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Type 1'stars R Us

slip said:
I wasn't aware of the issue with injection sites so it sort of makes sense, but a bum injection site can last just as long as another area........o_O However I'm now wondering if pumps enable more 'exotic' injection sites to be used - ie not the usual stomach/thigh that suddenly changes their control (let alone the actual pump)?
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I don't know. I think the idea might be that with a pump you can use less insulin, and reduce the problem that way. But sometimes people using pumps can have injection site problems too.

I'll have to bow to the assumed superior knowledge of @smc4761 doctor, on this.
 
helensaramay said:
Although it is not explicitly mentioned in the criteria, I wonder whether they will also do any unofficial means testing - if you can afford to fund the Libre yourself, there is no need for the NHS to pay for it
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Just to drag this up again a day later as it was still reasonably fresh in my memory..

The 8 CCGs that make up Lancashire and South Cumbria announced 2 new policies focused on Libres and pumps - I don't think the full policy has been published yet (or I've not located it :pompous:) but the interesting section to me was this:

Diabetes patients must meet the access criteria, which have been expanded following a public consultation to include patients who are already self-funding these devices, as long as they can demonstrate they would have met the criteria when they began to self-fund.
This also applies to patients who have self-funded insulin pumps and continuous glucose monitors.
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It doesn't affect me as none of them are the CCG for my area. I just found it interesting that they were willing to assess those who had been self funding under the same criteria which adds some weight to what you were saying about them considering this behind the scenes in yesterday's post.

The criteria you list is incredibly strict! I wonder if they would relent in a similar style to @kev-w's to someone putting them under pressure. But then that doesn't resolve it being a policy issue by making exceptions.

Edit: It looks as though the forum's multiple posting gremlins are back in for the evening!
 
Hospital appointment this morning. Saw my lovely consultant. HbA1c down 2 to 47. Going in the right direction. Thank you Libre (asked about availability again-as I thought, ‘pigs might fly!)
Also changing me to Fiasp to help with my problems in the morning. Am injecting an hour before I eat breakfast. It comes down painfully slowly which makes mornings hard work. 6 months to give it a good go and then will review. It also has half units, whoop!
Babysitting grandson tonight. Fingers crossed he stays asleep as it is the last episode of No Offence!
In other news, absolutely fabulous sunny, warm day here in Leeds. Hope everyone else has been similarly blessed. It makes you feel good to be alive.
 
Thanks for the replies guys, appreciate you taking the time to post your thoughts. I have been type 1 since 1981, so a long time. Injection site wise, my arms are a no go as are large areas of my abdomen and legs due to lipohypertrophy.

It probably does not help that I think I take relatively high doses of insulin. I am on ratio of 1:4 at breakfast and 1: 5 for lunch and dinner. Until I started low carbing about 6 months ago, i was taking around 38 units of Novo rapid and I still take 18 Levemir in morning as well as 22 Levemir overnight.

As others have mentioned the bum for me is a good site but in time I assume this will also develop lipohypertrophy. Also its blood y awkward trying to view where you are injecting. being right handed its OK in right cheek but a bit more awkward in left one.

As for pump sites I have seen people having the input on their back, so it does give a bit more scope for other areas to use.

I am really pleased the way things have been going recently and I do to a large extent agree with @slip do I really need a pump. I am sure there will be others out there whose need is much greater than mine. I was lucky to get the Libre about 5 months ago and that has certainly helped a great deal, that and a lot more self control.

I have however spoken with a few people I know outwith this forum who have a pump, they say it is the best thing ever. Most folks on here who have pump also seem to think it is much better.

To be honest, if I could continue with decent BG most of time like at present I would not be too fussed if I did not get the pump. What you have never had you will never miss
 
becca59 said:
Hospital appointment this morning. Saw my lovely consultant. HbA1c down 2 to 47. Going in the right direction. Thank you Libre (asked about availability again-as I thought, ‘pigs might fly!)
Also changing me to Fiasp to help with my problems in the morning. Am injecting an hour before I eat breakfast. It comes down painfully slowly which makes mornings hard work. 6 months to give it a good go and then will review. It also has half units, whoop!
Babysitting grandson tonight. Fingers crossed he stays asleep as it is the last episode of No Offence!
In other news, absolutely fabulous sunny, warm day here in Leeds. Hope everyone else has been similarly blessed. It makes you feel good to be alive.
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Well done on the HbA1C ( i can never get that right), really good figure. Does not get much better than that
 
helensaramay said:
Lucky you. Maybe, one day, my CCG will follow suit.

Currently, the Bath and North East Somerset, Swindon and Wiltshire policy does not include anything like this. It states

"Patients with Type 1 diabetes mellitus (DM), aged 4 years and above, or total pancreatic failure who despite intensive specialist input continue to have poor control (target HbA1c not achieved or inability to achieve target due to frequent episodes of hypoglycaemia (particularly at night) or disabling fear of hypoglycaemia overnight in children & their carers) of their blood glucose levels and meet one or more of the following:"

And then goes on to list the criteria such as 8 or more test strips (note, this is in addition to poor control), 2 or more incidents of DKA with hospital admissions, 2 or more severe hypos, etc.
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Are they using the same criteria for Libre as for CGMs? Freestyle Libre shouldn't be being used as a cheaper alternative to proper CGM monitoring. It should be about making similar, but less expensive technology, available to a wider range of patients, not reducing the availability of CGMs, and giving them libre instead.

