Worrying Facebook Post

Oldvatr

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why should you apply this? They all use whole blood for testing but they should all now report the results with plasma calibration, It was relevant some years ago, when there was still a mix in the UK with some meters reporting whole blood values and others plasma. This is what I wrote in my blog at the time
"In the UK, the manufacturers have been changing over the years and now according to DUK they all use plasma except for for those made by of of the largest manufacturers Roche ie Accu chek meters. DUK says that ‘ Roche is in the process of adjusting their meters to give results as plasma values, which they hope will be completed before the end of 2009"
Accuchek were, as said the last to change, they didn't change the meter, they changed the strips.(as stated at the end of 2009)
I note though that one of the criteria in the report was that they provided 'plasma calibrated readings' so perhaps some of the newer meters from smaller manufacturers don't have this calibration.
If your meter is by chance whole blood calibrated then you shouldn't be subtracting 12% you should be adding it. The figures used for hypo when I was diagnosed(in France so in mg/dl)) were for a whole blood calibrated meter and were lower than what my doctor would use today
View attachment 21579
I agree with your analysis, but it is the opposite of what I said, I know how to convert, thank you. The problem is that the figures given by NICE and DVLA still seem to be for the days of whole blood. so taking my example from the other night, my NEO (whole blood) measured 4,1, my SD Codefree (plasma) read 5,7, and my new CareSense (also plasma) read 5,6. So which is closest to the 3,9 quoted for hypo?

Consistently my NEO ties in with my physical symptoms of hypo, but I have had readings above 6 from my Codefree. But it is within the 15% allowed by ISO so is technically reading accurately but giving me a bum note. The Codefree says I can drive, my NEO says I am close to hypo, and shortly after my body proved it. So, should I multiply the data given by Daisy1 by 12%, or divide my plasma readings by 12% each time I measure? I think that the data given to us should be changed so all users of the new plasma meters can relate their measurements to the ranges without having to convert every time, That is my stance unless someone can convince me otherwise.

It is one thing changing meters from one standard to another, but the target information must also change to agree. Abbot meters are not changing, and My NEO from Sept 2016 is definitely whole blood. My XCEED was also wholeblood (2015).
 
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phoenix

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Don't know about your 'NEO' as don't recognise it but the xceed was plasma calibrated long before some of the others http://www.diabetes-support.org.uk/info/?page_id=151 it would seem strange to 'revert'.and the evaluation that you referred to says that it is plasma calibrated .http://www.elmmb.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=55225. p 18
I really think that this is now a non issue (back then there were yellow card warnings and worries about the 2 systems being used simultaneously; just as there were worries about the ability to freely change from mg/dl to mmol/l which caused some people problems. Neither of these occur now)
At that time I was using a non plasma calibrated meter whilst others were using more recent plasma calibrated ones. But in the end it really wasn't a big deal as accepted meter standards of accuracy were not very high (had to be within 20% over 5.5mmol) The new ISO standards are a little better but reliability still varies and is to a certain extent user dependent.
I would suggest that you stick with one meter rather than comparing results between them

My take on hypo figures is that people use rounded figures, 4mmol/l in the UK and 70mg/dl in the US. This is not really hypo, it is a reading that should allow the insulin user time to take remedial action. As I said, my 'figure' has changed, it was 65mg/dl with the old meter at diagnosis ( an eat something rather than panic mode, my doc only used to circle 60 and below on my logbook) it's now 70mg/dl so it has 'risen' with the change in calibration. ( Dafne appears to say to eat a small amount of carb at 3.5-4mmol/l and to treat at below 3.5mmol/l which would be in accordance with my HCPs advice (but that is for me not you!) http://www.dafne.uk.com/uploads/224/documents/Myths and Misconceptions.pdf)
 
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Shiba Park

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I bought a MyLife Pura the other day for £5 mainly for the test trips that came with it. Not relevant may be but just saying.
Well you were robbed then! I got mine for free from my local pharmacy... A nice little meter that gave the same results as my Accu-chek. I really liked mine, I don't know why my GP wouldn't prescribe strips for it.
 

No1DeadlyPoison

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My dad told me about this, I think he heard it on the radio. If this actually happens A LOT of people with diabetes will stop doing there blood glucose levels and probably ending up in hospital (I know I will, I can't afford that, like most people) which in the long run will cost hospitals more! It is ridiculous and disgraceful!
 

phoenix

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My dad told me about this, I think he heard it on the radio. If this actually happens A LOT of people with diabetes will stop doing there blood glucose levels and probably ending up in hospital (I know I will, I can't afford that, like most people) which in the long run will cost hospitals more! It is ridiculous and disgraceful!
The facebook misinformation is to do with new regulations in Australia for people not on insulin so will have no effect on you.

