Frustrated

Wow, they are pricey on ebay - I found on the internet the cheapest is Walmart for 36 dollars - I did not find a real link to that on the walmart site

42 dollars at walgreens in this link

https://www.diabetesdaily.com/blog/freestyle-libre-cgm-now-available-in-us-pharmacies-492429/

Hi and welcome here.

If you are using low carb diet / intermittent fasting to help control diabetes, you need to be consistent… it can take days to weeks of consistent effort (and maybe weight loss) to get numbers down… so patience and persistence is key.

I am curious about the 5 meds. Are these all for diabetes? Can I ask which meds you are taking are for diabetes? If you are already on quite a number of meds for diabetes, then the next step is typically continuing metformin, stopping the other meds, and adding insulin (basal-bolus). Insulin always works when it is properly dosed. But it is far better when it is combined with low carb diet (to reduce the insulin requirements).

A second thought, have you been tested for type of diabetes? Many adults with diabetes are misdiagnosed as type 2 when they are actually type 1 / insulin deficient. Type 1 testing includes testing for antibodies (but it is still possible to be t1 without detectable antibodies). If you are insulin deficient then you absolutely need to take insulin. Insulin deficiency can be tested for by testing c-peptide and fasting glucose together.

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It would be interesting if all diabetics and even “prediabetics” got tested for antibodies. What we may very well see if Joslins research is on the right path is most would test positive if the attack was active or recent enough.

More are getting tested lately and we have a growing population of LADAs. No surprise there.

It would also be nice if we could get more T2s on CGMs especially now that they are becoming mainstream. It makes it so obvious which foods are doing what and the PWD can easily adjust their diet. It also makes it obvious what the meds are doing or not doing when it comes to post meal spikes.

I’m hoping this clears up any confusion as it seems like it was getting a bit confusing to me.

You don’t have to be on low carb to control your blood sugars, it’s just easier for some diabetics to do so.

Type 2 is insulin resistant diabetes, imagine a cell that needs glucose as fuel and there are locks on that cell that insulin has the key to open the locks, but those locks are rusty and don’t want to open easily so all the glucose builds up in the blood stream until the locks finally work open. The pancreas produces more insulin to try to open those locks and it does start to wear out over time and that is why some type 2’s at that point might need insulin.

This was how it was explained to me years ago in a class I was taking. And it just made it an easy way to understand. Technically it’s a close enough explanation.

Type 1 is auto immune, you have a gene that makes you susceptible to what seems to be the prevalent thought nowadays, a virus that your body tries to fight and mistakenly you start to target your own beta cells. This kills off the beta cells faster when you are younger, but when you are older they label it LADA nowadays because it takes years to completely happen. There also might be other causes of type 1’s, they are still not sure of causes and effects completely. They also believe a bunch of type 2’s are misdiagnosed type 1’s. I was.

You really only know if you are a type one for certain if you are tested for it. If you come back positive from the test, you definitely are, but if the tests don’t come back positive you can still be a type 1 in the unknown what’s going on group. But they can also do a C-peptide test to know if you are still producing insulin.

This is kind of important when you are eating right but still are having an issue. Because LADA’s will still produce insulin in what we call the honeymoon phase and production slowly goes away over time.

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It might be nice if all T2’s had access to CGM mostly for those who already follow the BG levels and are interested in managing diabetes. Before we make them available to the general t2 population, I believe we need to reform the diabetes education support system which has failed, More numbers that many don’t understand or care about does not help.

FYI I just returned from Ohio (family matters). Not a wealthy area, but not destitute. The shopping carts left the grocery store over flowing and the cars are new. I have known some of the people for over 50 years. They don’t really care to play with tech toys, or even worry about what they are eating. They just want a magic pill to make it go away. I do see that many love their pumps, numbers too high, just add insulin. Especially after a high carb meal.

Before I advocate for expanding CGM. I would want to make sure they are properly used and not wasted. I would hope there would be someway to prequalify to get the equipment, so that it does not end up in a drawer.

I am considering trying a CGM just for my information, no insurance would pay for it so it would be out of pocket. I test 5 to 8 times a day as a well controlled T2 (excessive some say, I don’t agree with that, and out of pocket for strips (CVS))

What should I expect it to cost?

