[Diabetes] General Chat and Support Thread

ohnonotgmail · 01-12-2019 9:12pm

I was in with my gp on friday and i had my prescription renewed while i was there. He mentioned that the green LTI book was being done away with. Has anybody else heard that?

Harry Palmr · 01-12-2019 9:14pm

Nope but I stay well away from my GP, only renew the book when I'm pushed into it by circumstances.

Meauldsegosha · 01-12-2019 9:16pm

ohnonotgmail wrote: »

I was in with my gp on friday and i had my prescription renewed while i was there. He mentioned that the green LTI book was being done away with. Has anybody else heard that?

I think the book is being replaced with a card but the scheme in continuing.

Aceandstuff · 01-12-2019 10:54pm

https://www.youtube.com/watch?v=

ohnonotgmail wrote: »

I was in with my gp on friday and i had my prescription renewed while i was there. He mentioned that the green LTI book was being done away with. Has anybody else heard that?

I went to a GP about three weeks ago who claimed she'd never seen the LTI book before, and I was only given a one-off prescription for my stuff. I'll be changing doctors again in a month or so, and I thought that might have been why. She never mentioned to me that the scheme was ending, and neither did the diabetes clinic at the hospital.

I just looked it up there, and apparently the booklet for the scheme is being replaced with a card, but the scheme is not being "done away with".
https://www2.hse.ie/services/long-term-illness-scheme/long-term-illness.html
"Long-Term Illness Scheme card
If your application is successful, you will get a Long-Term Illness Scheme card. This card replaces the Long-Term Illness Scheme green book."

I don't know if this means we all have to apply for the scheme again, but I'm sure we'll find out!

Buford T. Justice XIX · 01-12-2019 11:32pm

ohnonotgmail wrote: »

I was in with my gp on friday and i had my prescription renewed while i was there. He mentioned that the green LTI book was being done away with. Has anybody else heard that?

I haven't seen my book in years. I get a 6 month prescription every time I see my endo and hand it into the chemist.

ohnonotgmail · 02-12-2019 10:02am

Meauldsegosha wrote: »

I think the book is being replaced with a card but the scheme in continuing.

Yeha i didnt think the scheme was being done away with, just the book. Would be nice if they informed people who are currently on the scheme.

CramCycle · 02-12-2019 11:10am

ohnonotgmail wrote: »

Yeha i didnt think the scheme was being done away with, just the book. Would be nice if they informed people who are currently on the scheme.

I don't think it makes a difference, I haven't seen my book in years, just hand the script into the pharmacist for a photocopy every now and again.

ohnonotgmail · 02-12-2019 11:21am

CramCycle wrote: »

I don't think it makes a difference, I haven't seen my book in years, just hand the script into the pharmacist for a photocopy every now and again.

but how does the pharmacist know it is an LTI prescription?

CramCycle · 02-12-2019 11:25am

ohnonotgmail wrote: »

but how does the pharmacist know it is an LTI prescription?

They have my LTI number on the computer, and the orders are similar to what was before. In fact, my current pharmacy has never seen an LTI book from me, just gave the number the first day I went in, dropped in a script after my next check up and that was that. A pharmacist should have a fair idea of what should and should not be covered by the LTI scheme.

ohnonotgmail · 02-12-2019 11:31am

CramCycle wrote: »

They have my LTI number on the computer, and the orders are similar to what was before. In fact, my current pharmacy has never seen an LTI book from me, just gave the number the first day I went in, dropped in a script after my next check up and that was that. A pharmacist should have a fair idea of what should and should not be covered by the LTI scheme.

Fair enough. When i was first diagnosed i was told that all LTI prescriptions had to go into the book and that i had to show the book every time i wanted any medication.

CramCycle · 02-12-2019 11:43am

ohnonotgmail wrote: »

Fair enough. When i was first diagnosed i was told that all LTI prescriptions had to go into the book and that i had to show the book every time i wanted any medication.

Once you have the number, most pharmacists will just take your details, put it in the PC and it pops up, the booklet seems redundant. I leave my script in the pharmacy now but I have often stopped in others and just given my number and never had an issue.

banie01 · 02-12-2019 11:48am

ohnonotgmail wrote: »

but how does the pharmacist know it is an LTI prescription?

Each of the LTI scripts are approved for a core group, rather than specific medications. Examples can be seen here
So your LTI book is approved for particular core list, rather than set medications.
The use of the book means that you still have to go and have a list of meds written up and added to the book every 6 months, but in general if you are on the core F list your pharmacist will dispense any core F approved med.

ohnonotgmail wrote: »

Fair enough. When i was first diagnosed i was told that all LTI prescriptions had to go into the book and that i had to show the book every time i wanted any medication.

