One easy way to improve your diabetes control……

If you’ve been diagnosed with diabetes you will have had all sorts of information thrown at you; about the disease itself, your treatment options, diet and exercise advice, driving safely and avoiding ‘hypos’ – low blood sugar. It can be a confusing time, with so much to take on board and so many changes to your lifestyle in order to stay healthy.

Your GP, and probably a specialist diabetes nurse, will help guide you through the best options for you in terms of medicines and lifestyle changes. Treatment will depend on whether you have type 1 or type 2 diabetes, as well as your age, state of health and current lifestyle.

Whichever options you choose, unlike most other diseases, there is a relatively easy way of making sure your treatment is working and your condition is being managed as well as possible. You don’t have to go to hospital or your GP for regular blood tests; you can do it from the comfort of your own home, any time, any place. It’s called self-monitoring of blood glucose (SMBG). Your blood sugar level is a measure of how your body is responding to your medication, food intake and physical activity.

Self-testing should make it easy to build in to your daily routine, but of course, it also makes it easy to forget and easy to ignore. Especially if no-one has told you why it’s so important. The specific details of when and how often to test will be different for different people. But no matter your personal circum­stances, monitoring your own progress has many benefits:

  • It helps maintain your blood sugar within defined limits – your target range
  • This means you can detect and prevent low blood sugar (hypog­ly­caemia) – something that can put your life in danger if not reversed
  • Detecting and preventing high blood sugar is just as important. Prolonged high sugar levels lead to many of the compli­cations of diabetes – vision loss, skin ulcers, even gangrene
  • It can tell you if your medication is working, or if your dose needs adjusting
  • It can tell you if changes to your diet or exercise plan are helping

There is a difference between monitoring and testing – the test just gives you a result, a snapshot of your blood sugar level at one moment in time. It’s not enough just to test; you need to record your results over time, evaluate them and above all, act on them. What are your test results telling you about your condition? Do you need to adjust your medication, or your food intake? By acting on your results you will have better control of your condition and prevent serious compli­cations.

There are lots of different testing meters available with a wide range of functions. The Accu-Chek® brand is popular with different meters to suit all budgets. There are also FreeStyle® meters, CareSens®, GlucoRx®, and many more. They all work with a small blood sample applied to the brand’s matching sensor strip. Whichever meter you choose, check that the test strips are allowed on NHS prescription – most are, but some aren’t.

Now there is an even easier way to keep track of sugar levels – it’s called Flash Glucose Monitoring, or just Flash monitoring. The best known flash monitor is the FreeStyle Libre® system. It involves attaching a small sensor patch to your skin that stays there continuously for 14 days. The sensor measures the amount of sugar in your tissue fluids, rather than your blood, and has been shown to give reliable results when compared to measuring blood sugar1.  The sensor takes a measurement every minute and the data can be uploaded to an app so that you can track your sugar levels and see trends.

The key advantage of flash monitoring is that you can build up a much broader picture of how your sugar levels change over the day, based on what you are doing or eating. It means you can make finer adjustments to treatment and see the effects more clearly. And because you wear it at night, you can now see what happens to your sugar levels when you sleep. It also means much less finger-pricking to get blood samples; applying the sensor has been described as ‘painless’ for most users1.

If you use flash monitoring you will still occasionally need to test your blood sugar – for instance if the device is showing results outside of your target range, if you are ill or have an infection. In the UK, the DVLA requires you to take a blood glucose test prior to driving. This is because blood testing still gives a better, more accurate result.

Of course, you still need to act on the information the sensor is giving you. Building up a huge database of test results doesn’t help if you don’t do anything with it. Monitor your results, evaluate them and act on them; have better control of your diabetes and stay healthier for longer.

Although FreeStyle Libre® is now allowed on NHS prescrip­tion, doctors cannot yet prescribe it for everyone with diabetes. The NHS always has to weigh up the benefits of any new technology against the costs of treating whole populations. This means that currently only certain patients can be funded and there is variation across the country. Speak to your doctor or nurse to see if you are eligible on the NHS.

We are aware of two other Flash devices coming to the UK market in 2018; the Eversense® and SugarBEAT® systems. Watch this space for more information…….

1National Institute for Health and Care Excellence (NICE); Medtech innovation briefing [MIB110]; FreeStyle Libre for glucose monitoring; Published date: July 2017

This medical information was written by our clinical pharmacist Michael Stewart.

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