Suggested new insulin’s after 19 years...

tim2000s

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Tim, just wanted to let you know I left a hospital without being trained with a new pump. I then legged it up the road and got trained January 2nd.
As I said.... In most cases.... ;)
 

Scott-C

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The real cost difference comes in the transmitter which you need for the dexcom, which is ~ £200 every 120 days or so, although I believe those using xDrip+ on Android have been able to get longer out of them.

They sure have got longer with xdrip+!

It was the cost of replacing the transmitters which kinda put me off dexcom, but there's an interesting thread from some tech geeks at the link below getting 180 to 190 days out of G5 transmitters by running it to xdrip+ instead of the official dexcom app.

Looks like the g5 transmitter carries on transmitting quite happily after the "official" period runs out: it's the "official" g5 app which is coded to just ignore it. Whereas xdrip+ just says, no, happy to continue receiving till the battery run outs.

Interesting program, xdrip+.

https://forum.fudiabetes.org/t/how-...w-transmitter-update-2nd-transmitter/1307/131

Of course, us blucon people just need to change the cheap cr2032 battery every 2 or 3 weeks to get a few years out of our pretty little transmitters.....
 

CDM9

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Thank you. I’ve just had a call to say I’ve been put forward for the libre trial and it’s been agreed ;) so I’ll keep all
posted.

Re Tresiba went to bed at 7.1 awoke at 2.30am at 12.7 had a correction dose of 2 woke up at 8.2 so may need increasing slightly.
 
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Levy

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Thank you. I’ve just had a call to say I’ve been put forward for the libre trial and it’s been agreed ;) so I’ll keep all
posted.

Re Tresiba went to bed at 7.1 awoke at 2.30am at 12.7 had a correction dose of 2 woke up at 8.2 so may need increasing slightly.

I've also just been put on Tresiba (I was on 2x Levemir). It was quite a strange appointment. He was gushing about how impressed he was with my control since I started using the Libre, then in the same sentence went "I'm going to put you on a new insulin!"

Hoping it works out for me as with Levemir I was taking a much smaller dose at night than during the day, but he assured me it wouldn't be a problem with Tresiba. Guess I'll find out!
 

scotteric

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Hoping it works out for me as with Levemir I was taking a much smaller dose at night than during the day, but he assured me it wouldn't be a problem with Tresiba.

It seems to be an insulin that works exceptionally well for some people and is absolute **** for others. I was very excited when it came to Canada as I've read comments from people who wax completely evangelical about it. My endo suggested it as well when I told him I was trying MDI with Levemir. I tried it a few times and could not get it to work as intended. It was way too strong at night and then would wear off as the day went on. I tried taking it in the morning and then had noticeable DP, presumably because it was wearing off at night when I did that. I hope you are in the category of people that it works wonders for!
 
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scotteric

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In most cases, NHS hospital selection of pumps is down to two or three major factors. Cost is only one of those. The others are reliability (which is why very few trusts offer either Cellnovo or Omnipod) and staff training (due to the NHS H&S requirements you must be trained on a pump before it leaves the hospital with you these days).



I've done a large amount of observation of Fiasp on myself. It's all documented here: http://www.diabettech.com/fiasp

Whilst most people don't require any changes in dose on Fiasp, a significant minority of people have suffered issues with it and in discussions with various HCPs that I've had I've learned that a significant proportion of those that have been put on it by hospital clinics have since come off due to issues with consistency of action. It's turned out to not be the panacea everyone thought for a significant minority.

My brother and dad are both type 1s as well. We are all pumpers, all tried Fiasp and all of us went back to Humalog or NovoRapid after a short while. It's too bad!
 

donnellysdogs

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My thoughts are:

You may fall in to a normal hba1c but still suffering hypers and hypo's.

My own hba1c falls in to normal... but because I could prove that it was so **** hard to manage on mdi (and other illnesses too though) that I could get funding for a CGM. My hba1c is supposedly in the top 5% of patients at our hospital but showing my books of daily records has enabled funding to be granted.

