Updated NICE Guidance aims to improve CGM access for both T1 and T2

[BlueArmy]

They should prescribe it to any T2 that shows a desire to manage their condition and can prove they have been using it by checking the app logs. Although my need is not as necessary as a T1 or insulin treated T2, the fact I am using it and keeping things under control is saving the health service a larger cost in the long term, but me £1200 a year at the moment!

 

[trophywench]

@Catsymoo how did you settle on 1 unit of insulin to 10g of carbs? Clearly it isn't enough. So experiment. Eat something with exactly measured carbs - eg one biscuit, and try 1.5u to 10g instead of 1u. does that work? If not, repeat experiment with a different amount per 10g of carb. until you find the right amount for yourself.

 

[SB2015]

Yes, I was declined it. I was told I have to do the DAFNE course first then never heard anything

I know that having done a carb counting course was listed for Libre originally and is again mentioned in the link Mike posted. I wonder whether that is because we need that knowledge to make effective use of the data that we can get from the sensor.

I suspect that being prescribed a Dexcom would carry the same requirement, for the same reason.
Have you done any sort of carb counting course? Although I was already carb counting I still found attending the course very useful, in particular having the chance to draw on other people‘s experience.

 

[Robin]

Yes, I was declined it. I was told I have to do the DAFNE course first then never heard anything.

Just an example of how volatile my type 1 is. I woke up at 14 mmol. I took 2 units to correct, waited 2 hours. Ate 30g carbs, took 3 units, blood sugar was 20.1. I waited another 2 hours to let the 3 units of Novo work - I am now at 20.8. How?

I did the online Bertie course, while I was waiting to be referred back to the hospital to get the Libre on prescription, and they accepted that instead of doing a DAFNE. Although I'd been Type 1 for 13 years at the time, I still found it a useful refresher, and I could work through the modules at my own pace.

 

[rayray119]

I really hope I can get a Dexcom from this, I am currently using finger tests with the FreeStyle Freedom Lite and my blood sugar control is horrendous. I have such bad hypo anxiety I purposely run my sugars 15-20 for peace of mind.

I feel that a CGM could get rid of this anxiety as I will be able to clearly see the trends of my blood sugars overnight and what they are doing.

Sorry to interrupt but can I ask if the freestyle lite is still available

 

[gillrogers]

Has anyone gps stopped allowing you to have test strips for back up in the light of this news. I currently think I've got a failing sensor. So used some test strips to check. Ended up querying my test strip reading too so used a couple more up on the control solution tests. Turns out the meter is ok. So my sensor readings are just over the 20% and that's with time allowed for the lag. Only got one tub left, that's ok, but then twigged that they had been removed from my available list on my repeat prescription. I've not had any since last year so it's not because they're not due.

 

[rayray119]

Has anyone gps stopped allowing you to have test strips for back up in the light of this news. I currently think I've got a failing sensor. So used some test strips to check. Ended up querying my test strip reading too so used a couple more up on the control solution tests. Turns out the meter is ok. So my sensor readings are just over the 20% and that's with time allowed for the lag. Only got one tub left, that's ok, but then twigged that they had been removed from my available list on my repeat prescription. I've not had any since last year so it's not because they're not due.

I don't think there allowed to do that(but I get but I have had refusals of strips before filling knowing I basically run out)

 

[Bruce Stephens]

Has anyone gps stopped allowing you to have test strips for back up in the light of this news.

Mine hasn't, and doing so would be against the guideline (which emphasises that test strips are sometimes necessary).

 

[gillrogers]

Well that's what I thought. I'll tackle them about it. Thanks Bruce.

 

[helli]

Has anyone gps stopped allowing you to have test strips for back up in the light of this news. I currently think I've got a failing sensor. So used some test strips to check. Ended up querying my test strip reading too so used a couple more up on the control solution tests. Turns out the meter is ok. So my sensor readings are just over the 20% and that's with time allowed for the lag. Only got one tub left, that's ok, but then twigged that they had been removed from my available list on my repeat prescription. I've not had any since last year so it's not because they're not due.

Strips are definitely still required. It is a requirement to carry them when you are driving. Libre and CGM readings are accepted but you are also required to carry test strips, I assume, in case they fail.

Regardless of driving, I believe it is important to use finger pricks to check sensors. Otherwise, how would you know you have a badly calibrated sensor which is alway 2mmol/l or more out?

 

[gillrogers]

Strips are definitely still required. It is a requirement to carry them when you are driving. Libre and CGM readings are accepted but you are also required to carry test strips, I assume, in case they fail.

Regardless of driving, I believe it is important to use finger pricks to check sensors. Otherwise, how would you know you have a badly calibrated sensor which is alway 2mmol/l or more out?

Exactly Helli! I read someone on the libre Facebook page telling someone to forget taking strips and our meter out with you and just trust the sensor cos thats what she does. I guess she's never had one fail on her

 

[Proud to be erratic]

I had a prescription ointment drop off my repeat prescription list, because I hadn't requested any in over 12 months. I phoned in and was prescribed a new tube, but it's never been added back onto my repeat list.

