Diabetes Service - Salford Royal, Salford Community

Safety Alerts: There is currently a shortage of Fiasp Flextouch (insulin aspart) 100units/ml pre-filled pens. Pens will be out of stock from April 2024 until January 2025. If you use Fiasp in a Flextouch pen we will contact your GP to provide advice on an alternative quick acting insulin, in the meantime if you have any questions, please contact your GP or your Diabetes Specialist Team.

There is also an ongoing shortage of Tresiba FlexTouch 100units/ml pre-filled pens if you take this insulin your G.P or specialist will be changing you to Tresiba cartridges with to be used with NovoPen 6 (reusable pens) instead. If you have any difficulty using the new pen device please reach out and let us know.

The Diabetes team provided specialist support, advice and education to people with diabetes, and supports the facilitation of self-management.

The team is an integrated service and provides care to people with diabetes who are admitted to hospital with diabetes and within the community setting.

We provide education for Salford patients with Type1 and Type 2 diabetes

Living well with diabetes can be a real challenge. The Salford Diabetes Team provides a range of courses for patients who want up to date information, professional input to improve their health or to learn from others living with the condition. The courses on offer are all free to Salford patients you can self-refer by contacting us on 0161 206 5882 or emailing us at diabetes.admin1@nca.nhs.uk

Please see below for more information on the courses we offer.

Education courses for patients with type 2 diabetes   

​​​Diabetes Basics

  • Sessions for people who have been recently diagnosed, or those who have been diagnosed for longer who would like an update, to learn the basics about managing their own diabetes.
  • A single 2½ hour session at a local gateway or two 1 hour ‘remote’ sessions via Microsoft Teams.

I Have Type 2 Diabetes – What Can I Eat?

  • A one-off 2½ hour workshop-style session taking a practical look at helpful (and not so helpful) food choices for people with Type 2 diabetes.

Living With Diabetes

  • 3 x 2½ hour sessions based on poster-type illustrations designed to prompt conversation around several aspects of living with Type 2 diabetes.
  • Sessions cover the following topics and are interactive in style:
  • What diabetes is, lifestyle changes to manage diabetes, how to monitor the condition.
  • Controlling Type 2 diabetes with diet and the role of physical activity.
  • Long term complications and how to reduce the risk, exploring your own health results and how to improve them.

X-PERT Diabetes

  • 6 x 2½ hour sessions taking an in-depth look at many aspects of Type 2 diabetes.
  • Sessions cover the following topics:
  • What is diabetes - how the body works, what health results mean. 
  • Nutrition for health - weight management and different dietary approaches.
  • Carbohydrate awareness - starches and sugars, amount and type, basic carbohydrate counting, self-assessment of carbohydrate intake.
  • Understand food labels – what the numbers and words mean.
  • Complications – avoiding hypoglycaemia, promoting long term health and preventing diabetes complications.

All face-to-face sessions are held at one of the local gateways.

Insulin refresher session for insulin users who have type 2 diabetes

  • One 2½ hour session taking an in-depth look at insulin management in Type 2 diabetes. This is to increase the skills and knowledge for patients with type 2 diabetes who are already taking insulin.
  • Sessions cover the following topics
  • What is diabetes & insulin action
  • How to self-adjust insulin doses to maintain diabetes control.
  • Increase awareness of managing lifestyle alongside insulin therapy

Contact us by phone (0161 206 5822) or email (diabetes.admin1@nca.nhs.uk) to obtain more information or to book onto a course, or ask your GP for a referral.

Here are some comments from others who attended the above sessions:

Diabetes Basics:
’As well as good advice, I enjoyed being in a group of similar people.’
‘Time very well spent.’

I Have Type 2 Diabetes. What Can I Eat?
‘Excellent presentation of very practical information’
‘Very interesting, and hearing others experiences was really helpful’

Living with Diabetes:
‘Didn’t believe the sessions would help but after 10 mins of the first session, I was converted!’
‘I’ve learnt more in the 3 sessions than I have in 20 years of having diabetes.’

X-PERT Diabetes:
‘Learnt a lot more than I thought, as research has moved on from when I was diagnosed.’
‘I learned a great deal and have put the skills I’ve learned into practice.’


Education courses for patients with type 1 diabetes   

The Salford Diabetes Team offers several courses for patients with type 1 diabetes who want up to date information, professional input to improve their health or to learn from others living with the condition. The courses on offer are all free to Salford patients you can self-refer by contacting us or by speaking to your diabetes specialists.

Dose adjustment for normal eating (DAFNE)

We understand that attending an education course means taking time out of your busy schedule therefore we offer DAFNE in the following formats.

Face to face courses run for 5 full-day sessions at a local gateway. Please note, you are required to attend all 5 sessions.

  • Standard courses are one full week, Monday to Friday from 9:00am – 5:00pm each day.
  • 5x1 courses are one day a week from 9:00am – 5:00pm for 5 weeks.

Virtual courses are run via Microsoft Teams and will take 6 weeks to complete.

You will attend a group video call each week with the other participants and your DAFNE educator, and online learning is to be completed via the Open University. To attend these sessions, you will need an email address and either a tablet, laptop or PC with a microphone and webcam.

  • Virtual courses are one day a week from either 9:00am to 12:30pm or 1:00pm to 4:30pm for 6 weeks.

There will be a requirement to attend a one-to-one appointment with your DAFNE educator approximately 2 weeks before the start of the course which may take up to 45 minutes. This will be arranged when you contact us to reserve your place.

