Are We Seeing the Beginning of the End?

Listlad

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A few weeks ago I discovered a work colleague of mine has T1 diabetes. He explained he had that condition for a number of years. And that he had changed medication a number of times. I didn’t understand his predicament but for him it was something he hadn’t yet resolved. He also explained that he had quite severe neuropathy, something I could identify with as I had experienced it at lower levels.

Then he told me that he was so tired of finger prick testing. I then asked him if he had heard of the Freestyle Libre and he said no. I explained to him what it was, did and how it was fitted. In the light of what he previously had said he could see a benefit there and as coincidence would have it, he had an appointment that afternoon with his GP. I suggested he ask about one. I did give him a printout of the NHS directive on the issuing of the Freestyle Libre but that was the following day.

The following day he read the printout and could see for himself the point I was making but he told me that his GP had told him at their appointment the day before, that he would look into it for him. No more than that.

This person lives in the Fylde region too, but his surgery is adjacent to mine and adjacent to @Debandez ’s surgery. I haven’t spoken to him for a few weeks as he hasn’t been into work, so I don’t know the outcome but it didn’t sound promising.

I gave him the Diabetes.co.uk address as ironically he was a member of the other diabetes body. I explained that there might well be people on the Diabetes.co.uk forum that might help him with his medication issues.


Beginning of the End?
So, on the topic of the Freestyle Libre, though on a slightly different note, it has been said that now the Libre is on the scene, that the opportunity for medical practioners to deny the benefits of LCHF solutions to their T2 patients will become much more difficult. This seems to make a lot of sense. If so, is this the beginning of the end of such occurrences?
 
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Diakat

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A consultant needs to sign off on the Libre, his GP cannot do this for him. There are also individual CCG guidelines that affect Libre prescription.
Not sure how Libre affects LCHF?
 

zand

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Well if a patient has a CGM and LCHF helps them control their BGs better then the CGM can prove that LCHF works. It's hard to deny it works when the hour by hour readings are there in front of you.
 

MeiChanski

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A few weeks ago I discovered a work colleague of mine has T1 diabetes. He explained he had that condition for a number of years. And that he had changed medication a number of times. I didn’t understand his predicament but for him it was something he hadn’t yet resolved. He also explained that he had quite severe neuropathy, something I could identify with as I had experienced it at lower levels.

Then he told me that he was so tired of finger prick testing. I then asked him if he had heard of the Freestyle Libre and he said no. I explained to him what it was, did and how it was fitted. In the light of what he previously had said he could see a benefit there and as coincidence would have it, he had an appointment that afternoon with his GP. I suggested he ask about one. I did give him a printout of the NHS directive on the issuing of the Freestyle Libre but that was the following day.

The following day he read the printout and could see for himself the point I was making but he told me that his GP had told him at their appointment the day before, that he would look into it for him. No more than that.

This person lives in the Fylde region too, but his surgery is adjacent to mine and adjacent to @Debandez ’s surgery. I haven’t spoken to him for a few weeks as he hasn’t been into work, so I don’t know the outcome but it didn’t sound promising.

I gave him the Diabetes.co.uk address as ironically he was a member of the other diabetes body. I explained that there might well be people on the Diabetes.co.uk forum that might help him with his medication issues.

So, on the topic of the Freestyle Libre. It has been said that now the Libre is on the scene, that the opportunity for medical practioners to deny the benefits of LCHF solutions to their patients will become much more difficult. This seems to make a lot of sense. If so, is this the beginning of the end of such occurrences?
Hello, as @Diakat said, your friend needs to see his diabetes team at a hospital and ask his consultant. If he doesn't have a consultant, he'll need his GP to refer him asap. It sounds like he is having a number of troubles with diabetes, so he'll need more expert help other than his GP. Also I don't know if you told your friend about the NHS criteria for one, it's not as simple as seeing his consultant and walk out with one. Depending on his area, he might need to be educated as well for it.
 

Listlad

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Hello, as @Diakat said, your friend needs to see his diabetes team at a hospital and ask his consultant. If he doesn't have a consultant, he'll need his GP to refer him asap. It sounds like he is having a number of troubles with diabetes, so he'll need more expert help other than his GP. Also I don't know if you told your friend about the NHS criteria for one, it's not as simple as seeing his consultant and walk out with one. Depending on his area, he might need to be educated as well for it.
I couldn’t and didn’t even try to advise him on his T1 troubles except to suggest the Libre and that was mainly to help him reduce his finger pricking levels.