 

[nonethewiser]

Has anyone gps stopped allowing you to have test strips for back up in the light of this news. I currently think I've got a failing sensor. So used some test strips to check. Ended up querying my test strip reading too so used a couple more up on the control solution tests. Turns out the meter is ok. So my sensor readings are just over the 20% and that's with time allowed for the lag. Only got one tub left, that's ok, but then twigged that they had been removed from my available list on my repeat prescription. I've not had any since last year so it's not because they're not due.

Probably just error, ring surgery up get them to put strips back on repeat, shouldn't be any issues.

 

[rayray119]

I had a prescription ointment drop off my repeat prescription list, because I hadn't requested any in over 12 months. I phoned in and was prescribed a new tube, but it's never been added back onto my repeat list.

I'm guessing that's because you really feel the need to double check things?

 

[Proud to be erratic]

I'm guessing that's because you really feel the need to double check things?

Sadly, yes!
As a young adult, after school, it was impressed on me to "never assume, .... check". This has become so ingrained that even I sometimes feel I've become a control freak! But this principle has served me well on numerous occasions: as an engineer (calculations and on site); in managing people (both at work and after unusual behaviour); and now since my original cancer diagnosis.

 

[rayray119]

Sadly, yes!
As a young adult, after school, it was impressed on me to "never assume, .... check". This has become so ingrained that even I sometimes feel I've become a control freak! But this principle has served me well on numerous occasions: as an engineer (calculations and on site); in managing people (both at work and after unusual behaviour); and now since my original cancer diagnosis.

Sorry I meant to say rarely as you said you hadn't ordered them in 12 months 🙂

 

[Proud to be erratic]

Sorry I meant to say rarely as you said you hadn't ordered them in 12 months 🙂

Well, in this case your original 'really' was correct.

I hadn't requested the ointment for a long time because I still had some left and the original problem had almost disappeared; then it seemed to have returned with a vengeance and I couldn't get a GP appointment to discuss alternative ointments or even get a referral for a dermatologist review.

But my main point was that, at my Surgery and probably across Bucks, there has been deep reviews of repeat medications in an attempt to reduce waste. I understand our CCG has required this and I think I've seen something from NICE requiring CCGs and GP Practices to do this. Although there is an inconvenience to us patients in the sometimes erroneous consequence, I suspect this is overall a good and necessary practice. It's very easy to just demand a repeat of all the items on repeat, even if you don't need all of these. I know of 2 cousins, my age group, living on their own and each with a whole kitchen cupboard given over to their stockpiles of medications; they're only mildly embarrassed by their hoarding and certainly not likely to alter their ways.

 

[JJay]

Well, in this case your original 'really' was correct.

I hadn't requested the ointment for a long time because I still had some left and the original problem had almost disappeared; then it seemed to have returned with a vengeance and I couldn't get a GP appointment to discuss alternative ointments or even get a referral for a dermatologist review.

But my main point was that, at my Surgery and probably across Bucks, there has been deep reviews of repeat medications in an attempt to reduce waste. I understand our CCG has required this and I think I've seen something from NICE requiring CCGs and GP Practices to do this. Although there is an inconvenience to us patients in the sometimes erroneous consequence, I suspect this is overall a good and necessary practice. It's very easy to just demand a repeat of all the items on repeat, even if you don't need all of these. I know of 2 cousins, my age group, living on their own and each with a whole kitchen cupboard given over to their stockpiles of medications; they're only mildly embarrassed by their hoarding and certainly not likely to alter their ways.

I think my surgery must be immune from such requirements - they do indeed review medication annually but never remove anything! Glucogel remained on my repeat for years after I stopped ordering it, as did my old Autopens, and Digoxin even though a cardiologist had directed it be discontinued. I suppose I should have pointed it out at the time but obviously I never ticked the boxes for those items so no harm done. Eventually told the GP at my diabetes review last year.

But I really can't understand people who order things they don't need - it's hardly rocket science to tick the right boxes, surely?

 

[helli]

After have a polite but firm discussion with my surgery, they will not be removing my insulin from my prescription again!
But agree about the waste from people who build up stashes. My FIL always offers me Aspirin from his cupboard full of unused prescription meds.

 

[rayray119]

Well, in this case your original 'really' was correct.

I hadn't requested the ointment for a long time because I still had some left and the original problem had almost disappeared; then it seemed to have returned with a vengeance and I couldn't get a GP appointment to discuss alternative ointments or even get a referral for a dermatologist review.

But my main point was that, at my Surgery and probably across Bucks, there has been deep reviews of repeat medications in an attempt to reduce waste. I understand our CCG has required this and I think I've seen something from NICE requiring CCGs and GP Practices to do this. Although there is an inconvenience to us patients in the sometimes erroneous consequence, I suspect this is overall a good and necessary practice. It's very easy to just demand a repeat of all the items on repeat, even if you don't need all of these. I know of 2 cousins, my age group, living on their own and each with a whole kitchen cupboard given over to their stockpiles of medications; they're only mildly embarrassed by their hoarding and certainly not likely to alter their ways.

oh sorry i only seem to have red haflf of post without relsiing i thought you were talking about test strips