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Type 1'stars R Us

Alison54321 said:
I'm impressed by your defence of a "too low" HbA1c, though I'm not sure what an HCP can do to stop you having a lower HbA1c than they want, confiscate, or ration, your insulin? send someone round to force you to eat carbs? make big pizzas and pies compulsory?

Maybe this is the reasons CCGs are having so much trouble agreeing to fund Libre, it's a massive shift of control, away from the HCP to the patient, perhaps they just can't handle it.

When we had our "inducation" for libre I remember the doctor it jokingly saying you won't need us any more soon, as technology allows you to monitor your own health more and more, but maybe this is the root of the problem.
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Thanks Alison - i'd actually enjoy being told to eat pizza and pies if given the chance too :) Although the reality would mean i'd probably end up high as a kite for 2-3 days afterwards !! (favourite saying is I need drugs to stop me getting high..)

I am not so sure that CCG's are so concerned about control and who becomes responsible as it is very much down to the individual, it is mostly a cost issue having discussed this with a few nurses at my last pump meeting, also with my particular CCG it is also the variation on readings on the libre and the time lag. Every time I see/speak to my DSN I always give her a run down on how my management has changed/improved on the basis of using the system and she can see how important it is in my control, if she could access it for me she would but in my CCG there is unlikely to be any funding available for the next 2 years.

My case as it stands now is presenting a very credible picture for what CGM's can do to improve many aspects of diabetes control, whenever I speak to a GP/nurse/consultant, to help promote this for the wider insulin dependent audience. I wasn't in full launch mode today as my brain was signalling in the background telling me to ease off the glucose gas, but it was great to hear a GP say this and without hesitation to discuss the benefits of why my 42 doesn't impact on my hypo awareness due to the fact that I have less of them and they are less severe than when I was trying to fumble around in the dark ricocheting with levels of 2.2 to 18 (that's my control at it's worst when trying to live normally with injections and a meter and a moderate to high carb diet). Yes there's a combination of factors involved in control but being able to see a moving picture of your control is very empowering if used in the right way.
 
Juicyj said:
Thanks Alison - i'd actually enjoy being told to eat pizza and pies if given the chance too :) Although the reality would mean i'd probably end up high as a kite for 2-3 days afterwards !! (favourite saying is I need drugs to stop me getting high..)

I am not so sure that CCG's are so concerned about control and who becomes responsible as it is very much down to the individual, it is mostly a cost issue having discussed this with a few nurses at my last pump meeting, also with my particular CCG it is also the variation on readings on the libre and the time lag. Every time I see/speak to my DSN I always give her a run down on how my management has changed/improved on the basis of using the system and she can see how important it is in my control, if she could access it for me she would but in my CCG there is unlikely to be any funding available for the next 2 years.

My case as it stands now is presenting a very credible picture for what CGM's can do to improve many aspects of diabetes control, whenever I speak to a GP/nurse/consultant, to help promote this for the wider insulin dependent audience. I wasn't in full launch mode today as my brain was signalling in the background telling me to ease off the glucose gas, but it was great to hear a GP say this and without hesitation to discuss the benefits of why my 42 doesn't impact on my hypo awareness due to the fact that I have less of them and they are less severe than when I was trying to fumble around in the dark ricocheting with levels of 2.2 to 18 (that's my control at it's worst when trying to live normally with injections and a meter and a moderate to high carb diet). Yes there's a combination of factors involved in control but being able to see a moving picture of your control is very empowering if used in the right way.
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I think what is happening with Libre is that it's beneficial in lowering HbA1cs for people that are too high, but for people with better HbA1cs the benefit lies in improved ability to stay in the target range.

I saw something recently about research done by people developing closed loop systems showing that Type 2s who spent more time in their target range had less complications, so I suspect that more of that evidence will appear, and the best argument for Libre for people with already lower HbA1cs will be improved time in range.

It's interesting to think that that was an unmeasurable thing before Libre for most people, and yet it's so blindingly obvious how important it must be.

So you're right it's good to persuade your DN that you are staying more in target, even with a lower HbA1c.
 
Juicyj said:
also with my particular CCG it is also the variation on readings on the libre and the time lag.
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I can't see how they can say that! the NHS gives proper CGMs to people who have real trouble and/or no hypo awareness - yet all CGMs suffer from this time lag, variation might be slightly worse possibly shown by MARD scores but again any CGM can be variable if not calibrated correctly which the libre does away with - so in one breath they are saying CGMs are good at catching hypos and warning the wearer in a timely manner yet it's not good enough for normal people who are probably more aware of what their body is telling them..................
 
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Not content with the tinkering I've done in xDrip so far, I've spent some of this morning setting up a Nightscout site to upload the data too. I intend to use this to gain reporting functionality which xDrip doesn't really show much of.
 
