Libre on NHS

[Peppergirl]

https://jdrf.org.uk/news/flash-glucose-sensing-available-nhs-type-1-diabetes/

 

[Juicyj]

That's very good news

Obviously needs to be used in conjunction with meter testing for those who drive as it's not DVLA approved but for those who struggle it's a lifeline.

 

[Diakat]

Lovely news. It'll be interesting to see how they decide who 'those that I'll benefit' from the technology are.

 

[Peppergirl]

Sky News are reporting on it too

 

[Mickyduff]

This is great news, I just hope I qualify...

 

[tim2000s]

So. A few thoughts on this announcement. The key points in the announcement come in the third paragraph:

The device will, subject to local health authority approval, be available on the NHS across the United Kingdom from 1st November 2017.

Given the equivalent for lots of other treatments for various diseases, this does not mean it will be particularly available anywhere on 1st November. The precedent in these cases is for slowness rather than rapidity. It's a step in the right direction, but only that. It also makes the imposition of ridiculous conditions by authority very easy. I hope I'm wrong, but I feel this is set up to operate like CGM, without NICE guidelines to provide a national position. I therefore think it's going to be difficult to get hold of.

Secondly, what does it mean for access to CGM, which in my opinion is a better and more accurate system? I suspect that this has just made access to CGM considerably more difficult for many, and that funded CGM will come with the requirement that you will need to be completely hypo unaware, and you'll still be given Libre first. And if you have an adverse reaction to Libre glue, you are going to be stuffed.

I'm not so sure this is the great news that people think it is for Type 1.

On the other hand, if this also allows type 2s to be prescribed the Libre, think of this scenario. Instead of "You're type 2. Gliclazide and Sulphonyreas for you", the model is:

"Here, have a Libre for a month. Scan it 4x per day. I'll see you in two weeks to discuss the results". It potentially allows much better self-education about diet, and more importantly, if used in this way, gives the opportunity to see how destructive the recommended diet for T2 diabetes prescribed by the NHS is.

Potentially then, could this be the catalyst for better diet based treatment of T2.

 

[Juicyj]

Ok let's re-phrase that @tim2000s - it's a step in the right direction.

 

[Ann1982]

I'd love to try one as I am type 2 but only on insulin and having to fund my own test strips as doc says they are too expensive and fobbed me off with a rubbish meter!

 

[tim2000s]

I'd love to try one as I am type 2 but only on insulin and having to fund my own test strips as doc says they are too expensive and fobbed me off with a rubbish meter!

You need to go back to your doctor and ask him if he was giving himself injections of a lethal substance multiple times a day whether he'd be happy to not have a way to monitor it safely.

He's breaching NICE guidance on insulin use, as all insulin users are supposed to be prescribed test strips. I'd definitely go back and have a fight on that point. From the guideline for Type 2:


Self-monitoring of blood glucose
1.6.12Take the Driver and Vehicle Licensing Agency (DVLA) At a glance guide to the current medical standards of fitness to drive into account when offering self‑monitoring of blood glucose levels for adults with type 2 diabetes. [new 2015]

1.6.13Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  
  
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]

 

[pinewood]

I hate to be pessimistic but I'm sure this will be a postcode lottery and that there might be strange criteria attached before your GP will prescribe it (possibly hba1c linked?). Also disappointing that there is no alternative to Libre for those of us who are allergic to the Libre adhesive.

 

[Louise_1965]

Morning all , I got type 1 when I was 41 , I'm now 52 , I've just got a freestyle libre , it's amazing , I feel free for the first time in years , as I also have epilepsy and low sugar can make my epilepsy worse x

 

[**shell**]

As someone who has been considering some form of CGM/Flash but the funding side of things makes it impossible this is very welcome news.
Although my first thought was 'I ain't going to qualify for this'.

It sort of leads me to think that some things which come with conditions ie poor control, low hypo awareness etc should perhaps also be means tested in which you can help subsidise if you do not officially qualify according to NICE etc. - probably a bit controversial for this time in the morning...

xoxox

Sent from my SM-G920F using Diabetes.co.uk Forum mobile app

 

[Peggymac]

Good news for the U.K. I live in France and it became available for Type 1s from June this year. I had to wait until July for the pharmacies to have them available for me. It has changed my approach to my diabetes dramatically. It is not without flaws but bearing them in mind it is still a great aid to control. I am learning now to avoid the debilitating spikes in blood sugar. I have read many of the discussions on this site since I started using my Libre and have learned so much more about this condition which I have had since I was diagnosed on my 21st birthday 43 years ago. It has given me much more interest in changing many aspects for my daily life to help me feel better and healthier.

