Libre sensor prescription for type 2 non insulin

[finzi1966]

I would be seriously worrying about that nurse’s competence to give you advice.

It is absolutely not true that a hypo is fine in the elderly “provided they feel alright”. (Well, it’s not really true for anyone, particularly insulin users). Hypo unawareness is a big concern (and, in fact, is in itself a reason for prescribing a CGM). And the more hypos you have, the bigger the risk of hypo unawareness.

Its true the odd 3.9 May not be a reason to panic, but BG’s going into the two’s is absolutely not OK for someone of 90.

In the meantime, is it worth her having a high carb snack before she goes to bed? At 90 years old she really, really doesn’t need tight immaculate blood sugar levels.

 

[Valeee]

It's really quite difficult when you have no knowledge of a condition and have to trust the 'experts'.
I've learnt more on this forum, in a few days, than I have in the last 6 months.
Mums waking levels are usually in the 4's. Of course, the CGM also isn't as accurate as the prick tests, so I've got to balance accuracy, along with not hurting her.
She's on repaglinide and on the nurses advice we've had to give it to her at different times and at different dosages, to try to find what works for her.
What do you do if a nurse says not to panic if a daily range is from 4.1 to 18.9? She's gone as high as 25!
It seems to be settling down more but as mum is in good spirits, that's all I have to go on...

Mum eats really well and she's always put to bed and left with some biscuits, crackers and a couple of boiled sweets.
She's not a huge snacker, but has been putting on loads of weight around her mid section recently.
Its just made me wonder if repaglinide causes weight gain??..

I've recently asked for her annual diabetic check to be booked. She used to be seen by her previous diabetes nurse, without problem. She's actually not been seen by anyone since before covid struck! I will chase this up.
Thank you for the advice!

 

[Daibell]

It's really quite difficult when you have no knowledge of a condition and have to trust the 'experts'.
I've learnt more on this forum, in a few days, than I have in the last 6 months.
Mums waking levels are usually in the 4's. Of course, the CGM also isn't as accurate as the prick tests, so I've got to balance accuracy, along with not hurting her.
She's on repaglinide and on the nurses advice we've had to give it to her at different times and at different dosages, to try to find what works for her.
What do you do if a nurse says not to panic if a daily range is from 4.1 to 18.9? She's gone as high as 25!
It seems to be settling down more but as mum is in good spirits, that's all I have to go on...

Mum eats really well and she's always put to bed and left with some biscuits, crackers and a couple of boiled sweets.
She's not a huge snacker, but has been putting on loads of weight around her mid section recently.
Its just made me wonder if repaglinide causes weight gain??..

I've recently asked for her annual diabetic check to be booked. She used to be seen by her previous diabetes nurse, without problem. She's actually not been seen by anyone since before covid struck! I will chase this up.
Thank you for the advice!

Repaglinide works by stimulating the pancreas to produce more insulin. If it works and you have too many carbs you may put on weight. If the dose is too high without enough carbs you will go hypo. I would suggest keeping the carbs down and it's possible a lower dose may be indicated but you need to agree that with the medics. As always the carbs are the key to this and like insulin these drugs don't themselves cause weight gain but enagle the body to use food more effectively

 

[finzi1966]

I agree up to a point with Daibell - these type of drugs can both make you gain weight *and* have hypos. For a younger person, they might want to limit their carbs more to avoid this weight gain. Again, with your mum, I would not recommend this as a good idea if she’s already having hypos. Just as tight glucose control really isn’t a top priority in a 90 year old, worrying about weight gain probably isn’t either. I genuinely think that the *most* important thing is to avoid hypos. A hypo could make her fall, a fall might fracture her hip.

One thing you could do is discuss with her GP coming off these tablets altogether. And, at that point, she could restrict carbs a bit if she wanted. But really - at 90 - why? What would she be wanting to achieve? There’s a good argument for saying that the *most* important thing is for her to be happy and comfortable.

 

[SKB_9]

Hi, so sorry to hear about your mum and I really hope you get a positive result from the GP practice. As I’m reading I’m wondering whether age discrimination could be a factor in their decision making here, I.e. she’s 90 so why bother with a libre, what difference does it make at her age etc etc (not my beliefs but beliefs unfortunately held by many/some in healthcare) and if you get a negative result and you’re unhappy about the outcome you may want to consider this. Best of luck

 

[embayweather]

I was type 2, since a near fatal COVID attack what was left of the working pancreas no longer seems to be working. I am on single dose insulin with metformin and my blood sugar does vary considerably, influenced no doubt by some of my other conditions including muscular dystrophy. I have not seen a diabetic nurse since my emergency admission at a non local hospital with COVID, about a year ago. It is hard to do pin pricks sometimes eight a day as I use a mobility scooter to get about and I must do a test before I go out as well as around meal times. Reynauds Syndrome means often I cannot get blood out of one side so the other side gets a battering. All that said Libre is off the menu for me as well because the diabetic team where I live has never seen me and said I cannot have one. Post code lottery is certain, clinical judgement is non existent.

 

[Smiter55]

https://www.nice.org.uk/guidance/ng28/chapter/Recommendations#blood-glucose-management 1.6.17 states

 

[Babscoop]

Hi,
I've seen a few posts regarding getting the libre sensor on prescription, so I'm trying to get some advice.

My mother is almost 90 and has been type 2 for over 40 years and always well controlled with medication.
Until June this year when we were told that her meds would be changed.

Within 2 weeks she had hypo'd with a reading of 0.7, was comotose and spent days in hospital.

Since then, its been a struggle regulating her levels, with regular adjustments of her medication.
We've been getting readings ranging from 3.0 to 25.4!

So, from occasional pinprick tests, we've gone to several times a day and she hates it!

Found the libre system. She likes it, but at £100 per month, it's really out of our budget.
Asked if she could get it prescribed. Told no as she's type 2.
But I see that some people with type 2 are getting it prescribed.

Can anyone advise on whether she is eligible and how I can get this system on prescription for her?

Any help would be much appreciated!
Thank you

Have you checked any benefits she can get like attendance allowance which is not means tested and if she needs help day and night with her condition she could get around £95 per week which would go a long way to paying for it.

 

[LIAnneB]

Awwww how sad for you all after managing her diabetes so well for such a long time.
I can't offer any help unfortunately. I am type 2 and although a specialist nurse friend of mine says in my area prescribing the libre is on the cards, my actual nurse point blank refused and said it's just for type 1s and those with learning disabilities.

I wonder if it would be worth writing to the practice, so effectively go over your diabetes nurse head to those that run thr practice, I'm just thinking aloud now though.
I really hope you find a way.

I was given the Libre2 at my last appointment...I was very surprised andd pleased as I am type 2 on tablets and insulin. I am in Darlington.

 

[In Response]

@embayweather sorry to read of your problems and the frustrations of Libre postcode lottery.
I too experience Reynauds and can have challenges getting blood out of my fingers. I find "cuddling a cuppa" before pricking helps but I can understand you don't want to boil the kettle every time you head out the door. I also have a couple of USM charged handwarmers. These were bought on Amazon a few years ago (the exact brand is no longer available but Amazon have different ones) and have been great.