Understanding libre email

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rosy_nic

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Hi everyone, I have thinking of going on Libre sensor after my Accek-Chek meter was discounted, but I'm now a little confused by it all, and that things are going rarer quickly. I have signed up for a webinar to start using a sensor, but I got an email saying if I don't do these following points the funding will stop. I'm confused, any help would be great, thanks 🙂

" Continuation criteria for FGS (depending on why you have been initiated)*

  • Patient performs >8 scans per day, demonstrating evidence of FGS use in self-management and use the sensor >70% of the time.
AND any of the following:

  • Reduction in severe/non- severe hypoglycaemia frequency by >1 episode per week.
  • Reduction in DKA events.
  • Reversal of impaired awareness of hypoglycaemia.
  • HbA1c reduction of 5mmol/mol (0.5%) within 6 months.
  • Reduction in frequency of self-monitoring of blood glucose by finger prick testing
  • Continued delay of CSII/pump therapy initiation due to sustained HbA1c < 69mmol/mol (8.5%) or reduction in disabling hypoglycaemia
  • Improvement in time in range
  • Improvement in psycho-social wellbeing


Discontinuation criteria*

  • Failure to achieve any of the above criteria (dependent on the indication) OR
  • Failure to engage in diabetes follow up appointments (miss no more than 1 consecutive diabetes follow-up appointment).
 
Those look like the old criteria. The new one is simpler - everyone with Type 1 should be offered a CGM.

1.6.10 Offer adults with type 1 diabetes a choice of real-time continuous glucose monitoring (rtCGM) or intermittently scanned continuous glucose monitoring (isCGM, commonly referred to as 'flash'), based on their individual preferences, needs, characteristics, and the functionality of the devices available. See box 1 for examples of factors to consider as part of this discussion. [2022]


So I'd guess it's an automated email they haven't fixed, but if they mean it then you may need to complain. They really should fix the email regardless.

As far as I understand it all areas in England are now believed to be following the NICE guidance and offering a choice of (at least) Libre 2 and Dexcom One to everyone with Type 1. If yours isn't, I'm sure Prof Partha Kar would like to know about it.
 
That does sound outdated. Now we have the Libre 2, the need for scanning if you have it set up on your phone as a CGM no longer applies. (I still use the reader, so do scan at least 8 times a day) and it wasn’t hard to find one of the other criteria, I could always go for 'Improvement in psycho social welfare' just because it made my life less stressful than finger pricking and not knowing what was going on between finger pricks. But as @Bruce Stephens says, nowadays, all Type 1s should get one without having to jump through any hoops.
Whenever I have a hospital appointment (and I haven’t had one for 18 months, they canceled my annual one) they haven’t even bothered to look at my data, (unless I mention it, whereupon there's a flurry of clicking as they look it up) and the question is usually 'how are you getting on with the Libre? Fine? OK. Nothing has ever been said about it being discontinued.
 
Hi everyone, I have thinking of going on Libre sensor after my Accek-Chek meter was discounted,
i just want too add that you will still need a BG meter as there will be times where you need to back the libre up. so make sure you get another BG meter too.
 
Those look like the old criteria. The new one is simpler - everyone with Type 1 should be offered a CGM.

1.6.10 Offer adults with type 1 diabetes a choice of real-time continuous glucose monitoring (rtCGM) or intermittently scanned continuous glucose monitoring (isCGM, commonly referred to as 'flash'), based on their individual preferences, needs, characteristics, and the functionality of the devices available. See box 1 for examples of factors to consider as part of this discussion. [2022]


So I'd guess it's an automated email they haven't fixed, but if they mean it then you may need to complain. They really should fix the email regardless.

As far as I understand it all areas in England are now believed to be following the NICE guidance and offering a choice of (at least) Libre 2 and Dexcom One to everyone with Type 1. If yours isn't, I'm sure Prof Partha Kar would like to know about it.
Thanks 🙂 It does look the old criteria and that my local NHS have not updated their information for patients yet
 