( the withdrawal of subsidies for these strips in Australia has been flagged up for a couple of years. There are now very few places (any?) left where strips are freely prescribed to people not using insulin. Whether this type of blanket restriction is a good thing is another matter)
 

tim2000s

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Okay guys, let me make one thing completely clear here. I've been and read a bunch of the CCG reports relating to this on-line. According to the current information:

In the UK, T1s (and as far as I can tell, anyone on Insulin or other BG lowering drugs) are not going to be getting their test strips reduced.

All the CCG reports (even the ones updated in October 2016) quote the NICE guidance in relation to Self-Monitoring of Blood Glucose in relation to this and state that they will continue to be provided. To be honest, without having some form of insurance cover, which in the UK we don't have, anyone in the "government" suggesting life risking changes in healthcare leaves the "government" open to legal action, which I imagine Diabetes UK and JDRF UK would be quick to engage in.

The GMMMG report referred to by @Oldvatr is purely an exercise in reducing the costs of accurate "Blood Glucose Test Systems" (BGTS) as stated in the Background section of the document:
Accuracy.JPG

It's basically looking at getting the costs down safely.

Below are the aims of the report, taken directly from it:

Aims.JPG


This is about moving to reduced cost, safe systems, with the hope that the better known manufacturers will follow suit on pricing, no doubt.
 
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No1DeadlyPoison

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The facebook misinformation is to do with new regulations in Australia for people not on insulin so will have no effect on you.

( the withdrawal of subsidies for these strips in Australia has been flagged up for a couple of years. There are now very few places (any?) left where strips are freely prescribed to people not using insulin. Whether this type of blanket restriction is a good thing is another matter)
It is still pretty disgraceful, even if you aren't on insulin but medicated by tablets and such you still should really be able to test your bloods.
 

Oldvatr

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Okay guys, let me make one thing completely clear here. I've been and read a bunch of the CCG reports relating to this on-line. According to the current information:

In the UK, T1s (and as far as I can tell, anyone on Insulin or other BG lowering drugs) are not going to be getting their test strips reduced.

All the CCG reports (even the ones updated in October 2016) quote the NICE guidance in relation to Self-Monitoring of Blood Glucose in relation to this and state that they will continue to be provided. To be honest, without having some form of insurance cover, which in the UK we don't have, anyone in the "government" suggesting life risking changes in healthcare leaves the "government" open to legal action, which I imagine Diabetes UK and JDRF UK would be quick to engage in.

The GMMMG report referred to by @Oldvatr is purely an exercise in reducing the costs of accurate "Blood Glucose Test Systems" (BGTS) as stated in the Background section of the document:
View attachment 21585
It's basically looking at getting the costs down safely.

Below are the aims of the report, taken directly from it:

View attachment 21584

This is about moving to reduced cost, safe systems, with the hope that the better known manufacturers will follow suit on pricing, no doubt.
I agree, The question of reducing or stopping strips was one you raised, but I never said that was the issue. The thing is that the cost of strips is being used in the UK as a yardstick to persuade us users to select a different meter entirely, just based on cost, and that many reading this may be asked to consider selecting from a shortlist, just as I am being told to do, For me as a T2D not on insulin, the choice is stark - select one or be damned, and thus cease to be supported in my SMBG. This is NOT applicable to an insulin dependant for obvious reasons, but may require negotiations if seeking to retain a non approved meter system. That is how I read the updated CCG agenda.
 

tim2000s

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I agree, The question of reducing or stopping strips was one you raised, but I never said that was the issue. The thing is that the cost of strips is being used in the UK as a yardstick to persuade us users to select a different meter entirely, just based on cost, and that many reading this may be asked to consider selecting from a shortlist, just as I am being told to do,
This was the statement at the start of the entire topic @Oldvatr, not one that I raised. That's what has driven the concerns of people on this thread.

