General thoughts on experience T2s, education, Freestyle Libre.

[LittleGreyCat]

I have thought for a long time that people with diabetes, especially T2s, get a frantic scramble of activity on first diagnosis and are then generally cut adrift thereafter.

IMHO there should be the offer of a course to update knowledge every 5 years for those who want it, definitely every 10 years.
Because knowledge and research is constantly moving forward.

Having just embarked on a self funded Freestyle Libre I have found that it has made an enormous difference to understanding how my body reacts to food and other stimuli.

With "Nanny" looking over/through my shoulder I have modified my eating and drinking and managed to lose 5 lbs in 2 weeks without any major pain.
[ Beer! ]

This in turn makes me think that there could be a whole range of long term T2s out there who could benefit from the information and make major beneficial lifestyle changes if they had, say, two Freestyle Libre sensors and the loan of a Reader (if they don't have a suitable mobile phone) over a month and then an in depth review with a diabetes expert (GP or endocrinologist).

The cost to the NHS should be low - £100 for two sensors and a one of cost of a Reader. The day to day readings would go into their clinical records and provide a solid baseline for review.

You could even consider one sensor a year to be worn just before your scheduled review.

This wouldn't work for everyone because you have to be motivated and also willing to read the sensor at least once every 8 hours, but it could potentially save the NHS a lot more than the modest outlay.

 

[LittleGreyCat]

@LittleGreyCat I think you have some great ideas and they apply equally to T1.
A few years ago (before Libre were available), I asked for a CGM for a month.
I wanted to be able to see what impact things like different foods, exercise, stress, etc. had on my BG.
Knowing the cost of a CGM, I thought this would teach me some lessons I could then apply without the sensor such as avoiding certain foods, reducing my insulin at a particular time when exercising, taking my insulin different times before meals depending on what I was to eat and learning whether my high BG in the morning was DP or not enough insulin.
Like you, I thought the cost would be relatively low for great return.

Your suggestion of one sensor a year, just before the annual review is brilliant - it gives some great data to discuss in the review.
Given the recent discussion about the value of Hb1AC I wonder whether 2 weeks of Libre may be more valuable. I don't know how much a Hb1AC test costs (including the time from the phlebotomist) and how a single Libre cost would compare.

I think I would like both as I have a long history of HbA1c records.
The blood test also covers a lot of other things including kidney function so I wouldn't want to drop that.
I was regarding it as additional information to help explain HbA1c results.

 

[Resurgam]

I never even got much of any sort of activity - good thing I don't seem to need it.
I've been told that my practice does an annual review after 40 years of age - I did tell the receptionist last year that I most definitely did not get one - so this year I was sent for a 5 yearly lifestyle check, and again said what about the so called annual health check - 'oh you'll have had one every year since you turned 40' I was told.
Sigh.
I probably wouldn't like it if I got one - but I can't help being a bit jealous.

 

[lucylocket61]

IMHO there should be the offer of a course to update knowledge every 5 years for those who want it, definitely every 10 years.
Because knowledge and research is constantly moving forward.

I have to shake my cynical head and say Nope - the information from the NHS is not being updated, and any small changes made are in the wrong direction. If they wont even fund test strips, or acknowledge that what we eat affects our blood sugars despite us proving it to them with our results from self testing, they are not going to listen to any other technology.

sorry. Great ideas, but it wont happen.

 

[Scott-C]

The cost to the NHS should be low - £100 for two sensors and a one of cost of a Reader. The day to day readings would go into their clinical records and provide a solid baseline for review.

On the theme of prescribing libre to T2s, hat tip to @becca59 , who recently posted this link in another thread:

https://www.diabetesonthenet.com/jo...-world-population-southampton-city-experience

It's to do with Southampton's experience of libre with T1s, but there's a paragraph at the end regarding T2s which may be of interest. I've copied it below.

The battle for more liberal policy on scripting libre for T1s has been a difficult one and it's not over yet, but at a seminar I was at a few weeks back, a speaker, I think it was a senior executive of JDRF said that patients making a noise about it did actually influence things politically. The docs on the panel agreed with her.

Here's the extract:

"Future projects
Due to the success of introducing the Libre in Southampton, we are now looking at working with a specific set of patients with type 2 diabetes. This will be a small initial project but will work in the same way as with the type 1 diabetes cohort. Those taking part will similarly be offered 6-month use of the Libre. The aim is to look at reducing cost burden for the NHS but, more importantly, improving the life experience for these people. We aim to focus on high-risk patients, such younger people, those who are frail, those on long-term steroid treatment and, perhaps, those who are house-bound. We are also considering the possibility of using the Libre in newly diagnosed people with type 2 diabetes, who might benefit from a 3-month trial in order to learn about their diabetes and blood glucose levels."
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