Tag: NHS

Seven observations on using the FreeStyle Libre for a week

Emma7 Comments
hand holding FreeStyle libre meter
You will prise this from my cold, dead hand…

Blood, I miss the sight of you… I’d gotten used to those tiny beads that popped from the tips of my fingers several times a day. This week, not so much.

And as misses go, it’s a rubbish one, right?

As the proud new owner of a FreeStyle Libre (may the universe rain her blessings down on NHS Greater Glasgow and Clyde), I know the much-vaunted advantages. Ability to test more often and easily. Probable positive effect on your HbA1c levels (the long-term measure of blood glucose in the body) and reduced likelihood of complications.

Here, then, are my observations on the lesser quoted points you notice when you wear one…

  1. I’m clumsy as heck. Yes, I keep bumping into door frames. Maybe I always have walked into them on a regular basis but when I hit my right arm (the one I’m wearing the sensor on) off a door frame, I notice. Three times in the first four hours of wearing it.
  2. The absence of black dots. Those of us who’ve spent our lives doing five or six blood tests a day (see above) can hold out fingers tips covered in tiny black dots. Occasionally, the skin peels away in protest. Three days in and mine VANISHED.
  3. Oh, the joy of the night-time test! You wake up, roll over, grab the sensor from our bedside table and wave it in the direction of your arm. Voila! The result. No messing around opening that wee case up, taking out the tube of sticks, popping it open, finding a stick and taking three attempts to insert it into meter, pricking your finger and missing the stick with the dot of blood, etc. And all done in the dark because you don’t want to disturb your other half.
  4. No more vampire impressions. I did blood tests on public transport, in offices, when out and about, in the gym, the cinema, the pub, restaurants and more. And I was discreet about it, but when your finger bleeds you suck it to get rid of the excess, right? Some folks think that is disgusting or that you should always wipe it on a tissue or surgical wipe. Who has the foresight to carry all that around as well as everything else?
  5. Having to remind yourself you can test whenever the heck you want. I’ll get used to the feeling quickly but I’m still adjusting. Shall I test again? No, no I only pricked my finger an hour ago and I’m only prescribed XX amount of sticks every months so no… Stop right there, lady. Shall I run the meter over my sensor again? Yes, yes, yes!*
  6. Staring at your graph. Oh the fascination of watching what your blood sugar levels get up to over eight hours. Telling yourself you will record this properly, oh yes you will, and work out patterns so you can make educated adjustments, rather than relying on guesswork.
  7. Missing the sight of blood. As you might have guessed, the intro to this piece was a big, fat lie. I’m one hundred percent happy that bloody fingers are a thing of the past (ish, you still have to do some).

* Ten’s the recommendation, in case you were wondering. Too many’s not good on the sanity levels.

My people all together – #type1diabetes

Emma6 Comments

blood testing equipment type 1 diabetesEver sat in a room and thought, “I am with my people”? That was my experience this week as I attended an education session the NHS had put on; my attendance a condition for prescription of the Abbot FreeStyle Libre.

I doubt I’ve ever been in a room with so many other type 1 diabetics. Sure, type 1 is a hidden condition. Perhaps others travel on trains with me or flit about the offices of the University of Glasgow dropping their test strips wherever they go?* Still, my original statement holds. I reckoned on about 200 people there, with perhaps a third of them partners or parents.

All shapes and sizes

I arrived at the Queen Elizabeth University Hospital early and watched in fascination as folks trooped in to the lecture theatre. We come in all shapes and sizes—all ages, all colours and all creeds. Who were the ones with diabetes? I put it down to those of us who carried our precious bag—the FreeStyle Libre and the doctor’s letter handed out when we registered—tightly. I’d expected lots of young people, but that wasn’t the case. The average age, I reckon, was mid to late 30s. Every time I saw someone who looked a lot older come in, I cheered silently.

Take that, reduced life span, and shove it where the sun don’t shine.

Our session took the form of a PowerPoint presentation by one of the diabetologists at the hospital, followed by some Q and As. I didn’t bother asking anything. As an introvert, I’m not going to raise my hand in a room that full of folks—even if they are my people. But there were plenty who didn’t suffer from shyness who dived in.

Can you scan your sensor through clothes? Yup. (So handy!)

Can you swim with it? Yes, but only half an hour is recommended. (Seriously, do people swim for longer than that? It’s the world’s most boring form of exercise unless you’re in open water.)

How long does it take for the prescription to come through once you hand the letter to your doctor? About 48 hours.

Can you connect it to your phone? Yes—there’s an app for it.

What happens if it keeps falling off? Some people have slippier skin than others. Thankfully, the two times I tried the sensor it stayed in place for its allotted fourteen days.

