Would they let me have a dexcom?

So currently on the Freestyle Libre 1. Really has helped me control my bloods better. Not perfect as I'm still finding what effects my bg levels and when to inject for certain foods. Normally inject 15 minutes prior to eating but if I'm having wholegrain carbs I tend to have it after I finish eating to prevent a sudden drop and combat the slow releasing sugar.

My hypo awareness is really bad. A week ago was asleep and was in a hypo of 3.1 for 3 to 4 hours. Woke up and had no symptoms of a hypo but noticed as soon as I looked at my phone my eyes were blurry. Same in the day, can be fine 2 hours after dinner and I'll randomly check my by levels on the libre and glucose monitor and notice I'm in a hypo. Again, not aware until I check. Ratios and basal are fine. Sometimes I do make a correction dose error but works out most days.

Dietician and diabetic team keep refusing me for a insulin pump and I don't mind as much since pens are normal for me.

Even though the libre is a game changer for me I need to be alerted for when I'm going into a hypo or hyper. Even though I'm still in the trial period of 3 months on the libre, I feel like a cgm like the dexcom would benefit my control even more. Give me confidence on not setting alarms 4am in the morning to make sure I'm not high or low blood sugars. I have advanced diabetic retinopathy and my eye specialists that are currently giving treatment have said to prevent going blind I need to be under good control.

I've developed bad anxiety of hypos and when I do have a really bad hypo, a few days later a new floater comes out of nowhere. I feel like a dexcom would help me preserve further damage but not sure if it would be possible to get one on the nhs.

I can't afford to buy a dexcom myself and I do always double check on my blood glucose monitors to make sure I am hypo.

Really stressing me out and would be neat to have a smart watch linked to the dexcom so I can look at it throughout the day and feel better and more in control.

HbA1c level was 99 in February, 68 in June and 63 recently. Dietican told me I'm doing very well and I feel better for it. Never missing a dose, eating low carbs and being more active and healthy. Dropped from 12 stone to 11 and don't eat much calories in the day.

Sometimes the libre can be off for me and the trend arrows do nothing for me unless it's at a critical low. For example I was 5.8 with a down trend arrow but my gm monitor reads 6.3. Did nothing and levels sat between 6-7 anyway 2 hours later. Sometimes my libre reads 3.2 but my glucose monitors both read 4.5-5.

I know libre reads fluid instead of blood glucose but it's not 100% accurate.

Atleast with a cgm I can feel more confident and finger prick less. I'll always fingerprick before meals, 2 hours after eating and before bed/waking up in the morning.

Always have bad morning levels. Wake up with 6.0 and within 30 minutes jump to 8.0.

So I always inject about 2 units of humalog to counter the rise and it works out fine.

But yeah... do I fit the criteria for a dexcom? Aniexty of hypos, unaware of hypos until I'm critically low and just want to check my bloods fairly often.

Any advice would be great, thank you =).

In Response said:

You can ask but ...
- all CGM use Interstitial Fluid rather than testing bloods so there will be a lag
- NHS has approval for Libre 2 which should be available in the new year. Libre 2 alerts via Bluetooth when your blood sugars are too high or too low.
So, I would not be confident that you will get the more expensive Dexcom.

Alternatively, you could "pimp" your Libre with a Bubble or Miaomiao. These are a one-off expense (rechargeable) which attach to your Libre and converts the NFC signal to Bluetooth so your phone receives the BG and applications like xDrip. Spike or Glimp respond to the readings in real time with alarms if you go too high or too low. The added advantage of these apps is that they allow you to calibrate your readings against finger pricks. They, basically, convert your Libre into a CGM.

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Next year hmm. Will everyone who's currently on the libre 1 be entitled to upgrade when it becomes available? Might be good to go on that. Thank you =)

Rokaab said:

If its the same price then possibly, if its more expensive I wouldn't bet on it, but this is guesswork on my part

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Let's hope for the best =). Wouldn't mind ******* for a dexcom myself but lost my job due to covid and currently gettinf my health on track.