This is NOT applicable to an insulin dependant for obvious reasons, but may require negotiations if seeking to retain a non approved meter system. That is how I read the updated CCG agenda.
As it happens, I agree with this point. Reading all the CCG minutes suggests that you can keep non-standardised meters as long as they can be justified. Included as justification is:
  • Use of a Bolus calculator after doing DAFNE
  • Meters that work specifically with pumps
 

Oldvatr

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Don't know about your 'NEO' as don't recognise it but the xceed was plasma calibrated long before some of the others http://www.diabetes-support.org.uk/info/?page_id=151 it would seem strange to 'revert'.and the evaluation that you referred to says that it is plasma calibrated .http://www.elmmb.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=55225. p 18
I really think that this is now a non issue (back then there were yellow card warnings and worries about the 2 systems being used simultaneously; just as there were worries about the ability to freely change from mg/dl to mmol/l which caused some people problems. Neither of these occur now)
At that time I was using a non plasma calibrated meter whilst others were using more recent plasma calibrated ones. But in the end it really wasn't a big deal as accepted meter standards of accuracy were not very high (had to be within 20% over 5.5mmol) The new ISO standards are a little better but reliability still varies and is to a certain extent user dependent.
I would suggest that you stick with one meter rather than comparing results between them

My take on hypo figures is that people use rounded figures, 4mmol/l in the UK and 70mg/dl in the US. This is not really hypo, it is a reading that should allow the insulin user time to take remedial action. As I said, my 'figure' has changed, it was 65mg/dl with the old meter at diagnosis ( an eat something rather than panic mode, my doc only used to circle 60 and below on my logbook) it's now 70mg/dl so it has 'risen' with the change in calibration. ( Dafne appears to say to eat a small amount of carb at 3.5-4mmol/l and to treat at below 3.5mmol/l which would be in accordance with my HCPs advice (but that is for me not you!) http://www.dafne.uk.com/uploads/224/documents/Myths and Misconceptions.pdf)
If you read further down the GMMG report, you will see that Abbott were unable to provide independant evidence to the GMMB, and were eliminated. None of their meters made the shortlist that my CCG used for selection.

As a matter of interest, what would your DAPHNE training advise me to do if both my plasma meters are reading above 4.7 mmol/l, and I have had to dump my trusty NEO, and I feel ******?

This is where I was last night. My new Caresense meter was telling me I was perfectly able and 'legal' to drive, my Codefree said I was marginal and needed some carbs, but as it turned out my NEO read 3.1 mmol/l and screamed Feed Me Seymour. Which meter is right? Who should I believe? All three meters are working within the ISO limits, so apart from the extra 12% caused by the difference between plasma and whole blood, then this is a potentially serious situation if I had decided to drive.
 
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Deleted member 308541

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I will be testing the new strip conditions on Thurs when I ask for 100 strips, I put my 6 month approval form in after xmas.

I wonder how much they will be now as they were $1.60 for a 100 Performa strips, but I was getting them free as I hit the safety net in August 2016 so not sure of the price now.
I am in Australia and not part of the NDSS, so I am paying $50 for 100 test strips. Yeah it's tough. And unfair.

I wa s charged only $1.30 for 100 Accu Chek Performa test strip thiss morning.

Join the NDSS for free and you will get subsidised strips so it's not unfair.

FnCBpVd.jpg
 

Indy51

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@Tipetoo - that only applies to you because you're a new member of NDSS. I've been a member since diagnosis, but my entitlement to strips expired officially on 31 December. When that happened, I was given a special form by the pharmacist that needs the signature of a GP, endocrinologist, diabetes educator or nurse practitioenr to say that I still require scripts for a specific reason - the choices are: intercurrent illness; medication affecting BG; clinical need for self-monitoring; diabetes management changes; diabetes management not stable. Since I don't have a valid reason, I doubt very much my GP would sign it. And I'd have to get a new form signed every 6 months.

I've currently got a reasonable supply on hand (I'll admit, I stockpiled when the changes were announced a year ago) but once that runs out, I'll have to consider my options and whether I really want/need to keep testing as often as I do. It's not strictly necessary, more like a security blanket nowadays :D
 

kesun

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What exactly is the situation for type I diabetics in the United Kingdom? Are there changes afoot? What are the facts? I'm confused now!
At my GP T1s were all moved to a different meter, but we still get 100 strips a month. I escaped the meter change because my weird mitochondrial diabetes was put down as T2 in their computer system though treated as T1 in practice. Bureaucracy moves in mysterious ways.

Kate
 
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Deleted member 308541

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@Tipetoo - that only applies to you because you're a new member of NDSS. I've been a member since diagnosis, but my entitlement to strips expired officially on 31 December
I have been a member of NDSS since I was diagnosed T2 in March 2014, and my entitlement to subsidised strips expired in December as well.

I download the application form for the strips, and my GP signed it stating ongoing medical conditions and I needed strips. If he did not sign the Diabetic Educator told me she would sign it if my GP did not.

So get your form signed Indy, and hand it in to your pharmacy.

Bookmark the strip application form link I have posted above and it's good to go till they change the system. :D

Edit: Clarity.
 
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