T1 Tenor

June Update & Miaomiao (Libre CGM-enabler) Libre Funding - Data to end of April Funding for Libre continues to ebb and flow with some great advances, some significant let-downs and plenty of fence sitting.  I have taken a special interest in three areas.  Birmingham/Solihull CCG (because it's where I live and is the largest CCG), Bristol, North Somerset, South Gloucestershire CCG (because it's the second biggest, people from our Facebook group have set up a separate pressure group and because their decision is similarly flawed to the Birmingham decision), and South Warwickshire (as their decision to fund with a ridiculous criteria, whose only logic is to stop anybody actually meeting the criteria set!). So, to update the current prescribing situation - note Scotland - more later! The situation is Scotland is being driven by the Edinburgh Centre for Endocrinology & Diabetes led by Dr Fraser Gibb .  They are being innovative both how they are initiatin...

I often see questions about supply and get asked for updates.  I try and keep in touch with retailers to ensure that any issues are quickly resolved and people get the full picture.  Here's the current 'state of play'.  I've taken my March update and updated it, as much of the information is still relevant. Getting it on Prescription Firstly, the prescribing of Libre.  Wales have said yes, most other areas have said perhaps.  This map shows the current status by CCG:  Diabetes UK Joint Policy Tracker .  There are improvements, but this demonstrates the postcode lottery. The data on prescribing rates are published but this data is woefully slow to become in the public domain. Here's the data so far: There are CCGs like Manchester and many London CCGs that have now approved prescribing, but it's slow and notable CCGs have rejected funding, for example Birmingham & Solihull (BSol CCG).  Myself and others are working to overturn the...

The first couple of weeks of April has seen the remaining UK data for sensor prescriptions released for January 2018 and today (11/04), the data for February for Northern Ireland has been released. Here is a summary of the total sensors prescribed and the number of prescriptions written for the four countries of the UK. The increase in sensors prescribed is shown graphically below. It will be interesting to see how the increase continues and at some point it will level off - if the London area CCGs make a positive decision, then I think the England spike will dwarf anything that's gone before. In the meantime, Abbott still don't seem to be able to supply effectively.  I'm not convinced that manufacturing capacity is behind the long lead-time.  Logistics are undoubtedly complex and will take time to sort.  Meanwhile, it seems sensible to procure sensors from pharmacies - if you can convince them to read their emails from Head Office!

Since November 2017 and the official listing of Libre on prescription, so much has changed, but has it changed for the better? I think broadly the answer to that question is No, but not for want of trying.  The situation has become increasingly confusing and disjointed. Getting it on Prescription Firstly, the prescribing of Libre.  Wales have said yes, most other areas have said perhaps.  This map shows the current status by CCG:  Diabetes UK Joint Policy Tracker .  There are improvements, but this demonstrates the postcode lottery. The data on prescribing rates are published but this data is woefully slow to become in the public domain.  The final UK country to publish data was Scotland, which finally released December data on 13th March! Here's the data so far: This shows an increase, but hardly an avalanche!  Wish I could see the January data...Northern Ireland should publish very soon though. There are CCGs like Manchester that have...

Can anyone advise on where my logic falls down? It must do, but this has been playing on my mind for a while. The basic question is...why would someone on MDI need to test 5-8-10+ times a day? I can feel people's heckles being raised already, but keep reading. I'm T1 on MDI, Levemir (split dose) and Novorapid (peak action 1-3 hours, tail of action 3-5 hours). Clearly, testing regimes must be very different if you're on a pump. Have a look at the table below showing a typical 'Nick Day'. OK, I don't eat lunch, both because I like the nice flat line I get on my Libre (hence better A1C, I hope) and I've found I don't need it. If you look at the table, I've only managed to find five times where I think it could be worthwhile to check levels - in time, I think one of the morning ones could go too, so in reality four. At all other times, it seems pointless to me as either nothing should have changed (perhaps the 'should' is the key here) ...

First response from the diabetes lead ​Dear Nick Thank you for your email;  I have forwarded to the CCG Medicines lead for a reply.  We already have limited access to the Libre along RMOC lines and anticipate adopting the new guidance in full. Yours Final Response - Links have been changed - this works though: LINK Comprehensive reply from Bedfordshire CCG ( original letter ) : Dear Mr Cahm FreeStyle Libre®   Glucose Monitor Thank you for your letter regarding the availability of the Freestyle Libre® Glucose Monitor on the NHS in Bedfordshire. In June 2018, the Bedfordshire and Luton Joint Prescribing Committee (JPC) agreed to support the prescribing of Freestyle Libre® in adults and children in line with the recommendations produced by the East of England Prioritise Advisory Committee (EoEPAC). In addition Bedfordshire CCG agreed to fund Freestyle Libre® subject to minor amendments in line with the JPC recommendations and criteria outlined in...

Final Response