KK123 said:

Hi @Dazphoenix28, I don't know if you do this but are you sure you actually ARE in a hypo when it's reading 3.1 during the night? You might be of course but I find the Libre inaccurate when it's reading under 4 so I always follow up with a finger prick check which shows over 4 at least 70% of the time. I know the libre is 15 minutes behind so you have to factor that in of course. It could be that you are not feeling the hypos physically because you're not in one. I would always follow up with an immediate finger prick test even during the night. Obviously if your libre is reading under 4 then it likely indicates you are going low so you should bear this in mind too. I love the libre but it has its moments, it's good for trending purposes for example. I'm on insulin and have to use the libre readings to dose insulin (according to my team although others say not to) and at the moment there isn't much choice because once you're on the libre they massively restrict test strips. x

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I always double check my hypos on my bg machine. Most times it reads a 3.2 on the libre but it's 4.6 or 5 on my machine but my issue is that I can be in a hypo during the day, no symptoms, scan it's 3.1 and machine actually does read 4.1 and then I know I'm actually going into a hypo. I have no awareness anymore and my eyes tend to change where so my vision is dark and I do get confused. The problem is I don't have shakes, sweats, hunger. I just randomly check and confirm with my bg monitor and I'm in a hypo.

I need alerts as when I do sleep I tend to dip towards the lower 4s. If I do dip to 4s I know within 30 minutes I'll go hypo but I'm so unaware and still finger prick 8 times a day to make sure my bloods are fine. If I could get a cgm with alerts I would feel more comfortable and like you said, the libre is inaccurate when it reads 3.2 but sometimes it's spot on.

I just don't want to sit in a hypo for too long as yesterday matching my sensor and my bg machine it was sitting low for about an hour. Felt fine but noticed my vision was changing. After I tested on my machine with finger pricks and saw it was 3.3 I started to panic.

I've become really good at treating hypos. Tend to have 4 - 6 glucose tablets and wait 15 to 20 minutes and recheck again. If bloods are sitting at 4.5 I eat 10g of carbs which will rise my blood levels to 5-6 to prevent it going down again.

But yeah, sorry for the long reply. Just would feel better knowing if a alarm would notify me and I can blood test to confirm and tackle a hypo before it happens.

I've had high blood sugar for years. HbA1c levels were 99 in February and dropped to 63 in November. Never been over a 14 reading for a month now and tend to be within my target range 80% of the time in a 2 week period. I've adjusting my insulin ratios and my basal is set to the right amount.

I'm more sensitive to high bloods now(body tends to tense up at around 10-11 so I have 1 unit of rapid to bring it down to 7.

If the libre 2 comes out next year that will be better. Think you can set alarms and stuff so that's good.

KK123 said:

Yes, I get you, it's not pleasant to be running in the very low 4s or 3s all the time as you do worry that then there is no buffer. I wonder whether because your levels are low regularly whether you have just lost your hypo awareness. It can have consequences so I sympathise. On a recent course they did say that if you are constantly checking your levels and reacting immediately to them it can make your general management much worse and you will get those up & down swings. x

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Yeah =(. Just trying to find a day when it's straight line or not as much jumping or falling spikes. It's not too bad but in the morning my bloods rise fast when I get out of bed so have to take 3 units of rapid. Bloods sit at 5-6 when I wake up and jump to 8 within 15 minutes of waking. Don't eat after 10pm and find once I inject the 3 units it brings it level to 6-7.

Hopefully my hypo awareness does return but I scan every half hour or hour anyway. Still new to the libre so still find it fun to do.

But I used to run 15-25 constantly and feel fine and don't know how I left my self get that bad. That's why I'm making sure I'm eating healthy, drinking nothing but water and 1-2 black coffees in the day and also started to go for walks.

Each day I learn something new about diabetes and always keen to learn more. Found out on how to slow down rises and also if that extra correction dosage is needed or not. Also learned to let my humalog take it's 4 hour cycle into my system before I decided to inject.

Like sometimes I'll be 9 and has a trend arrow saying it's rising. Let 2 hours past and it's slowly going back to 7. But each day at a time =) x.

In Response said:

Detecting hypos on a Libre can be a challenge as it is 15 to 20 minutes behind. So if your Libre scan says 4.2 and falling, you are already in hypo.
Likewise, testing post hypo you need to test with a finger prick. Otherwise, you risk over treating it because your Libre will take 5 to 20 minutes to detect the rise.

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I always double check with my blood monitor and I know the libre lags 15 minutes behind. I take the trend arrows with a pinch of salt because a lot of the times I can be 5.5 and falling but my machine reads 6.4 and I don't treat the fall and it works out fine anyway. I only use the libre as a light guide on how my levels do inbetween fingerpricks.

Same if the libre says 9.0 and rising. Most times it sorted it self out as my glucose monitor always comes back fine anyway.

But yeah if the libre reads 3.2 and I check my machine knowing it's 15 minutes ahead to just make sure and it's mainly sitting at 4.9.

But the trend arrows don't so much unless it's 4.0 and directly down or 10 and directly up.