Technically they do, but I know in my own case my book stays in my local pharmacy apart from a couple of days every 6 months when i take it off to my GP to be renewed.
Even when i was switched to Insulin, the script from the endo was dropped into my pharmacy and it ran concurrently with the book until i got the LTI rewritten a few months later.

The card has been talked about for years, never seen one nor heard anything official yet tho.

MrMacPhisto · 02-12-2019 12:58pm

Does anybody have any experience of using FIASP insulin compared to NOVORAPID? Any opinions? I find it difficult to take insulin 10-20 minutes prior to meal, so the FIASP sounds appealing.

echo beach · 02-12-2019 8:07pm

The LTI book is your authorisation to use the scheme for whatever indication you have been approved for. Your number is recorded by the HSE so all pharmacies can check if it is valid.

The prescription allows you to obtain the medicines. It doesn’t matter if it is written into the book or not but if it isn’t the pharmacy they can’t know if a it is on LTI unless you give them the number.
All new applicants are getting a card. There are no plans to replace existing books but that might happen in the future. The important thing is to have a record of your number.

Wanton · 04-12-2019 9:53am

Re the LTI.

Not only can they search any LTI number, they can also search the system using your PPS number (or what ever its called recently).

I have for years had my LTI number saved to my phone for emergencies. Have more than once had to go into some random chemist for emergency suppies, gave in my LTI and went about my business.

Recent trip to Cork everything that could go wrong went wrong and ended up in a late night chemist. Gave my LTI. "thats great Steven, thanks". Eh, my name isnt Steven. Turns out I had two number reversed with the number i have saved all this time. But my he could search under my PPS to find the correct number.

As previous post suggests, all the LTI does is say your approved for the scheme, then the perscription is only required really so the chemist knows what medication your meant to take. They will get paid either way!

echo beach · 04-12-2019 2:48pm

Wanton wrote: »

As previous post suggests, all the LTI does is say your approved for the scheme, then the prescription is only required really so the chemist knows what medication your meant to take. They will get paid either way!

The prescription isn't just for the pharmacy to know what you are taking. You need a valid prescription (i.e one written within the previous six months) to get any medicine that is subject to prescription control, which includes most diabetic medicines but not strips, needles or lancets.

No matter what anybody might tell you, no prescription is valid for more than six months.

ebbsy · 04-12-2019 8:59pm

Back over in Newcastle today for another 6 months of Noctura glasses plus a scan. It does not appear to have got worse since the last time.

I have also not had a bleed for around 18 months now, a record for me.

banie01 · 04-12-2019 9:27pm

ebbsy wrote: »

Back over in Newcastle today for another 6 months of Noctura glasses plus a scan. It does not appear to have got worse since the last time.

I have also not had a bleed for around 18 months now, a record for me.

Thanks for the update Ebbsy, delighted to see the Noctura working out so well for you

The updates are very much appreciated.

robinph · 04-12-2019 11:27pm

MrMacPhisto wrote: »

Does anybody have any experience of using FIASP insulin compared to NOVORAPID? Any opinions? I find it difficult to take insulin 10-20 minutes prior to meal, so the FIASP sounds appealing.

I switched to Fiasp in my pump earlier this year and the difference was definitely obvious in the reaction time. Like you I don't take the bolus 20 minutes before, will normally be only once the food is infront of me and never before.

However, after a couple of months on Fiasp it seemed to not work as well and I was constantly having to bolus extra corrections but even they would take ages to work. Also I'm convinced that it was affecting my thyroid medication as well so after a bit of messing about with the GP refusing to change my prescription until they got another letter from the hospital I finally switched back to Novorapid.

Reports I've seen online seem to vary and for some people it continues to work fine, just be aware incase it doesn't. If it does stay working for you then it's definitely an improvement on Novorapid so I think it's worth trying despite the chances that it might not work.

MrMacPhisto · 04-12-2019 11:50pm

robinph wrote: »

I switched to Fiasp in my pump earlier this year and the difference was definitely obvious in the reaction time. Like you I don't take the bolus 20 minutes before, will normally be only once the food is infront of me and never before.

However, after a couple of months on Fiasp it seemed to not work as well and I was constantly having to bolus extra corrections but even they would take ages to work. Also I'm convinced that it was affecting my thyroid medication as well so after a bit of messing about with the GP refusing to change my prescription until they got another letter from the hospital I finally switched back to Novorapid.