 

[karen8967]

thats great news i asked my dn about one of these a couple of months ago as i was going to purchase one he told me to hang fire as there was a chance it may become available on prescription he also told me it would probably only be available for type 1 on nhs .x

 

[jimmysmith]

Well this has made me really happy, yes I know there'll be some hoops to jump through but they're hoops I'm happy to jump through. Coming to the end of my free trial and I feel so much more optimistic about my diabetes because of it. Thanks to the Libre I actually feel more motivated to look after myself

 

[slip]

On the other hand, if this also allows type 2s to be prescribed the Libre, think of this scenario. Instead of "You're type 2. Gliclazide and Sulphonyreas for you", the model is:

"Here, have a Libre for a month. Scan it 4x per day. I'll see you in two weeks to discuss the results". It potentially allows much better self-education about diet, and more importantly, if used in this way, gives the opportunity to see how destructive the recommended diet for T2 diabetes prescribed by the NHS is.

Potentially then, could this be the catalyst for better diet based treatment of T2.

Seriously Tim do you really think this could happen???!?!

 

[Diabeticliberty]

Sorry to be a fly in the ointment but if some of our GP's see the Libre as a replacement for good old regular finger prick testing and call me cynical but there is a real risk that some might as there are cost savings that can be made then it is very much a backward step for the cause of all diabetics. We are well and truly up there without a paddle and I do use a Libre currenmtly

 

[pinewood]

So. A few thoughts on this announcement. The key points in the announcement come in the third paragraph:



Given the equivalent for lots of other treatments for various diseases, this does not mean it will be particularly available anywhere on 1st November. The precedent in these cases is for slowness rather than rapidity. It's a step in the right direction, but only that. It also makes the imposition of ridiculous conditions by authority very easy. I hope I'm wrong, but I feel this is set up to operate like CGM, without NICE guidelines to provide a national position. I therefore think it's going to be difficult to get hold of.

Secondly, what does it mean for access to CGM, which in my opinion is a better and more accurate system? I suspect that this has just made access to CGM considerably more difficult for many, and that funded CGM will come with the requirement that you will need to be completely hypo unaware, and you'll still be given Libre first. And if you have an adverse reaction to Libre glue, you are going to be stuffed.

I'm not so sure this is the great news that people think it is for Type 1.

On the other hand, if this also allows type 2s to be prescribed the Libre, think of this scenario. Instead of "You're type 2. Gliclazide and Sulphonyreas for you", the model is:

"Here, have a Libre for a month. Scan it 4x per day. I'll see you in two weeks to discuss the results". It potentially allows much better self-education about diet, and more importantly, if used in this way, gives the opportunity to see how destructive the recommended diet for T2 diabetes prescribed by the NHS is.

Potentially then, could this be the catalyst for better diet based treatment of T2.

Tim, do you think there is any possibility that those of us who'd prefer to use Dexcom (for whatever reason, whether that is for the alarms, due to adhesive reaction etc.) might be able to receive a partial contribution toward Dexcom costs equal to how much the NHS would otherwise spend on a Libre prescription? Is there any evidence of a contribution of this type having been made available in any other situations?

 

[Ann1982]

You need to go back to your doctor and ask him if he was giving himself injections of a lethal substance multiple times a day whether he'd be happy to not have a way to monitor it safely.

He's breaching NICE guidance on insulin use, as all insulin users are supposed to be prescribed test strips. I'd definitely go back and have a fight on that point. From the guideline for Type 2:


Self-monitoring of blood glucose
1.6.12Take the Driver and Vehicle Licensing Agency (DVLA) At a glance guide to the current medical standards of fitness to drive into account when offering self‑monitoring of blood glucose levels for adults with type 2 diabetes. [new 2015]

1.6.13Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
  
  
• there is evidence of hypoglycaemic episodes or
  
  
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  
  
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]

I have tried but the contour next one test strips are apparently too expensive. They gave me the True You test meters and strips but I found it to be very unsatisfactory. My blood sugars were 85% out of range but using the next one they are now 95% within range.

 

[lely]

I have been considering buying this system. Not to use permanently but on occasions when I'm not getting the results I'd like.
Id use it to establish better basal rates and bolus calculations then use strips in-between. Also I have considered how useful this would be in the gym. when running on treadmill ( about 25/30mins) I stop at 15 mins walk and test to be sure I'm not gonna hit the floor of the treadmill and be flung across the room. ( Imagine the embarrassment.) so being able to just test without stopping would be really great.
From a practical sense this would be great. Wouldn't it??

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