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continuous blood glucose monitors?

H

howie

Well-Known Member
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181
Location
kent
hi all, i was wondering if anyone could tell me if continuous blood glucose monitors are available through the nhs? my nurse didn't seem to know, she just told me to phone medtronic.

i know there's some that come as part of a pump kit but apparently i'm not ready for a pump yet cos i'm only about 6 weeks in.

thanks,
howard
 
Not yet it seems. You look at the costs involved with using the current ones and you can see why.
I'd like to try the freestyle navigator but it costs something like £40 plus for a sensor implant that last only a couple of days :shock:

http://www.freestylenavigator.com/en_US/application/html/freestyle-navigator.htm

The other downside of these are that your advised to take a reading using a conventional meter if an alert goes off if your hi or lo which seems to be going against the whole point of getting one :roll:
 
Some diabetic clinics have them to loan for 3 days at a time (the life of one sensor). My DSNs only seem interested if you mention the risk of night hypos. I asked about a longer loan, or buying my own (to track changes during my monthly cycle - 3 days at random doesn't tell me whats happening the rest of the month) and they were very much against the idea. Said it would make me "too reactive" - I thought the idea was to react to bs readings??!!! But they have no objection to me setting an alarm to test several times during the night, then oversleeping and being late for work...
 
Why would a PCT who won't fund test strips, fund an expensive item like one of those. Hospital clinics have access to stuff which GPs don't.
 
Howard

I can tell you a bit about CGM as I am fortunate to have it full-time. My consultant cares more about his patients than the hospital's overdraft. Having trialled the sensors over a few months here and there I decided they were definitely something I wanted to continue with. So, my consultant applied to the NHS Exceptional Funding panel (every PCT has one), and in short they finally agreed. But I'm the only one in Bristol (out of 80 pump users) so I'm very lucky in that respect.

If you listen to Medtronic, the sensors last 3 days each and cost £40. In practice they can last much longer than that - I've heard some get 14 days out of one - but I replace at 6 days to avoid any site infection, which still halves the cost.

The sensors don't replace testing, they're not consistently accurate enough yet and require regular calibration with a meter reading. But they are invaluable to me as I have zero hypo awareness. Useful too for tracking reaction to different foods and insulin combinations.

Progress is constant however, and I think we may see the first "closed loop" systems appearing in the next few years.
 
I asked about CGM's but was told thet they just aren't good enough for everyday use at the moment to justify the expense and that testing using a finger prick and BGM are more accurate and cost effective. The only time I can see a benefit in using a CGM, personally for me, is for night time monitoring. My understanding is that the CGM's curently available are all first generation and that the real problems lie with the sensor. The sensors degrade over time and also record the interstitial blood glucose so there is a time lag between actual BG and BG recorded on the CGM. If the sensors could be made to act real time with no or predicatble degredation over time the closed loop system will become a reality. Personally I think that it is only a matter of time before a real time CGM becomes available which can be connected to a pump using very fast acting insulin and some fancy algorithms. I think this is the closest we can get to recreating the action of the Pancreas.
 
This certainly is an interesting topic everyone. I think aside from something coming out of stem cell research, progress with CGMs has got to be the most viable option for T1s in the meantime. The idea of creating an artificial pancreas is almost tangible when you look at conjoining a pump with a CGM.

I'd be interested to know if the embedded sensors for the CGM are in anyway painful. kegstore?
 
The idea of creating an artificial pancreas is almost tangible when you look at conjoining a pump with a CGM.
Click to expand...
you might be interested in this

Clinical experience with an implanted closed-loop insulin delivery system
Eric Renard
Endocrinology Department, Lapeyronie Hospital, Montpellier, France

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302008000200023
though the one person I've met that had had an implanted pump for a while didn't like it at all.
 
The sensors are not unlike a normal cannula/infusion set in design, although the needle size is larger at 23G I think, so you feel it a bit more initially. But once it's in you forget about it apart from the calibration every 6-12 hours. As mentioned before by someone, it measures interstitial fluid so can be around 20 minutes behind actual blood glucose levels, but it is definitely a step forward for someone like me.

I read today that a closed loop system is currently under preliminary trial in the US, so it won't be long before we get the artificial pancreas dreamed of by so many! The advancement of medical technology in the last 15 years or so has been stunning.
 
HI keggie. You sound like you got friends in high places ? Sounds like you're doing real well. Keep kickin'.

D.
 
Cheers Phoenix & kegstore.

It's a brave person who trials these closed loop systems! Guess someone has to, they're doing something similar here in Leicestershire diabetes research. Apparently it's a small metal ball that's implanted inside you with insulin that can be remotely operated. Upon a signal the ball opens several of its 'pores' to release a prescribed amount of insulin before closing again. The problem with this is that it obviously has no longevity, again like the artifical bete cell trials. Until someone knows how to kick start the pancreas back into life the artifical pancreas would be best located on the outside of the body it seems.
 
thanks for the informative replies guys,

i wouldn't care where i have to wear it if its ensuring no damage to my body and and no complications. that's a shame that the continuos meters are 20 minutes behind though i think it would be a cheaper option for the nhs on me with the amount of strips i use!

i've read that these artificial pancreases will eliminate complications providing there's damage already, does this seem to be the case from what others have read?

thanks,
howard
 
also does anyone know if this 'artificial pancreas' will be aiming for levels of say 5.2 like most people have or will it be aiming for 6 or something to avoid hypos?
 
howie,

I guess target BS for such devices would be individually calibrated for the individual as not everyone aims for the same targets.
 
howie said:
...i've read that these artificial pancreases will eliminate complications providing there's damage already, does this seem to be the case from what others have read?
Click to expand...
Hmmm, not sure about that. There's some evidence that if caught early enough some complications can be reversed by really clamping down on control (which an artificial pancreas would do), but I don't think that's the case when they're well-established or have progressed to any degree. But halting further damage has to be almost as good I reckon!
 
would an artificial pancreas replace the whole organ?

seems a waste of time with the current insulins available.

I just need a few beta cells :wink:
 
DiabeticSkater said:
would an artificial pancreas replace the whole organ?

seems a waste of time with the current insulins available.

I just need a few beta cells :wink:
Click to expand...
I doubt it, one of the reasons for the high failure rate of pancreas transplants historically was the complex plumbing involved - the pancreas does a lot more than just produce insulin! Current procedure adds an additional pancreas which is used purely for insulin production, leaving the existing organ to do everything else. I would think an artificial pancreas is likely to go along similar lines.
 
i've heard the first closed loop 'artificial pancreas' won't be out for another 10 years though, which is a bit annoying.
 
Hi Kegstore,

My husband who has had type one for 30 years has been using medtronics system for 2 years with great success. The hypos have been reduced dramatically. However we do not have any funding from the NHS. We have tried twice but they just say the NICE guidelines do not allow this device. How did you manage to get this funding? Do you have any suggestions regarding this?
 
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