Abbot Libre

Am trying to find the new NICE guidelines re criteria for prescribing Libre - can anyone please give me the relevant link.
Thanks

I am not sure why you have started another thread about the Libre when they are many already on the forum.
The search function on the top right will help you find the 29 pages of threads on the topic.

But to clarify the points you have made ...

People with type 1 in the UK can purchase Libre whenever they want.
They are already available in the NHS under very tight criteria.
The only difference from April 2019 is the criteria should be the same through England but still very tight. It is expected about 25% of people with type 1 diabetes should qualify.

I (and many other people with type 1) on the forum have been self funding the Libre.
Whilst, on its own, it does not alert, it provides a lot of data by taking readings every 5 minutes which, if you know how to interpret, is incredibly useful for working out insulin doses and timings. Knowing how much insulin to take and when to take it can save your life.

It is not a replacement for finger pricking; it is not recognised for driving in the UK and, like any CGM, is not as accurate as finger pricking.

On its own, the Libre is not a CGM like the Dexcom. However, you can pimp the Libre with Miano miao or Blucon to make it a CGM which will add the alerts, effectively turning into a Libre into a CGM. This is cheaper than the Dexcom.

livabet1 said:

no better than pricking your finger and recording the results to look for trends.

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Well, before Libre I finger pricked between 10 and 16 times a day, and I admit it's possible to detect trends and post meal spikes that way. However, I doubt most diabetics are willing to prick that often.
Besides, I couldn't have achieved my hba1c of 38 with almost no hypo's and certainly nothing below 3 without the Libre, especially as I don't do very low carb. How long have you used the Libre?

livabet1 said:

It doesnt warn of nocturnal hypoglycaemia which can be devastating and an essentail function.. It doesnt warn of hyperglcaemia to allow correct management.

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Mark 2 of the sensor will ADD Bluetooth and include warnings. See https://diabetestimes.co.uk/abbott′s-freestyle-libre-2-includes-optional-real-time-alarms/, just one source of further information. I believe Abbott had intended rollout to have started in Germany several weeks ago. On one of the Libre FB pages someone from Germany has said that they are still waiting.

stonyb said:

Am trying to find the new NICE guidelines re criteria for prescribing Libre - can anyone please give me the relevant link.
Thanks

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Here it is here, stonyb:

https://www.sps.nhs.uk/articles/reg...committee-freestyle-libre-position-statement/

One of the problems had been that all the different ccgs hadn't been adopting those rules and coming up with different ones, leading to a postcode lottery.

However, last week NHS England got fed up and basically told them these are the rules, follow them.

They are still a bit tight, but the thinking is that they'll loosen up as time goes by and more evidence comes in about how effective libre is.

I’m not sure why there is another thread but I have to self fund a Dexcom for nocturnal alarms. If you are concerned you could look into this.

@livabet1
I am not sure how long you have been type 1

for me as a long term veteran of type 1 ( 46 years )

the libre has been one of the greatest changes we have seen --why ????

because it tracks movement 24 hours a day with a minimum of 3 -4 scans every 8 hours --- tracking BG movement allows intelligent changes to dosing management which previously did not exist

yes dexcom is a full cgm -- but the nhs is not funding for many

if you add miaomiao and an app ( xdrip , glimp or spike ) you can turn libre into full blown cgm for about 1/4 the price of dexcom

helensaramay said:

The only difference from April 2019 is the criteria should be the same through England but still very tight. It is expected about 25% of people with type 1 diabetes should qualify.

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The interesting thing about the "very tight" criteria is that they talk about an Hba1C of more than 8.5% being applicable and testing more than eight times per day.

In the last NDA, the number of people with Hba1C of more than 7.5% was something like 75%, and more than 8.5% was more than 25% (I think it was around 35%-40%). On this metric alone, it means that more than 25% of people qualify.

Secondly, to achieve Hba1C values of less than 7.5% (as 30% of the NDA covered T1s did) usually requires the use of Libre, CGM or testing more than 8x per day. So I think this is another area where you'll find a lot of people qualify. I think the 25% number was used to not scare CCGs. I think the reality will be much nearer 65%.

Bit negative, I wonder if liveabet1 has shares in Dexcom or works for them.

As per out the box yes Libre can be restrictive but with a bit of thought and research there are ways around the short coming of Libre which can work out less money than investing in the Dexcom system.

And as there are a fair old bits of info around plus what others have said that Libre has help them or even transform the lives they live.

Not everyone needs alarms.........for me, the people that do are in a minority......the Libre isn't intended to serve that purpose.....

Agree alarms are very important if you've lost hypo awareness or have problems overnight. However, it's also pretty useful to have reminders pop up when things are not going to plan and have gone high unexpectedly or have stayed high despite a correction a couple of hours earlier. As with many others I'm using the Spike App to use the Libre as a CGM. In terms of relative benefit Libre got me from 9% to 7% HBA, CGM will get me to 6% based on a few weeks usage so far.

I am hypo unaware. I use the Libre (luckily prescribed) I also use the MiaoMiao reader which turns my FGM into a CGM. I use the Xdrip+ app on my phone and have the signals sent to a Pebble Time smartwatch. I set alarms for Lows and highs. To me alarms are very important