Some of these CCGs are an absolute disgrace.
 
hh1 said:
I think this is a really difficult one. If I remember correctly, @smc4761 has had diabetes for over 30 years, same as me. When I asked the nurse consultant how long it'd take for my lipohypertrophy to disperse, shel ooked at me and said, 'how long did it take to develop'? as in, it's not likely to disappear in my lifetime. So I've scrabbled around for new sites and at the moment I'm managing. Injecting in some places, like my bum, is an option but it has problems for me: seeing what I'm doing in certain areas, and managing to keep track of where I've injected so I don't end up injecting repeatedly in the same place. I find that so much easier in my abdomen and to some extent my arms. Thighs are out as for some reason absorption seems quite erratic there. So even if it's working now for @smc4761 , if it was me I'd be wondering how long that would last. And I'm not sure how you measure who really needs a pump...
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I had 2 horrendous lipohypertrophy bulbs on my stomach the size of my fist when I was around 9 years old. I started rotating my sites after I seen them in a photo. They were gone by the time I was 15. Had 1 on the top of my right leg, was too stoopid to rotate around 5 years ago. That one has 90% gone now
 
helensaramay said:
I don't know for absolutely certain as I was only sent the "Policy for Freestyle Libre® Flash Glucose Monitoring System use in Type 1 Diabetic Adult & Paediatric Patients."

However, I suspect there has been some editing at least as one of the Libre criteria is
"Those who meet the current NICE criteria for insulin pump therapy (HbA1c > 68mmol/mol (>8.5%) or disabling hypoglycaemia as described in NICE TA151) where a successful trial of Freestyle Libre® may avoid the need for pump therapy. If the patient ends up requiring a pump, the funding for Freestyle Libre will be reviewed."

So Libre may not be seen as a cheaper alternative to a CGM but is seen as a cheaper alternative to a pump.

By the way, the policy is a 4 page document. As well as describing the criteria for getting the Libre prescribed, it also includes the conditions for keeping a Libre.
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It's like drawing blood from a stone, isn't it. There aren't even that many of us.
 
Lipohypertrophy can be difficult to spot a lot of the time.
A few years back my consultant told me I had it on my stomach but only one side. Problem was that from above really couldn’t see it. Head on it was blatantly obvious. A good way to check can be to stand in front of a full length mirror as naked as needs be. If you don’t spot any lumps it’s still a good way to have a laugh:)
 
When I was diagnosed I was shown where I can inject. When I left my hometown and moved to Reading, my nurse said I was using the wrong sites and can’t use my arms?!

I have expressed how useless I think she is- so I use the back of my arm- but mainly stomach and thighs. Have others been told anything like this?

Parent teacher meetings all done 1 day to go. #halfterm
 
CranberryIce said:
When I was diagnosed I was shown where I can inject. When I left my hometown and moved to Reading, my nurse said I was using the wrong sites and can’t use my arms?!

I have expressed how useless I think she is- so I use the back of my arm- but mainly stomach and thighs. Have others been told anything like this?

Parent teacher meetings all done 1 day to go. #halfterm
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On diagnosis I was told no arm injections and no pinching. My consultant asked today if I was pinching when discussing the marks I have all over. No I said. Good you shouldn’t was his answer.
I manage a 6 week rotation of sites. 2 legs 2 bum cheeks and 2 sides of stomach. Each are then getting a 5 week breather.
 
When first diagnosed I was told to pinch and only use my thighs. Was given a card with holes in to place on thighs. Holes had days of week on. Idea was to rotate sites. Was only on 2 injections a day and was using the old syringe type needles.
Nowadays with the smaller needles I inject thighs ( sides and front ), arms, stomach and occasionally calves for bolus.
Basal is always buttocks, ambidextrous so manage very well on both sides. No longer pinch, the needles are far to short nowadays.
Have to admit that when in a rush or injecting sub consciously it’s very easy to have a “go to spot “.
A bit like finger pricks. One finger always gets the most hits. Stupidly I will prick a finge, think no, that one needs a rest and then prick another instead.
Feel free to comment :):):)
 
As I am full of holes I think I have injected in most areas below the waist.

Was told that out side of the legs was not recommended, this was after many many years of doing so, and now back on the recommended list.

Same with the inside of the legs.

I think basically anywhere where you can get more then a pinch of skin/fat is a useable area. Saying that never tried the arms, did not know you could until reading this thread.

However thinking about it every other injection goes in the arm so why not insulin?
 
Goodnight everyone after a day of a fair few lows my head is banging so early than usual bedtime sleep well all
 
Diakat said:
Was told not to use my back. I still do though.
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Only one I haven't tried, seems awkward to do. Never really discussed this with my team aside from being advised on diagnosis not to use arms.

On Fiasp depending on food I sometimes use 2 sites for the same dose to split absorption rates.
 
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