruce Stephens]

I just did not expect to have to use them with a web site, and had imagined that I could take data from reader to computer directly. I do not see why the data should be sent by such a circumlocutory route.

It is weird, yes. I was expecting to use the desktop software they offer and to upload from that (and as far as I can tell that's not possible at all). Presumably there's some shared bits of code, but to have the two ways of doing things so apparently distinct was unexpected, and using the web browser is strange.

 

[ClaudiaKiwi]

The first thing that I would point out is that technology is a noun and can not be used as an adjective as you have done. That is because I am 74 years old and was taught, with the aid of a stick, that such thing are important.

Joking apart:

I have just been connected up, or Libre-ised, and if you would like a few words on this then I would be happy to provide them.

Hi there. I am curious to learn how you find the Libre?

 

[everydayupsanddowns]

Hi there. I am curious to learn how you find the Libre?

You can find more information about Abbott Freestyle Libre in the UK here: https://www.freestylelibre.co.uk/libre/

There are now mandatory nationwide criteria for access which can be viewed linked from this page: https://www.diabetes.org.uk/about_us/news/flash-on-nhs

We have several Libre users on the forum, both funded and self-funding, intermittent and full time. Maybe start a new thread with any specific questions you have?

 

[mike watson]

Hi all, I've just got the Libre system (self-funded) and found it makes a massive difference. However my doctor says it is not available on NHS - I thought it had been cleared. Has anyone else had this problem and know how to solve it? I'm not sure I can afford £50 for a fortnight's testing!
Thanks,
Mike

 

[Bruce Stephens]

However my doctor says it is not available on NHS - I thought it had been cleared.

It's available, but only for some patients. You can read the national criteria here https://jdrf.org.uk/information-sup...h-glucose-sensing/can-i-get-libre-on-the-nhs/ though your CCG may allow additional reasons. (The funding covers 20-25% of people with Type 1, so it's not the case that this is (at present) seen as something for everyone.)

 

[mike watson]

Thanks, Bruce, that's very helpful. I should know better than to believe headlines! Internal domestic budgetary negotiations will be taking place...

 

[MrDaibetes]

Hi all, I've just got the Libre system (self-funded) and found it makes a massive difference. However my doctor says it is not available on NHS - I thought it had been cleared. Has anyone else had this problem and know how to solve it? I'm not sure I can afford £50 for a fortnight's testing!
Thanks,
Mike

There is a criteria to follow, you should ask your consultant to send a letter to your G.P

 

[AndBreathe]

I didn't notice this thread when it was started, but i will nonetheless comment now.

When I was diagnosed in 2013, I was given a pot of urinalysis strips and sent on my way. That is the sum total I have had for medical support in managing my T2 diabetes.

To be clear, by the first post-diagnostic checks, my HbA1c had reduced to 37, then lower since, with my last at 27, so it could be argued that I have never needed technology or other kit. The reality is, however, that I, and many others like me, have invested heavily in both standard glucose monitoring kit, and a number of Libre sensors for additional context and knowledge.

I am very fortunate with my body's apparent ability to recover itself, and that I have been able to invest, financially as well as intellectually into my health, but this isn't the case for many others.

Every day there are significant numbers of people living with T2 diabetes whose conditions and/or quality of life could be enhanced by the provision of technology - whether that be the Libre/CGM or in the form of insulin pumps. It is such a shame that additional latitude doesn't seem to be available to those in a position to provide that, or for those stuck in the bind.

To wind up, I'm not having a whinge about T2s being treated badly (although the services available to a lot of us can be considered significantly wanting), I am trying to get on record that the awarding and distribution of technology seems to be done by label, and not necessarily by personal, clinical need or circumstances.

I'll wind up by saying that I don't grudge anyone the technology they can have to improve their quality of life and hopefully health outcomes. I just wish that for those non-T1s, whose only issue seems to be being stuck with the wrong label, it wasn't simply a distant dream.

 

[Lizzzie]

Hello! I have a Dexcom, which is a little sensor that sits on my tummy, measures my blood glucose and beams it to my phone. unfortunately I once had a dreaful hypo that left me with very mild brain damage and it helps no end to control my levels and detect hypos before they become bad ones. Unfortuantely it is also always there, invasive and intrusive and I have a love-hate relationship with it. I spend a lot of time looknig t it going 'wow! That is soooo clever!' but also feeling a bit like a robot.

 

[Sam A]

I'm using a Dexcom for about 2 months now. It is really helping me to understand what foods and exercise do to my blood sugar readings. The reporting from the sister app CLARITY to the core day to day DEXCOMG6 gives an amazing set of data analytics reports and estimated HbA1c.

 

[johntheterrier]

Hello! I have a Dexcom, which is a little sensor that sits on my tummy, measures my blood glucose and beams it to my phone. unfortunately I once had a dreaful hypo that left me with very mild brain damage and it helps no end to control my levels and detect hypos before they become bad ones. Unfortuantely it is also always there, invasive and intrusive and I have a love-hate relationship with it. I spend a lot of time looknig t it going 'wow! That is soooo clever!' but also feeling a bit like a robot.

Hi Lizzie, I'm looking into getting a dexcom, are you self funding? I presume getting one of these on the NHS is difficult??

 

[everydayupsanddowns]

Hi Lizzie, I'm looking into getting a dexcom, are you self funding? I presume getting one of these on the NHS is difficult??

It’s certainly worth having a conversation with your clinic about it, because there is NICE guidance (mostly focussed on hypos) however the evidence reviewed for the 2015 guidance was on the weak side, and full time CGM is pricey, so it’s a fairly weak ‘consider’ recommendation that many CCGs brush off to save budget.

If you live in the right area, and have the right consultant/clinic thoigh it can certainly happen (one of our mods @MrDaibetes was recently granted funding for CGM with his insulin pump)

Unfortunately, my CCG are pretty hardline with their ‘NO’s (though I keep asking!). There are very few at my clinic who have funding - even those costing tens of thousands in ambulance callouts a year. Madness!