Abbott Labs Libre is the cheapest

You have to buy a reader (one time)

sensors are prob around 60 bucks and last 14 days

they work great for some and not so great for others

my wife uses it and it has been a big help

Walmart is prob the best bet

Are you not on Medicare? They would pay for it or at least 80%, 100% with supplement, including all test strips, sensors, receiver, transmitters, meter etc.

I am on Medicare on Medicare advantage. I have not checked, but I will yearly visiting checkup soon. But I was under the impression that a well controlled T2 not on meds A1c under 6.0 they would not approve .

I will check in two weeks.

I am very interested in seeing. How my numbers do when I run longer distances.

AThanks

A1C or T2 is not an issue but when you say meds, you need to be on 3+ daily injections of insulin per day to qualify. Dexcom Medicare link below.
[Medicare Dexcom CGM FAQ]
(https://www.dexcom.com/faq/medicare)

Thanks, but no insulin, no meds. Thanks for the info.

If Iwant to do it out of pocket do I need an RX

Interested because, In the last 6 months (lots of family stress) moving not running much etc. I have gained 10 pounds, which before dx and after generally means I am over producing insulin probalbly cheating on the carbs. Before dx I went from 190 to 225 in a year, I just buckled down and controlled my eating (not carb controlled) and up exercise and ended up at 196 when I was diagnosed. Been down as low as 187.
My A1c is flat, my meter is showing that I am spiking/higher than previously.
Getting up to 140/150 on 15 carbs. So I thought the monitor would be the best way to check it out.

Now I want something that will make me 65 again. LOL

Yes you need RX but should be no reason your endo would not give you RX

Thanks, I will check with my PC, (I don’t qualify for much Endo time, once a year review of my records only. I did have a phone conversation once with an Endo.
He just said keep doing what I was, and that if all his patients were as controlled as I am, that he would not have a practice. So I am pretty much self managed.
My Pc looks at my A1c (under 6 for almost 7 years) and says that I should keep on doing the same. She is nice, but doesn’t really have a clue.
But it works for me.

Marie - what did they say when you asked them what makes the locks “rusty”. I often get the blank stare.

What the current research is starting to show is there are several different diabetes viruses and some are insulin-like and attach to the insulin receptors. Is the research correct, who knows but they are reporting specific viruses have been identified. The one thing about research and studies is we always need more.

Whether the research is correct is up for debate and of course further research is always needed.

However if you take it at face value it explains a lot. You mention a c-peptide test. What is a c-peptide? Is it insulin? No. Its a 31-amino-acid polypeptide that connects insulin’s A-chain to its B-chain in the proinsulin molecule. After the chains are bound its a waste product which gets excreted in the blood when insulin is released. Now, what if that same c-peptide is binding an insulin-like virus?This could explain a lot. It would also make the c-peptide test rather worthless.

Now here is a good simple write-up on insulin resistance https://www.diabetes.co.uk/insulin-resistance.html

The first point - "Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese. " OK which is it? That sounds like double-talk.

What we know is most obese people are not diabetic. Why? The just grow big clumps of beta cells in their pancreas to meet their body’s demand for keeping proper BG levels. Why don’t diabetics grow extra beta cells is the question. Is a virus killing the beta cells?

Their second point - “Modern research has shown that insulin resistance can be combated by treatment methods that reduce how much insulin the body is producing or taking insulin via insulin injections or insulin pumps.” OK - but that sounds like double-talk.

How can we over come the amount of natural insulin which is causing the resistance because we have to much by reducing demand placed on the pancreas to make less but yet if we take more insulin through shots we can reduce the resistance too? Wow! Do we want to reduce the amount of insulin in the blood or add more? Could the pancreatic insulin being released in the blood be bad? Could it be mixed with an insulin-like virus which then competes with the insulin to attach to the insulin receptors? This could explain insulin resistance. It would also explain the double-talk above. We clearly need more research.