Okay so not as easily acquired as I had supposed.
 

Listlad

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Libre is currently available for some people with type 1. I think it is very rare for it to be prescribed by people with type 2. The only such people I have read of manage their condition with insulin.
As discussed many times on this forum, by current and past members, insulin is used to manage bg more often than low carb with type 1 diabetes. There are people with type 1 who eat bread, cake, fruit, below ground vegetables, pasta, etc and maintain good bg management. They use Libre to work out insulin dose and timing.
I don't see how this relates to the benefits of lchf diets.
My fault for combining two ends of the Libre spectrum in one thread. Well, 3 really.

Firstly it was to highlight my T1 colleagues plight and apparent difficulty getting a Libre through the NHS (certainly hadn’t been offered one).

Secondly to highlight that an adjacent regional surgery appeared to be behind when it comes to dishing them out.

Thirdly and perhaps the most significant part of the posting was to try and gauge opinion on the role of the Freestyle Libre in effectively preventing GPs from dissuading T2 patients that a low carb solution should not be used. It seems the end is nigh.
 
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MeiChanski

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I’m very sorry your type 1 friend is having difficulties. If you ever see him, please do let him know that his consultant can prescribe the diabetes tech.

I think it would be an interesting debate if one were to present their libre results to their doctor, has anyone been able to do that? Or been to meetings with GPs/nurses/dietitians to show them? My DSN was quite happy and supportive with type 1s doing whatever way of eating to help their glucose management and I wish type 2s got the same type of response or reaction.
 

Listlad

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I’m very sorry your type 1 friend is having difficulties. If you ever see him, please do let him know that his consultant can prescribe the diabetes tech.

I think it would be an interesting debate if one were to present their libre results to their doctor, has anyone been able to do that? Or been to meetings with GPs/nurses/dietitians to show them? My DSN was quite happy and supportive with type 1s doing whatever way of eating to help their glucose management and I wish type 2s got the same type of response or reaction.
Hi @MeiChanski

My understanding was that the ultimate aim was that ones doctor would be able to access the Libre results? Maybe that was a potential that has not yet been fulfilled?

But yes, even if they could not, imagine presenting a set of Libre results to ones GP after he or she came out with a load of nonsense?
 

MeiChanski

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Hi @MeiChanski

My understanding was that the ultimate aim was that ones doctor would be able to access the Libre results? Maybe that was a potential that has not yet been fulfilled?

But yes, even if they could not, imagine presenting a set of Libre results to ones GP after he or she came out with a load of nonsense?

From my understanding, to have access to libre results, the gp surgery in theory would have a code that patients type in on libreview to link their app/reader results to their computer. From the GP’s computer, all they do is click your name and it shows your results. Oh imagine that, imagine proving GPs wrong, oh that would definitely throw out their degrees and phds out of the window. But I would be interested to hear from other fellow type 2s if they have been able to present a case with their libre results to say LCHF/ keto works for most people.
 

Listlad

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Oh imagine that, imagine proving GPs wrong, oh that would definitely throw out their degrees and phds out of the window. But I would be interested to hear from other fellow type 2s if they have been able to present a case with their libre results to say LCHF/ keto works for most people.
Exactly.

It’s quite ironic as I have often been told that the Libre is not really much use to a Type 2 or a Prediabetic. But it would seem it might well be the opposite.
 

Listlad

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Well if a patient has a CGM and LCHF helps them control their BGs better then the CGM can prove that LCHF works. It's hard to deny it works when the hour by hour readings are there in front of you.
Exactly.
 
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DCUKMod

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In my neck of the woods, in the research centre, the Libre is used, a lot (although quite often blind) in research, with al Libre data uploaded, and viewable by the researchers, so links are there.

In many instances, the data is not available on a day to day basis to the participant, but is available, after the research/trial is completed. The reason data isn't available real-time is because participants could, for a multitude of reasons react the what they see, which could skew the research.

Even when made available, a goodly percentage of participants show no interest in their own intense information.
 

Shiba Park

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In my neck of the woods, in the research centre, the Libre is used, a lot (although quite often blind) in research, with al Libre data uploaded, and viewable by the researchers, so links are there.