Now for me, a pump is out of the question duye to my body, but I did have one previously as I could prove my problems from my records.

Here's a photo of the stacks of A4 books that I have for past 6 months detailing everything... and these are given to hospital and CCG to prove I need help...on top are my previous sheets of paper that I used to use...

84eeda091d1773142aabb6258bda471d.jpg


What records do you pass over to your dsn/consultant as proof?
 
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Scott-C

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Also any thoughts re libre V Dexcom If I end up going self funded?

Hi, @CDM9 , @EllsKBells kindly tagged me in re the blucon thingy, so thought I'd chip in a bit on that.

Libre is pretty damned good on it's own but the factory calibration can often be a bit sketchy and there's no alerts. Even so, you'll still learn bucket loads from being able to see a more or less live 8 hour graph compared to the tiny snapshots strips alone give.

If you're not having major hypo issues, libre is probably good enough. Even without alerts, it is still very good for keeping in range: daytime, you get a heads up on drops well in advance provided you scan regularly; nightime, you can check each morning how basal worked out and adjust if necessary.

There's an admirable simplicity about it. There's been many old school posters of the, "nah, strips are good enough for me" variety who have been won over by the insights it gives.

It also teaches some very good lessons about calibration. Dexcom is manually calibrated a couple of times a day - do a bg test when stable, enter that reading into dexcom to tell it when it gets a raw number x from the sensor, it means y as a bg level. Libre is factory calibrated to avoid that, but, well, how do I say this diplomatically without getting sued by Abbott, it's sometimes a bit sketchy. So you learn by a bit of testing to sort of calibrate in your head, so that when libre says x, it actually means x +/- a bit.

Learning to do that in your head is like learning to do arithmetic on paper instead of using a calculator. It makes calibrating proper cgm like dexcom much more effective.

These tools are good, but worthless if not properly calibrated against blood. They're not plug-and-play. If you calibrate at the wrong times, e.g. when levels are rapidly changing, or too often, they become increasingly inaccurate.

I was delighted with libre but I hankered for alerts (although to be honest, I'm fed up with them now!). I didn't like the start up costs of dexcom, the attachment method, the size of it, the replacement transmitter costs.

Turned out there's a small company www.ambrosiasys.com set up by an ex-Abbot employee which makes a small reusable transmitter, blucon, which sits on top of libre sensor, reads every 5 mins and sends to a phone app.

Their inhouse app, linkblucon, ain't that great, but an open source app, xDrip+, was tweaked in September 2017 to take blucon data.

xDrip+ was originally called dexdrip: dexcom users felt the official app was lacking, so they wrote a better one, and it evolved into xDrip+. Many dexcom users prefer it to the official app. It has pedigree. Being open source and free, they have introduced some very sophisticated features which dexcom would have trouble getting FDA approval for.

Now that it has been tweaked to take data from blucon, it turns libre into full on cgm which, in my view, is as accurate as dexcom - calibrating xdrip+ makes it so. And alerts. For £100 for the blucon transmitter which is warranted for a year but will likely last way longer as it's just a bit of electronics. Only downside is it's not waterproof so needs to be taken off for showers, but no big deal.

I started a thread about it here which gives more details:
https://www.diabetes.co.uk/forum/threads/getting-hypo-alerts-with-libre-blucon-and-xdrip.127195/

CGM changes your mindset: make small adjustments on the fly; don't leave correction doses till meals - you can see situations starting to develop so take small steps proactively to head them off before they get messy. You can gently steer direction, instead of taking a sledgehammer to it after going out of range.

There's a couple of good books which explain the difference in approach, both on kindle: Sugar Surfing, by Stephen Ponder, and Beyond Fingersticks by William Lee Dubois.

Have fun, cgm of any type makes this unpredictable game much easier!
 

22nw22

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@CDM9 . It's Fiasp. I can't really offer anything on tresiba or fiasp. I get on fine with lantus and novorapid.
I'll tag @tim2000s as I believe he may have some useful information regarding Fiasp.
As for dexcom v libre. I can only comment on dexcom ( G4 ) which I've been using for 3 months. Initial outlay was pricey but well worth it. I find it extremely accurate, have managed to get an average of 20 days plus out of the sensors.
Customer service appears very good and I can't fault anything with dexcom as of yet.