Talking to my people

I longed to talk to my people, but didn’t. See above-mentioned introvert tendencies. Who would I have chosen? The Indian girl who talked about running, exercising and wearing a sensor? The man behind me who asked if the Libre 2—the one with alarms that sound if your blood sugar levels go up or down too rapidly—would be available for us in the future? The glamorous young couple where I couldn’t work out which one would hold out the fingers covered in black dots from too much finger-pricking?

No. The one I’d have picked out was the woman I guessed to be in her late 30s who came in with an older man and woman I took to be her mum and dad. I watched her sit down near me and wiped away a wee tear. That might have been me once upon a time, attending with my lovely, supportive ma and pa. My father died nine years ago and how I’d love to have shared this new, wonderful development in diabetes care with him.

Session over, my precious bag and I got onto the bus to go home. “A new chapter, Emma B,” I said to myself. “How terribly exciting.”

*About to become a non-problem. Yay!

FreeStyle Glucose Monitoring – an Update

Emma10 Comments

freestyle libre on the Diabetes DietHashtag love the NHS—and the NHS in Scotland if we’re going to be specific.

Off I trotted to the diabetic clinic on Thursday armed with my best persuasion skills. Oh pleasy-weasy dear doctor, may I have a FreeStyle Libre flash glucose monitoring system? One of my arguments was going to be—Hey, you won’t be paying for it for too long. Did you see the recent research that tells me I can expect to knock eighteen years off my life expectation?!*

In the end, my polished debate wasn’t needed. Just as well as I couldn’t sell hot-water bottles to the Inuit. Or ice-cold beer to Australian sun-bathers for that matter. I brought the subject up. The doctor queried the number of blood tests I do per day and voila. I’m on a list. I’ll need to go to an education event and after that, a letter wings its way to my GP recommending she prescribes the sensors.

Sensors

Flash glucose monitoring for those of you who aren’t familiar with it is where you wear a sensor on your body (usually your upper arm) and you can take a reading from it using a monitor. It differs from blood testing in that it’s super quick and easy. You don’t need to prick your finger and you can check endlessly and the sensor works through your clothing.

Those of us who tend towards obsessive compulsive disorder—it’s hard not to when you’ve got diabetes—might baulk at that, but I am looking forward to monitoring what happens to me during exercise. And when I’m eating.

The device doesn’t come with an alarm—i.e. a warning when your blood sugar goes too far up or down, or it changes rapidly but there is software for that. The cat lover in me is delighted the manufacturers chose to call the software MiaoMiao, and this sends readings to your phone every five minutes, and will warn you of spikes.

Hello Big Brother!

You can even connect it to others’ devices, so they can monitor you too. I’ll skip that as it feels too Big Brother-y to me. Most type 1s hate other people telling them when they are hypo. Imagine how much worse this would be!

Incidentally, all this new diabetes-related tech has had a knock-on effect on the hospital I go to. Thursday’s clinic was running one hour late because it was so busy. The doctor told me he can’t get the GP support (where a GP handles some of the patients to gain experience in diabetes care), thanks partly to the fast development of new tech.

Our GPs are under so much pressure, it’s too difficult for them to keep up with all the tech that type 1s use these days—pumps, continuous glucose monitoring, flash glucose monitoring, software and more. My appointments have been spaced eight months apart for the last few years and that’s likely to change to a year from now on.

But in the meantime, I have my new toy and a whole heap of questions for Google. Can you wear it in the steam room? How much is MiaoMiao? How many actual blood tests do I still need to do to calibrate the thing?

Thanks again NHS Scotland. I look forward to reporting back.

 

*Whatevs. I debated discussing the research here and decided it wasn’t useful. Doom-laden stuff is such a turn-off isn’t it? 

Diabetes: I’m Thankful For…

Emma4 Comments
diabetes diet
Go to bed early with a good book and other advantages to diabetes.

How much does diabetes shape your personality? If you’ve ever experienced high blood sugars while at a party or surrounded by other people, you’ll know feeling tired and ill turns you into an introvert. Making conversation, especially with strangers, requires far too much effort.

Perhaps many of we introverted diabetics are extroverts dying to get out? Without the ups and downs of diabetes, we’d be flinging ourselves at strangers, auditioning for the X Factor, dominating meetings at work and organising sing-songs whenever we get together with friends and family?! Everyone would secretly dread us coming into a room. “Oh no, it’s XXXX. Now we’re going to be bullied into singing/dancing/playing some daft game.”

Just a thought…

When you experience on target blood sugars, the resultant energy gives you confidence – the kind of confidence that makes life’s more extroverted activities do-able and possible. I was diagnosed with type 1 diabetes at the age of nine and it’s been with me for all of my adult life.

There are plenty of positives diabetes has given me. One of the blogs we follow – Georgina M Llloyd – listed 30 ways diabetes has helped improve her life. I had a think about some of the ways it has shaped mine.

Here they are:

Organisational skills. You need tip-top organisational skills to stay on top of diabetes – ensuring you have enough medication, ordering and picking up repeat prescriptions, making sure you have carry enough medical gear with you, planning for exercise, keeping glucose tablets or jelly babies on hand, preparing for holidays etc.