In many instances, the data is not available on a day to day basis to the participant, but is available, after the research/trial is completed. The reason data isn't available real-time is because participants could, for a multitude of reasons react the what they see, which could skew the research.

Even when made available, a goodly percentage of participants show no interest in their own intense information.

Even when made available, a goodly percentage of participants show no interest in their own intense information.

Interesting; do you suppose that's because 'the moment has passed', because people simply have no interest or don't know how to use the data?

Shiba.
 

Listlad

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In my neck of the woods, in the research centre, the Libre is used, a lot (although quite often blind) in research, with al Libre data uploaded, and viewable by the researchers, so links are there.

In many instances, the data is not available on a day to day basis to the participant, but is available, after the research/trial is completed. The reason data isn't available real-time is because participants could, for a multitude of reasons react the what they see, which could skew the research.

Even when made available, a goodly percentage of participants show no interest in their own intense information.
Bought privately funded then the data would of course be available to the purchaser.
 

Debandez

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From my understanding, to have access to libre results, the gp surgery in theory would have a code that patients type in on libreview to link their app/reader results to their computer. From the GP’s computer, all they do is click your name and it shows your results. Oh imagine that, imagine proving GPs wrong, oh that would definitely throw out their degrees and phds out of the window. But I would be interested to hear from other fellow type 2s if they have been able to present a case with their libre results to say LCHF/ keto works for most people.

I'm currently wearing one for a 3 reasons. 1) I'm working with a couple of surgeries, I have my own clinic for pt to pt diabetes and weight loss support so I wanted to be able to demo blood glucose monitors and also the libre 2) to gain even tighter control and to see exactly how my body reacts during the day as often as I like. Better picture and boy does it work 3) to show my DN the results on my next appointment (nov)

I also give presentations. My latest one just this week at central west primary care network integration workshop which was attended by many drs and HCPs (around 100 attending) I spoke of my journey and reiterated how important my bg monitor was in getting into remission (and staying there). I was on This morning with holly Willoughby and philip Schofield the week before sharing my story but wasnt allowed to bring on my monitor sadly (or mention names like DCUK and diet doctor). I was able to sing the praises of low carb AND high healthy fat.

On dx I asked if I could have a monitor 'not necessary and testing can become obsessive' was the reply after I had been told my t2d was progressive and advised to eat starchy carbs for my energy. Omg they have it so wrong.

I'm self funding for libre. It's expensive but a great investment for me especially as I hope to do many presentations in the future. I have another one planned for November. I'm hoping to get some PR around it 'as seen on TV' :) I will be waving my monitor around as usual.

I see more and more stories in the news now about t2d not having to be the progressive disease it was thought to be. Almost daily in newspapers. Dr unwin is in the mail this week with a diabetes special. Just this week David Davies got blood sugars down by following a lchf woe.

They want to save money. They need to listen. They will have to listen as the evidence states them in the face. Just a matter of time imo.

Just to add, when I went to my gp and said' look at my hba1c with lchf, down from 62 to 39 in weeks, found solution on Google' he thrust his cup at me which said 'dont confuse your Google with my medical degree, you could have done same on low cal'. (He should be supporting pts that want to help themselves!). So as a member of the ppg I asked for stats on how many had done what I had. Apart from bariatric pts apparently I'm the only one!!! I still have the email.

For info:

https://mol.im/a/7488217
 

Listlad

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I'm currently wearing one for a 3 reasons. 1) I'm working with a couple of surgeries, I have my own clinic for pt to pt diabetes and weight loss support so I wanted to be able to demo blood glucose monitors and also the libre 2) to gain even tighter control and to see exactly how my body reacts during the day as often as I like. Better picture and boy does it work 3) to show my DN the results on my next appointment (nov)

I also give presentations. My latest one just this week at central west primary care network integration workshop which was attended by many drs and HCPs (around 100 attending) I spoke of my journey and reiterated how important my bg monitor was in getting into remission (and staying there). I was on This morning with holly Willoughby and philip Schofield the week before sharing my story but wasnt allowed to bring on my monitor sadly (or mention names like DCUK and diet doctor). I was able to sing the praises of low carb AND high healthy fat.