That does sound outdated. Now we have the Libre 2, the need for scanning if you have it set up on your phone as a CGM no longer applies. (I still use the reader, so do scan at least 8 times a day) and it wasn’t hard to find one of the other criteria, I could always go for 'Improvement in psycho social welfare' just because it made my life less stressful than finger pricking and not knowing what was going on between finger pricks. But as @Bruce Stephens says, nowadays, all Type 1s should get one without having to jump through any hoops.
Whenever I have a hospital appointment (and I haven’t had one for 18 months, they canceled my annual one) they haven’t even bothered to look at my data, (unless I mention it, whereupon there's a flurry of clicking as they look it up) and the question is usually 'how are you getting on with the Libre? Fine? OK. Nothing has ever been said about it being discontinued.
Thanks 🙂 It does look outdated, I hope to get a reader, if I decide this is still the right path for me, as I still use carb-counting which I hoping would stop finger pricks, but I will have to wait to see
 
The more I think about it the more likely that is: the webinar process was set up before the guidelines changed (complete with this email which made sense at the time) and nobody's fixed it.
That is what I have drawn a conclusion to, I have asked for some clarity on some issues as well, with the libre sensor, regarding carb counting as well.
 
i just want too add that you will still need a BG meter as there will be times where you need to back the libre up. so make sure you get another BG meter too.
Thanks, well the Libre sensors don't do bolus calculations, so you need to still finger pricks for that, which I think defeats the objective of a sensor! It's what they suggest I do as well, for that, or use apps for that
 
Thanks, well the Libre sensors don't do bolus calculations, so you need to still finger pricks for that, which I think defeats the objective of a sensor! It's what they suggest I do as well, for that, or use apps for that
I was more talking about when you got expected results on the libre. Like if you felt low but the libre said you were find or the other way road(that's just one example of when to double check)
 
Oh okay, I knew that!! Of double checking how you feel, I was more thinking of the carb counting as well!
Ah okay it was just your wording "Hi everyone, I have thinking of going on Libre sensor after my Accek-Chek meter was discounted". I took it mean to mean you thought it meant you no longer needed a meter at all. Bur glad that wasn't the case.
 
Of double checking how you feel, I was more thinking of the carb counting as well!
The Libre Reader has a bolus calculator, which only works if you use test strips (the Reader is also a glucometer). I tend to rely on Libre for carb counting (I use a test strip every couple of days on average, just to check that the Libre sensor is still about right) but I'm not really trying to be precise about the number.
 
Ah okay it was just your wording "Hi everyone, I have thinking of going on Libre sensor after my Accek-Chek meter was discounted". I took it mean to mean you thought it meant you no longer needed a meter at all. Bur glad that wasn't the case.
Oh never, would that be the case, I'm not good with wording questions it seems!🙂
 
I was more thinking of the carb counting as well!
I genuinely use a calculator to work out my insulin so doesn't really make a difference to me weather I go by dexcom(I'm one dexcom one) or s finger prick in that respect.
 
I genuinely use a calculator to work out my insulin so doesn't really make a difference to me weather I go by dexcom(I'm one dexcom one) or s finger prick in that respect.
There exist apps that can do bolus calculations, too. But yes, occasionally I use a calculator too. (Though my mental arithmetic is good enough that usually I don't bother.)
 
There exist apps that can do bolus calculations, too. But yes, occasionally I use a calculator too. (Though my mental arithmetic is good enough that usually I don't bother.)
Yeah I have sometimes used to app. Sometimes it can be useful if I'm considering correcting I enter my dexcom reading in the app if I decide to use these and if I decide on that occasion I can go by dex.
 
The Libre Reader has a bolus calculator, which only works if you use test strips (the Reader is also a glucometer). I tend to rely on Libre for carb counting (I use a test strip every couple of days on average, just to check that the Libre sensor is still about right) but I'm not really trying to be precise about the number.
Yes, I did read that in the manual of Libre 2, which would be good for me, but it defeats the objective of no longer finger-pricking does it not? I would be using it for 3/4 meals per day, as I'm not very good with numbers and complicated workings outs
 
Yes, I did read that in the manual of Libre 2, which would be good for me, but it defeats the objective of no longer finger-pricking does it not? I would be using it for 3/4 meals per day, as I'm not very good with numbers and complicated workings outs
The I think the original idea was to see what's happening between figer pricks and it would give you more of a idea to spot Patten's and make decisions regarding adjustments.
 
Yes, I did read that in the manual of Libre 2, which would be good for me, but it defeats the objective of no longer finger-pricking does it not? I would be using it for 3/4 meals per day, as I'm not very good with numbers and complicated workings outs
Tthere will be far less needed once it becomes familiar, it gives valuable tools to monitor our diabetes, high/low alarms and the ability if the phone app is left open to see levels in real time which i find fantastic.
 
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