An appreciation of the UK health system. A civilised country provides free healthcare to its citizens. As a type 1 diabetic, I’m so glad I live in the UK. All my medication, hospital appointments and eye checks are free. If I want extra help from a diabetic  nurse, that won’t cost anything either. I’ve got gum disease (it’s one of the side effects of diabetes, but it’s also common among the general population) and I’m receiving treatment at the dental hospital. That’s free too.

The ability to say no. Georgina mentioned this one too. When you’re a people pleaser as I am, it jars to say no to food people have lovingly prepared and placed in front of you. Practise it enough and it becomes automatic. And then you can use that ability elsewhere; being asked to do too much, for example.

A love of walking. I’ve tried lots of forms of exercise over the years. Walking is the best – it’s gentle, easy and it serves more than one purpose. It’s exercise, but it gets you from A to B. It’s exercise, but it helps lower your blood sugar levels. It’s exercise, but it calms the mind at the same time. It’s exercise and it gives you access to fresh air, beautiful views, chats with dog owners and more.

Health and fitness is my hobby. It might have become one of my interests anyway, but thanks to diabetes I’ve always found diet and activity fascinating. These days, we’re lucky enough to have access to lots of information. we can do our own research and work out the best ways to look after ourselves.

It gives you an excuse to go to bed early. A cosy bed and a good book? Just tell your other half that you want to read, sneak upstairs, put your pyjamas on and dive in. It’s legit because you need more sleep anyway, right?

How has diabetes improved or changed your life? What are you grateful for? 

 

 

Diabetes in the News – the Perils of Being a Woman and “Smart Insulin” Trials

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Animals may have been harmed in the makings of this research.
Animals may have been harmed in the makings of this research.

It’s difficult to avoid news about diabetes, as there are regular articles in the press – from the doom and gloom predictions about burdens on the healthcare system to simplistic pieces about “cures”, diabetes makes the news on a regular basis.

Two news items caught my eye recently: one which talked about the greater risks faced by women with type 1 diabetes, and one about “smart insulin”.

As an optimist by nature, I prefer to ignore the first and concentrate on the second and its potential; however, if you are interested – there’s a good discussion of it on the NHS news website, which separates the attention-grabbing headlines from the facts and discusses the origins of the research.

[In short, the NHS reckons the Daily Telegraph’s coverage of the study which was carried out by the Universities of Queensland and other universities in Australia, the Netherlands, the UK and the US, expressed the results in way that could be misleading. Saying for example that “female patients are twice as likely to die from heart disease than men with [type 1 diabetes]” was too simplistic an explanation because men do not generally live as long as women.

The researchers did not directly compare rates of death in men and women – they compared risk of death over a given period in women with type 1 diabetes, compared to that of women in the general population and then made the equivalent comparison with men.]

The other piece of news was about the development of “smart insulin”: i.e. an insulin which can respond to blood sugar levels directly and bring them under control. Type 1 diabetics and some people with type 2 diabetes take insulin to control blood sugar levels, but it can be tricky to work out how much to take, as there are many different things that have an impact on your blood sugar levels – from doing exercise, to missing a meal, from feeling ill to feeling stressed, under or over estimating the number of carbohydrates in a meal, drinking alcohol, hormonal fluctuations in the lead-up to getting your period (women of menstruating age) and more.

The smart insulin study was carried out by researchers from Massachusetts Institute of Technology in the US, funded by donations from the Leona M. and Harry B. Helmsley Charitable Trust and the Tayebati Family Foundation.

An animal study on mice found that “smart insulin” containing a molecular switch could directly respond to blood glucose levels (high levels) and bring them under control for as long as 13 hours after the initial injection. The study involved giving mice with type 1 diabetes a sugary drink. The “smart insulin” was a modified insulin containing two small chemical molecules that bind to insulin, one of which was a glucose sensor. Having taken sugary solutions, the mice with diabetes who had been given the modified insulin were able to rapidly normalise blood glucose levels – in a similar way to healthy, non-diabetic mice.

The NHS news site called the results “promising”, but pointed out that the research was in its very early stages and that it had been carried out on mice. Years of research and clinical trials would be needed – developing the treatment for humans, seeing if it was safe for humans, carrying out research on large numbers of people – before “smart insulin” could be used by humans. Promising research into the treatment of mice with diabetes does not equate to effective results for human beings.

In short, a simple, take-home message is: don’t wait out in the hope of the appearance of smart insulin any time soon, and in the meantime those with type 1 and type 2 diabetes (male OR female) should look to controlling their diabetes as best they can.

 

You can read about research and low-carbohydrate diets and their effect on health and reducing blood glucose levels here. And if low-carbohydrate dieting is something you want to explore, please see The Diabetes Diet.