@Juicyj before I reveal my score I'd just like to point out that someone in the office (not me!) has a tub of Quality Street on their desk........................10.2 :rolleyes: (Must try harder, must try harder, must try harder.................)
 
Right this diabetic lark is getting on my nerves now. I have an appointment with hospital a week on Tuesday at the pump clinic with a view to being put on a pump. This is mainly due to unpredictable dawn phenomenon; I can go to bed with a 5.5 and wake up with a 13!!!!. It does happen intermittently however, but on a fairly regular basis.

Now for the past 10 days or so after speaking with DSN, she told me to start injecting my evening Levemir in my bum and area i had not used a great deal before. Ever since then my control has become really good. Bedtime 5.5, early hours maybe 6.5 then dropping back to 5.5 when i get up. Even my daytime BG have been fairly good, within 4--7 most of time except for small spike straight after eating before falling back. This is despite taking around 15% less Levemir.

Now if i go to pump clinic at end of month and if i keep up these decent BG are they going to turn round and say, your control is good why should we give you a pump.

Like Helensaramy has experienced, is better having poor control and getting all of the tech to help you
 
Looks like I’ve been climbing and getting an MOT, where in reality I’ve been sitting in an art gallery making a patchwork quilt...

Nothing to report diabetically, which is nice.

When I got told off for my 43 back in April, I wondered if the practice nurse was going to start delivering chips to my front door...
 
smc4761 said:
Right this diabetic lark is getting on my nerves now. I have an appointment with hospital a week on Tuesday at the pump clinic with a view to being put on a pump. This is mainly due to unpredictable dawn phenomenon; I can go to bed with a 5.5 and wake up with a 13!!!!. It does happen intermittently however, but on a fairly regular basis.

Now for the past 10 days or so after speaking with DSN, she told me to start injecting my evening Levemir in my bum and area i had not used a great deal before. Ever since then my control has become really good. Bedtime 5.5, early hours maybe 6.5 then dropping back to 5.5 when i get up. Even my daytime BG have been fairly good, within 4--7 most of time except for small spike straight after eating before falling back. This is despite taking around 15% less Levemir.

Now if i go to pump clinic at end of month and if i keep up these decent BG are they going to turn round and say, your control is good why should we give you a pump.

Like Helensaramy has experienced, is better having poor control and getting all of the tech to help you
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Do you have Libre? Might be worth going back to your old injection sites for a couple of weeks and telling them you’re using your bum? So that there’s no improvement? Just until you get approved...
 
@smc4761 if your control stays good do you really need a pump? - when someone else who might really need it doesn't get one.

I know we would all like to have the latest and greatest tech :playful:
 
db89 said:
Not content with the tinkering I've done in xDrip so far, I've spent some of this morning setting up a Nightscout site to upload the data too. I intend to use this to gain reporting functionality which xDrip doesn't really show much of.
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Be interested to know what you find out or what the reports do show.

Yes yes on my list of "things to do" but at the moment I'm distracted by pork pie.
 
Knikki said:
Be interested to know what you find out or what the reports do show.

Yes yes on my list of "things to do" but at the moment I'm distracted by pork pie.
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They look much more comprehensive than what you get in xDrip+ and I've been able to backfill data from the day my current sensor started. Can share more details in a PM if you like?
 
db89 said:
They look much more comprehensive than what you get in xDrip+ and I've been able to backfill data from the day my current sensor started. Can share more details in a PM if you like?
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Yeah go on then I'll pick it up later then bin it, unless it stays on the PM inbox.
 
smc4761 said:
Right this diabetic lark is getting on my nerves now. I have an appointment with hospital a week on Tuesday at the pump clinic with a view to being put on a pump. This is mainly due to unpredictable dawn phenomenon; I can go to bed with a 5.5 and wake up with a 13!!!!. It does happen intermittently however, but on a fairly regular basis.

Now for the past 10 days or so after speaking with DSN, she told me to start injecting my evening Levemir in my bum and area i had not used a great deal before. Ever since then my control has become really good. Bedtime 5.5, early hours maybe 6.5 then dropping back to 5.5 when i get up. Even my daytime BG have been fairly good, within 4--7 most of time except for small spike straight after eating before falling back. This is despite taking around 15% less Levemir.

Now if i go to pump clinic at end of month and if i keep up these decent BG are they going to turn round and say, your control is good why should we give you a pump.

Like Helensaramy has experienced, is better having poor control and getting all of the tech to help you
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You can't use your bum forever, so there is still an issue with other injection sites. This does show that injection sites are an issue for you, and if I recall that was what the doctor said when he recommended you for a pump.
 
Alison54321 said:
You can't use your bum forever, so there is still an issue with other injection sites. This does show that injection sites are an issue for you, and if I recall that was what the doctor said when he recommended you for a pump.
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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)?
 
slip said:
@smc4761 if your control stays good do you really need a pump? - when someone else who might really need it doesn't get one.

I know we would all like to have the latest and greatest tech :playful:
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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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