On dx I asked if I could have a monitor 'not necessary and testing can become obsessive' was the reply after I had been told my t2d was progressive and advised to eat starchy carbs for my energy. Omg they have it so wrong.

I'm self funding for libre. It's expensive but a great investment for me especially as I hope to do many presentations in the future. I have another one planned for November. I'm hoping to get some PR around it 'as seen on TV' :) I will be waving my monitor around as usual.

I see more and more stories in the news now about t2d not having to be the progressive disease it was thought to be. Almost daily in newspapers. Dr unwin is in the mail this week with a diabetes special. Just this week David Davies got blood sugars down by following a lchf woe.

They want to save money. They need to listen. They will have to listen as the evidence states them in the face. Just a matter of time imo.

Just to add, when I went to my gp and said' look at my hba1c with lchf, down from 62 to 39 in weeks, found solution on Google' he thrust his cup at me which said 'dont confuse your Google with my medical degree, you could have done same on low cal'. (He should be supporting pts that want to help themselves!). So as a member of the ppg I asked for stats on how many had done what I had. Apart from bariatric pts apparently I'm the only one!!! I still have the email.

For info:

https://mol.im/a/7488217
I think that armed with Libre data it will be perfectly possible to tell ones GP to put the Google Mug in a dark place.

I have pinged that link to the Daily Mail story to both surgeries here.
 
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NicoleC1971

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I couldn’t and didn’t even try to advise him on his T1 troubles except to suggest the Libre and that was mainly to help him reduce his finger pricking levels.

Okay so not as easily acquired as I had supposed.
On a practical note he could choose to self fund for 2 weeks (£58) to get his background insulin correct. You are very kind to think of solutions to his diabetic burn out! Currently only 20% of type 1s are budgeted to get the fsl and they want to ensure that anyone who does get it is clued up on carb counting and committed to reducing hypos and/or improving their ba1c so there are a number of hoops to jump through. Many consultants think fsl is a 'no brainer' for type 1s so I think once the choices and costs of cgms start to decline we will get more of them out there.
Re its' application for type 2s, I agree that it would be a great tool but in my low carb walking group for diabetics we cannot get a sympathetic GP to prescribe testing strips for those not on insulin/sulphonyureas without going against her CCG rules so it is going to take more low carbers on sites like this to keep banging that drum and curing themselves!
 
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DCUKMod

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Interesting; do you suppose that's because 'the moment has passed', because people simply have no interest or don't know how to use the data?

Shiba.

Shiba Park - I believe the reality is some are more interested and engaged in their health and the granular detail than others.

When research takes place, the researchers are rarely looking for those who are already turning every last stone to improve their health. They're more usually looking for those with specific issues, complications, or utilising a particular medication, plus other criteria.

As an example, I have been involved in various way at our local NIHR, biometric research centre and Diabates Cenre of Excellence for probably about 4 years now. To date, there has not been one research project I have qualified for, as a participant.

There may be a piece of work kicking off, looking at intermittent fasting, where they are looking for participants to commit to various forms of IF, but with no objectives of losing weight. They will be looking at various factors from Lire monitoring, activity and sleep monitoring, along with measuring (by urine) cortisol and melatonin, in line with the circadian rhythm. I might qualify for that.

For that piece, the Libre data will be blind, to prevent conscious or subconscious modifications to nutrtion, exercise, sleep behaviour etc.
 

Listlad

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On a practical note he could choose to self fund for 2 weeks (£58) to get his background insulin correct. You are very kind to think of solutions to his diabetic burn out! Currently only 20% of type 1s are budgeted to get the fsl and they want to ensure that anyone who does get it is clued up on carb counting and committed to reducing hypos and/or improving their ba1c so there are a number of hoops to jump through. Many consultants think fsl is a 'no brainer' for type 1s so I think once the choices and costs of cgms start to decline we will get more of them out there.
Re its' application for type 2s, I agree that it would be a great tool but in my low carb walking group for diabetics we cannot get a sympathetic GP to prescribe testing strips for those not on insulin/sulphonyureas without going against her CCG rules so it is going to take more low carbers on sites like this to keep banging that drum and curing themselves!
In his case I don’t think he would have the income to easily self fund. It’s a big ask on a low income.

But for those that can and for when they do get a bit cheaper for self funders then progress might well be made.