Reports I've seen online seem to vary and for some people it continues to work fine, just be aware incase it doesn't. If it does stay working for you then it's definitely an improvement on Novorapid so I think it's worth trying despite the chances that it might not work.

Thanks Robin, that's all interesting. I think I will stick with Novorapid until next review in May and see what my consultant thinks.

Currently I am doing ok with Novorapid but like you, I am calculating my carb intake and bolus just before I eat, which is not ideal.

I think you use the Libre? Was there a noticeable difference in your post meal graphs between FIASP and NOVO?

On another note, do you think it had any affect on your running training?

Thanks

robinph · 05-12-2019 12:03am

MrMacPhisto wrote: »

Thanks Robin, that's all interesting. I think I will stick with Novorapid until next review in May and see what my consultant thinks.

Currently I am doing ok with Novorapid but like you, I am calculating my carb intake and bolus just before I eat, which is not ideal.

I think you use the Libre? Was there a noticeable difference in your post meal graphs between FIASP and NOVO?

On another note, do you think it had any affect on your running training?

Thanks

The reaction times were noticeably quicker on the Libre graphs for the first while when it was working. I was delighted with it still when I went back for the review at the hospital after a bi more than a month. Not long after that though it seemed to stop working for me.

I didn't register any difference with the running although it was meant to be out of your system quicker I think which can be useful for when you can eat around training. But I then started to feel really really crappy due my thyroid levels being messed up which had a bigger effect on the running. It was only that I happened to have the annual bloods for that taken shortly afterwards that I figured out that was why I was feeling crappy though and I was then reading in great detail the contraindications on the Fiasp research papers and found some very minor notes of potential reactions to my specific thyroid drugs. Think that is a rare coincidence though as I've seen little else from other saying similar.

I think if they are prepared to put you on Fiasp then give it a go, although maybe not over Christmas with changes to routine and quantity of food on your plate happening.

MrMacPhisto · 05-12-2019 12:18am

robinph wrote: »

The reaction times were noticeably quicker on the Libre graphs for the first while when it was working. I was delighted with it still when I went back for the review at the hospital after a bi more than a month. Not long after that though it seemed to stop working for me.

I didn't register any difference with the running although it was meant to be out of your system quicker I think which can be useful for when you can eat around training. But I then started to feel really really crappy due my thyroid levels being messed up which had a bigger effect on the running. It was only that I happened to have the annual bloods for that taken shortly afterwards that I figured out that was why I was feeling crappy though and I was then reading in great detail the contraindications on the Fiasp research papers and found some very minor notes of potential reactions to my specific thyroid drugs. Think that is a rare coincidence though as I've seen little else from other saying similar.

I think if they are prepared to put you on Fiasp then give it a go, although maybe not over Christmas with changes to routine and quantity of food on your plate happening.

Cheers, thanks for all of that. Food for thought

I think I shall research a bit further. I am pretty stable at the minute and I have just started training for a spring marathon so I am reluctant to make any changes. I will probably wait until that's all done and dusted before making a change.

I was thinking the reduced working life of the FIASP could be a benefit for the running.

Thanks again.

echo beach · 05-12-2019 8:40pm

Alanstrainor wrote: »

So back in November I posted here to say that I had moved to a new insulin in my pump. FIASP claims to be the fastest acting insulin on the market taking affect after 2 minutes and helping to reduce spikes and making correction bolusing much quicker.

When I started I felt I could notice a difference immediately. Correction boluses would see my sugars fall rapidly after, and it seemed that it was exactly what was promised. I did have some trouble with my basals, as the new insulin would require a quite different basal profile which I had to figure out. All of this was expected and I tried my best to adapt.

However in the last 6 weeks I noticed my daily intake of insulin was increasing, bolusing was no longer as rapid, and my bolus dosages started to go through the roof. On top of this, I began having site issues, sites would not last 3 days any more, and would become irritated and sore after a relatively short time. This week I was forced to swap back to my tried and tested Novorapid. Despite having a vast supply of FIASP in the fridge.

So in conclusion, it started well and then went all tits up over time. To the point of being unuseable. It's a shame really.

