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Advice on smart meters please

Discussion in 'Type 1 Diabetes' started by CoolUserName, Jul 23, 2021.

  1. CoolUserName

    CoolUserName · Member

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    Hello all,

    Is there anyone out there who can recommend a good, reliable smart blood glucose meter please.

    Currently my child uses the Accu-chek Aviva expert but this is being discontinued.

    We are really after something that works in the same way - measures BS, suggests bolus based on when you last had insulin, stores and uses different insulin to carb ratios for different times of day AND is available on the NHS.

    The Accu-chek Aviva expert can't be the only meter like this surely? I've had a quick look but it's really confusing !!

    Any advice would be gratefully received, thanks.
     
  2. username3

    username3 · Member

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    I think you may be having some trouble with what you're looking for, because generally those kinds of calculations are done in insulin pumps.

    For example, Medtronic pumps link with a testing kit called Contour Next Link. The contour is paired with the insulin pump and sends blood sugar readings over Bluetooth directly to the insulin pump. The insulin pump then uses stored information such as active insulin, carb ratios, insulin sensitivity factor and different times of day to work out how much insulin to deliver.

    Is your child on an insulin pump? If not, i would look into getting one on the NHS if I were you.
     
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  3. searley

    searley Type 1 · Moderator
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    The only real alternative to the expert was the freestyle insulinx meter which I'm not sure is still made
    Call Abbott and find out

    so your only other option is to go an app route or start doing the maths in your head
     
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  4. StewM

    StewM Type 1 · Well-Known Member

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    Just some context for you, I've never once been offered a Smart Meter in 35+ years and it's never been discussed as an option.

    It wouldn't surprise me if price determines what's available. For instance, the Libre is the only CGM available on the NHS.
     
  5. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Luckily I am allowed a Dexcom to work with my Tandem IQ pump. I do think all type 1s should be eligible for libre if they would benefit from it.
    It is a shame to hear that Roche are pulling out of this market as bolus calculators are helpful IMO now that I am using one again with the new pump.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687095/
    This was a useful discussion on the merits of smart meters.
    https://jdrf.org.uk/information-support/treatments-technologies/blood-glucose-meters/
    Article on the subject mentioning 3 options (1 is Accuhek)
     
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    #5 NicoleC1971, Jul 24, 2021 at 3:06 PM
    Last edited by a moderator: Jul 24, 2021
  6. searley

    searley Type 1 · Moderator
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    They have not really pulled out.. what they expect is you will use the accucheck mobile with wifi add on with mysugr which has bolus calc

    Just a lot more cumbersome
     
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  7. username3

    username3 · Member

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    That's actually not true. There are a few CGMs and linked pumps available on the NHS, you can have your pick depending on what your hospital can support. Because it's expensive, there are specific NICE requirements for NHS funded CGM use. Realistically considering the guidelines, any diabetic T1 person should qualify to meet these. I am currently on the dexcom under NHS funding.

    These are the guidelines:
    Consider real time continuous glucose monitoring for adults with type 1 diabetes who are willing to commit to using it at least 70% of the time and to calibrate it as needed, and who have any of the following despite optimised use of insulin therapy and conventional blood glucose monitoring:

    - More than 1 episode a year of severe hypoglycaemia with no obviously preventable precipitating cause.

    - Complete loss of awareness of hypoglycaemia.

    - Frequent (more than 2 episodes a week) asymptomatic hypoglycaemia that is causing problems with daily activities.

    - Extreme fear of hypoglycaemia.

    - Hyperglycaemia (HbA1c level of 75 mmol/mol [9%] or higher) that persists despite testing at least 10 times a day (see recommendations 1.6.11 and 1.6.12). Continue real time continuous glucose monitoring only if HbA1c can be sustained at or below 53 mmol/mol (7%) and/or there has been a fall in HbA1c of 27 mmol/mol (2.5%) or more.
     
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  8. CoolUserName

    CoolUserName · Member

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    Hi,

    Thank you for all your replies and suggestions.

    I think long term we are going to start using the MyLife app with a small, standard glucose monitor - it's what our local NHS trust recommends. Ironically the Accu chek seems to be working again now we've set up the App - maybe it just doesn't like operating in really high temperatures ;) But now at least we have a back up in place for if it suddenly packs up.

    It's a massive pain the Accu-check smart meter has been discontinued as it's so handy and yes, as searly said up thread the general move is towards Apps, which work but are more cumbersome as now it's a 2 step process to finger prick and add the result into the App.

    He doesn't use a pump, but does use a CGM which is great. I can't imagine how difficult and stressful it must have been to manage blood sugars before they came along. Not sure how he would feel about a pump to be honest, that's for him to decide as it's all pretty new to us and he does have good control anyway (HB1AC of 5% at last check). Maybe once he gets older a pump might be something to look into.

    Thank you again for your replies, they've all been very useful.
     
  9. Hopeful34

    Hopeful34 Type 1 · Well-Known Member

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    @CoolUserName. Roche told me that the Accu-check Aviva Expert was still available until December this year, so you may be able to get another one, unless something's suddenly changed.
     
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  10. StewM

    StewM Type 1 · Well-Known Member

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    Well, again it must vary from authority to authority, cause Dexcom or anything other than Libre is not available where I am.
     
  11. searley

    searley Type 1 · Moderator
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    It will be.. but only in very limited cases.. its not generally available in my area but the hospital provide it for me
     
  12. CoolUserName

    CoolUserName · Member

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    Thank you I'll give them a call
     
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