What we do know is how to over come insulin resistance. Take external insulin or increase insulin sensitivity. Taking the insulin and reducing demand at the same time is the best one two punch. We also know the first thing to go for all diabetics is the robust phase one release and we know the only insulin which mimics phase one insulin release is afrezza. It also requires no needles and significantly reduces the chance of hypos. We also know few know about it and fewer doctor prescribe it but things take time.

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Tom - based on my experience over the last year most doctors do not want to prescribe the Libre to T2s. The big question is why?

The simple answer is most are not keeping up with the changing diabetes space and many really don’t want you to know your AGP. Once you see it you start asking more questions.

I recently had a PWD who we put on a Libre 3 weeks ago take her 2 week AGP to her PCP full anotated in LibreView with what was going on during spike periods. The PCP had no idea about the technology and no idea how valuable the AGP was. He actually called it “a miracle” once it was explained to him this past Monday. One small step but a huge win one doctor at a time.

BTW - if you have an Iphone 7 or better and OS11 you don’t need the reader. Save the money you will just use the phone - here is a nice write up https://diatribe.org/scan-freestyle-libre-cgm-sensor-your-iPhone-freestyle-librelink-app-approved-fda

Also - very important, they have had issues with bad sensors. If after a day if you are not getting good readings, use a new sensor and call Abbott and they will send you a new one.

The doctors I have talked to about different CGM’s for T2 say that none of the CGM’s are perfect and all have various issues but that in their experience Dexcom is the most accurate and therefore considered the gold standard which is the first choice they prescribe unless other factors are involved.

George44,
lol mine was not to question why the locks are rusty in the first place, but to explain the basic difference between the 2 types. It was also to try to make sure people know if they are not getting the result they want and they are working at it, they might be a type 1 and not a type 2!

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@T2Tom

I did a pretty good comparison of the Dexcom versus Libre on
Choosing a CGM
Costs
I don’t know the new Libre costs but as of last December…

The Libre reader was under a deal at Walgreens for $65, and now I am being offered a free new reader to change to the new sensor/ The sensors were $25 each, (old 10 day ones)with no insurance at Walgreens.

Whoa the Dexcom!
Mine I got free, but it was unknown if I had a copay at first so I got the original receipts. Total retail was $2800.00 for the reader, 1 transmitter and 9 sensors. I forget the breakdown.
But Costco has deals with no insurance on the transmitters, I think they were a pretty good deal and maybe the reader and the sensors I think were $70 each??
Someone on here should have more information about the Costco thing.

But they are wonderful, instead of finger sticking, you just look at your reader 50 times a day if you want, it gives you a much better understanding of what your sugars do. If Medicare won’t pay for yours, the libre really is worth it for it’s price, but it has more variance to it, but you can download some aps that gives you alarms and helps calibrate it.

The first person also mentions medicare paying for it.

Tom - here is the info on Medicare coverage. However here is the sticky point(pun intended)

“The beneficiary is insulin-treated with multiple (3 or more) daily injections of insulin or a Medicare covered continuous subcutaneous insulin infusion (CSII) pump; and The beneficiary’s insulin treatment regimen requires frequent adjustment by the beneficiary on the basis of BGM or CGM testing results”

BTW - This wording was carefully select to exclude afrezza users. Dr. Kendall is working to get it changed but he has an uphill battle. https://www.freestylelibre.us/content/dam/adc/freestylelibreus/documents/FreeStyle%20Libre%20-%20Medicare%20Guide.pdf

Marie - I buy WD-40 by the gallon and am always spraying my door locks, car under-carriages and anything else which will rust which seems like everything on the beach. It works great on cleaning shower doors too. Full disclosure - I am an official member of the WD40 Fan Club and proudly display my certificate.

Things to me need to make sense. When I drive down a road called School House Rd I wonder where the school house is OR was.

When they tell you insulin resistance can be reduced by reducing the amount of insulin in the blood by having the pancreas make less OR by adding more insulin into the blood by taking external insulin my reaction is to question. How does that work? Whats wrong with the insulin being made by my pancreas?

While we may not yet know those answers we do know how to treat it and stop T2 progression. Even better, as Ralph DeFronzo and Al Mann have shown in some cases reverse beta cell loss.