Bumping this as Fiasp has come up again

robinph · 10-12-2019 2:03pm

robinph wrote: »

Have currently got the Libre provided on prescription from the NHS and recently stumped up the cash for a Miao Miao to link it to my phone and smart watch as a CGM. Just decided to have a play with the Android Loop app, although it's not possible to actually loop with my pump as it's the wrong brand/ model. The app does seem to be pretty good with noticing when to make very minor tweaks to the basal settings on the pump based on the CGM readings that it gets, although I can see it getting old very quickly with me needing to manually change the settings every half hour. If I can manage to run the app for a couple of days without getting too annoyed it might give me a bit better insight into what tweaks to basals and boluses I might need to make.

If nothing else it shows what is technically possible from a few random people coding things together over the internet, even if getting it released as a properly licensed device is still years away.

So after just a couple of weeks of running in open loop mode with my phone beeping at me every now and then to adjust the basal rate a bit my Hba1c prediction on the Libre app is now descending in the right direction. Had be floating up around 9% for ages (although the actual blood test results would tend to come in a half percentage lower). I've now got it giving me a prediction of 8.5% and it's continuing to go in the right direction.

I'm sure it will become far trickier to get to move downwards soon, but so far the extra beeps from my phone telling me to make adjustments haven't been too annoying and the results from putting up with that extra beeping are fantastic after years of zero progress. Have even been able to run with slightly lower BG when running but the predictions it's giving me for during the run being something I need to better understand yet and figure out the easiest way to respond to those notifications.

pew · 10-12-2019 7:50pm

pew wrote: »

I had my best hba1c to date this week. They have gotten rid of the Glicazide and reduced my metaformin. I'm so happy. Its going to way I want it to go.

So I was started on Ozempic because I was struggling to loose weight. It's not that I wasn't trying I was watching what I was eating and doing loads of exercise but the weight just would not budge.

Still kinda have some effects I was on 0.25 dose for 4 weeks and now I'm on 0.5 for a little while. Lost a stone so far which I'm delighted about.

Problems with it: Its turned me off certain meats, dairy and peanuts oddly enough. A lot of nausea, and bum sickness

It reduces your appetite alot, so if you eat a normal amount you do generally feel ill.

It seems to be good so far but I'll see when I get on with the next hba1c. Sugars have been OK now that I've gotten used to it.

Harry Palmr · 11-12-2019 1:07pm

No one has ever suggested a pump to me, is it only for "hard cases"? Or does it just depend on what a given consultant thinks or the HSE budget at a given moment?

Buford T. Justice XIX · 11-12-2019 2:08pm

Harry Palmr wrote: »

No one has ever suggested a pump to me, is it only for "hard cases"? Or does it just depend on what a given consultant thinks or the HSE budget at a given moment?

My Endo was onto me for a while to switch over to the pump. My control was good, probably too good, tbh, a lot of hypos at different times of the day and night.

On the Medtronic 640c atm with CGM and an automatic turning off basals once my bloods drop to 4.0 and switch it back on once it goes above 4.0 again.

I had a small crisis last night when I dropped below 4 as it took me till 2am to get it back above 4 again. If I was taking basal injections as before, I would have been in a spot of bother as I went down to 2.0 for a good while before it started to rise again. As there was no short acting insulin from the pump, there was no insulin to fight against to get my bloods up. It would have been a struggle with long acting basal insulin, though.

6.7 for the rest of the night so worked out ok. There's still a bit of life in my pancreas yet:)

Harry Palmr · 11-12-2019 2:18pm

It's not something I'm seeking I should say, more curious than anything. My job can be pretty physical I'd worry about damage or unhooking the catheter and not realising.

Buford T. Justice XIX · 11-12-2019 2:33pm

Harry Palmr wrote: »

It's not something I'm seeking I should say, more curious than anything. My job can be pretty physical I'd worry about damage or unhooking the catheter and not realising.

It does happen, Harry, but there are different infusion types for peoples requirements. I'd be fairly active most days and use the Minimed Mio 30 rather than the Minimed Mio. It's a longer catheter and a shallower angle and it hasn't pulled out on me so far.

The older Animas pump I was using used be a nightmare as you would literally have to check every time you bolus to make sure it was still inserted. And if it wasn't, whatever insulin was pumped before you spotted it was disconnected was counted as being active even though it wasn't injected so you would have to increase your bolus to compensate and get an active insulin reading that was too high for a few hours after as well.

With the right catheter, it shouldn't be an issue except on a very rare occasion.

robinph · 11-12-2019 5:10pm

Buford T. Justice VI wrote: »

With the right catheter...

Cannula, a catheter would go somewhere else entirely. :eek:

[Diabetes] General Chat and Support Thread

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