Some good T1 news on world diabetes day

therower

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Crikey a news article aimed solely at Type 1 diabetes. That’s a turning point in itself.:)
 

Prem51

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It's good news if it actually means more T1s get the monitors. But there isn't any mention of additional funding to pay for the monitors, so it will still be up to local commissioning groups as to how they prioritise availability.
 

tim2000s

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From what I understand, this doesn't mean Libre for all types 1s. It means that NHS England has taken the decision to override local CCGs, aiming mainly at those who have stated that Libre will not be available, and apply the Regional Medicines Optimisation Committee (RMOC) criteria across all CCGs in England and Wales.

This means that if your local area was already offering under RMOC, then you'll still have the same criteria. If it was more restricted than RMOC, then it will widen access, and if you are less restricted than RMOC, we're not sure.

For what it's worth, the RMOC criteria are:

It is recommended that Freestyle Libre® should only be used for people with Type 1 diabetes, aged four and above, attending specialist Type 1 care using multiple daily injections or insulin pump therapy, who have been assessed by the specialist clinician and deemed to meet one or more of the following:

1. Patients who undertake intensive monitoring >8 times daily
2. Those who meet the current NICE criteria for insulin pump therapy (HbA1c >8.5% (69.4mmol/mol) or disabling hypoglycemia as described in NICE TA151) where a successful trial of FreeStyle Libre® may avoid the need for pump therapy.
3. Those who have recently developed impaired awareness of hypoglycaemia. It is noted that for persistent hypoglycaemia unawareness, NICE recommend continuous glucose monitoring with alarms and Freestyle Libre does currently not have that function.
4. Frequent admissions (>2 per year) with DKA or hypoglycaemia.
5. Those who require third parties to carry out monitoring and where conventional blood testing is not possible.

In addition, all patients (or carers) must be willing to undertake training in the use of Freestyle Libre® and commit to ongoing regular follow-up and monitoring (including remote follow-up where this is offered). Adjunct blood testing strips should be prescribed according to locally agreed best value guidelines with an expectation that demand/frequency of supply will be reduced.
 
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kev-w

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From what I understand, this doesn't mean Libre for all types 1s. It means that NHS England has taken the decision to override local CCGs, aiming mainly at those who have stated that Libre will not be available, and apply the Regional Medicines Optimisation Committee (RMOC) criteria across all CCGs in England and Wales.

This means that if your local area was already offering under RMOC, then you'll still have the same criteria. If it was more restricted than RMOC, then it will widen access, and if you are less restricted than RMOC, we're not sure.

'glucose monitors will be made available to tens of thousands more people with type 1 diabetes' can only be good news surely :) the RMOC guidelines alone do allow some leeway for individual negotiation in my opinion, depends on how you want to play out a recent loss of some hypo awareness ;)
 
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Knikki

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This was on the TV as well this morning had a chap on saying how good it was with a prefect Libre graph in the red all night and up to 13.7 on the program, guess the excitement or stress of the TV didn't help.

Mind you in the report the telling sentence "to those that meet the criteria...." so people may still have to jump through hoops to get one, especially if the CCG's are against it, only time will tell
 

tim2000s

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Mind you in the report the telling sentence "to those that meet the criteria...." so people may still have to jump through hoops to get one, especially if the CCG's are against it, only time will tell
The press release states "according to national criteria". Those are posted above. So there is clear guidance as to who can get it. And the process for getting it.
 
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kev-w

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It is recommended that Freestyle Libre® should only be used for people with Type 1 diabetes, aged four and above, attending specialist Type 1 care using multiple daily injections or insulin pump therapy, who have been assessed by the specialist clinician and deemed to meet one or more of the following:

1. Patients who undertake intensive monitoring >8 times daily

Right there is the way in, right there, test more and if you're testing 8 times a day then you meet the criteria, don't take no for an answer....

I'll have to edit that to say and if you're not testing around 8 x daily with finger sticks, why aren't you? more testing = better control, which is after all the point in the Libre....
 
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Type 1 diabetes in the news, well that's a nice surprise, I would think most people will be googling it now.
I wont hold my breath as I was told in July I would be eligible to get CGM, then at my diabetes hospital appointment, 6 weeks later, It was .................... no, I didn't meet the criteria, so it's a wait and see.
 

tim2000s

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Type 1 diabetes in the news, well that's a nice surprise, I would think most people will be googling it now.
I wont hold my breath as I was told in July I would be eligible to get CGM, then at my diabetes hospital appointment, 6 weeks later, It was .................... no, I didn't meet the criteria, so it's a wait and see.
CGM is different though.

1. It's not on tariff so is not available via prescription, only via an Individual Funding Request (which are few and far between and have strict NICE criteria).
2. Libre is available on prescription as long as you can qualify for only one of the above criteria.

So you are significantly more likely to get Libre than CGM, and you can sway that decision in your own favour by testing more.
 

kev-w

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So you are significantly more likely to get Libre than CGM, and you can sway that decision in your own favour by testing more.

I just came back to edit my post about this and to ask why people wouldn't be testing this much anyway? The more we test the better our ability to manage the illness after all, I know it's a pita but I was testing 8 x + a day for as many years as I'd access to finger sticks :)
 

quintel

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Right there is the way in, right there, test more and if you're testing 8 times a day then you meet the criteria, don't take no for an answer....

I'll have to edit that to say and if you're not testing around 8 x daily with finger sticks, why aren't you? more testing = better control, which is after all the point in the Libre....

I’d love to test that much in a day, but I’m not able and I desperately want the libre because I’m not able to test that often so have no idea of my blood. I have 7 month old twins and since they were born my bloods have gone downhill because these two are so hard to manage and my levels are suffering , but I’m not allowed the libre I’ve been told

If only it were as simple to just test more
 

tim2000s

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I’d love to test that much in a day, but I’m not able and I desperately want the libre because I’m not able to test that often so have no idea of my blood. I have 7 month old twins and since they were born my bloods have gone downhill because these two are so hard to manage and my levels are suffering , but I’m not allowed the libre I’ve been told

If only it were as simple to just test more
You weren't allowed the Libre. As of today, the rules have just changed.
 

squeezelouise400

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This has made my day. It would be good to see where my blood sugars are trending. Hope to be a recipient of a Freestyle Libre one day.
 

kev-w

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@tim2000s A T1 self funders question, how would they go about asking for the device on prescription would you know?
 

tim2000s

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@tim2000s A T1 self funders question, how would they go about asking for the device on prescription would you know?
Historically, the London guidelines suggested looking back at historic fingerprick data.

Right now I'd just show how frequently you scan and ask directly. They can only say no. If they do, then do more than 8 fingerpricks a day for a while.
 
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