I know about Tresiba, i am on it. It was helping, but I still get problems with my sugar level
 
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KK123

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I know not everybody can cope or manage with these pumps etc, but you would think in 2018 that everybody being diagnosed with insulin dependent diabetes would automatically start off on one of these instead of this archaic MDI regime. Those that don't get on with it or who are deemed unsuitable can then go on to MDI, not the other way round. The latest technology is available and it can be a life changer, but no, noone really seems to care about the general well being or quality of life of a person with diabetes so they can mostly soldier on with a regime from 20 plus years ago.
 
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hollypooh1

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Type of diabetes
Type 1
Hi all.

19 years as a type 1. No hospital admissions, control generally been good-fair but last few years lots of random highs and lows and no clear patterns on accu chek mobile graphs.

Today I went for my 12 month appointment at the hospital. My HbA1c was 56 which the consultant thinks is okay but it needs to be much lower in my opinion below 50 and after 19 years I have had no complications until very recently my eye test came back maculopathy from previous background results. Blood pressure is fine so it’s my erratic readings that although produce a semi ‘ok’ hba1c, in reality the highs have caused me some health issues.

So after a bit of a discussion and my persuasion to try and get a libre and really get more of an idea on my glucose readings , he has put me forward for the libre although I’ve been told it’s unlikely I’ll make criteria so I may have to just buy one - either that or Dexcom 5... I’m still researching..

He has told me that he thinks a change in both of my insulins would make a difference.. hmmm.

So he wants me to trial Tresiba ( over my current lantus ) and Masp or hasp of Fiasp?! fast acting insulin over novo rapid( I can’t read his writing ). The change from novo rapid seems to be a push on all patients in Leeds to this new one which is apparently not even available in pharmacy’s for the next 2 weeks. I’ll give them a whirl and see ( I don’t want a pump ). Bit dubious about the real rationale for change ...

Anyway - anyone tried a) Tresiba - bolus b) masp or hasp?! - fast acting

Do the doses differ from lantus or novo rapid? He’s told me to start with same dose...

Also any thoughts re libre V Dexcom If I end up going self funded?

Thanks all
Hi, l`ve just moved (3 weeks ago) from Levemir twice a day to Toujeo BI once a day, great results !!! and Fiasp fast acting this week, again great results, l feel its good to change over periodicly, onwards and upwards, not literaly
 

kitedoc

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51 years on insulin in Oz.
It sounds like you need to talk with your doctor about what his reasons are for says your current HBA1C is OK.
For example there is a possibility if you bring your HBA1C lower that you will get more hypo's, and hypos are more immediately damaging to you than hypers.
If maybe that he has read research showing that tight control of BSLS in first 10 years of TID is most crucial and that after wards the general BSL control is not as crucial.
I also know from my experience of 51 years on insulin that it does get more difficult to control blood sugars the longer you are on insulin. So your doctor might be suggesting new insulins to see if they will provide some better control and perhaps reduce the risk of hypos. Please do not always think that he has run out of ideas.
For me at the 45 years on insulin mark, I was on 6 to 8 injections of Novorapid ( 4 to 6 inj) and Levemir (usually 2 inj) and still having problems with night hypos ( the most dangerous time for hypos !!). I would have given my eye teeth to have had Fiasp to try. Tresiba, maybe, maybe not. The Levemir gave me flexibility to alter doses 12 hourly, that was a bonus to me.
By changing to a pump at that 45 year mark I have been able to stop night hypo's and live a quieter and better life.
 
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jedwards 2

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3
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Type 1
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Insulin
33 years w/ T1. I got a Libre two months ago. Results told us that Humalog was often taking 2.5-3 hours to start bringing my sugars down after a small meal. I'm on week three of Fiasp, and so far, same dose, much better results. Typical 20-30 minutes before sugars level out.
 
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