For further information about DAFNE please visit the website at What is DAFNE? - DAFNE

Carbohydrate Counting

We facilitate the Roche Carbohydrate Counting Course to help your management of type 1 diabetes. This hour-long course integrates what carbohydrate counting is, how to do it, the effects of day to day activities on your glucose levels and the current technology to support your glucose management. Speak to your clinician to be referred into this service and we will contact you to arrange a session. These are currently based solely at Swinton Gateway.

 

What to expect as an inpatient 

Admission

Please bring all your diabetes treatment into hospital with you, including blood glucose meter, sensors, pumps and insulin pens.

During your stay

During any inpatient stay you have access to the diabetes specialist nurse inpatient team if additional support is required. 

During your inpatient stay you will continue to have your blood glucose levels recorded with the ward meter and we also support and encourage self-management. 

After discharge

Following discharge from hospital you will either resume your diabetes care at your GP practice or be referred to the diabetes specialist team if appropriate. 


What to expect and bring to your outpatient appointment

During your appointment you will be reviewed by a member of the diabetes team, this will be a Diabetes Specialist Nurse, Diabetes Specialist Dietitian or both. Clinics and education can be face to face, telephone or over Video call If you have a preference on how you are seen, please contact us to let us know in advance.

Please bring you blood glucose meter and a list of your current medications with you to clinic. Please also bring a record of recent blood glucose results, either written in a blood glucose record book or uploaded via an App, such as Glooko, Dexcom, Libre view, mySugar, or my diabetes my way.
 
We often ask your GP to check your HbA1c results and other blood tests before your appointment. Please ensure if your GP has asked you to take bloods you get this done before your appointment with us. The results will be discussed with you at your consultation.
 

Our clinics and education courses are held in the following locations please note we do not have a drop-in service we can only see patients face to face if you have a booked appointment.  If you wish to contact us because you have concerns, please call or email and a face-to-face appointment can be arranged as required:

Pendleton Gateway
1 Broadwalk
Salford
Greater Manchester
M6 5FX

Swinton Gateway
100 Chorley Road
Swinton
M27 6BP

Walkden Gateway
2 Smith Street
Walkden
Salford
M28 3EZ

Eccles Gateway
28 Barton Lane
Eccles
Salford
M30 0TU

Irlam Medical Centre
Macdonald Road
Irlam
Manchester
Greater Manchester
M44 5LH

Patients can self-refer for education by contacting our team via telephone on 0161 206 5822 or email at Salford.diabetescare@nca.nhs.uk 

Referrals into the specialist team for clinic appointments should be sent by the GP via eSR.

Inpatient referrals should be sent to the inpatient diabetes specialist nurses on EPR. Please note they must be sent before 2pm for same day review. 

Please Note: Our phone lines are very busy as such you may be asked to leave a voicemail with your name and date of birth and your quire. A member of our team will aim to phone you back in the next 2 working days. Please note if we return your message and you miss our call, we will ask that you please call into our service again or contact us via email as we are unable to keep trying to contact patients repeatedly due to high demand.

Contents:

Diabetes and your feet

Diabetes and research

Diabetic eye screening

Diabetes and your feet 

We work closely with the podiatry team in Salford. If you have an urgent problem with your foot please contact the emergency line at 0161 206 3842 for advice and if appropriate you will be given an emergency appointment. Alternately you can self-refer for review by downloading this referral form and emailing it to  Podiatry.Referrals@SRFT.nhs.uk

Problems you may experience could include:

  • You notice breaks in the skin of your foot, or discharge seeping from the wound.
  • The skin over part or all of the foot changes colour and becomes more red, blue, pale, dark
  • You notice extra swelling in your feet where there was a blister or injury
  • There is redness or swelling around an ulcer or in an area where you have previously been warned to seek immediate attention.

Please note the podiatry team do not offer routine toe trimming services.

You can find more information about Salford’s podiatry service here Podiatry :: Northern Care Alliance

You can find information about how to maintain  good foot health here: https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/taking-care-of-your-feet

Diabetes and research

People who get involved in research tend to have better health outcomes, as they become better at managing their own condition and this is particularly true for those living with diabetes.  Joining the research community means you're also actively helping to improve care and treatments for you and for other people.
 
Help BEAT Diabetes is part of the Research for the Future programme, an initiative from the NHS encouraging people in Greater Manchester to get involved in health and care research.  Joining means you will receive information about research taking place in your area, along with details of how to take part.  There are lots of opportunities available from completing questionnaires to taking part in trials of new treatments.
 
You can register easily using one of the following options:

  • Visit the Research for the Future website
  • Call the office on 0161 206 3636
  • Text ‘RESEARCH’ and ‘YOUR NAME’ to 81400

Diabetic eye screening

It is important for all patients with diabetes to have regular eye screening appointments. You should be contacted yearly to attend an appointment for diabetic eye screening. If you have not attended an appointment in over a year please contact your GP and they will arrange an appointment for you. Please note the diabetes team can’t arrange appointment or review your results as this is a separate service.

The details to contact the eye screening department will be on your eye screening appointment letter you can also find further information at Information For Patients - InHealth Group

Diabetes UK
Diabetes UK up to date information on all aspects of living with diabetes including research and technology

https://jdrf.org.uk/
Registered charity funding research to cure, treat and prevent Type 1 diabetes. A library of resources to support people with Type 1 diabetes and their families.

https://www.nhs.uk/conditions/type-2-diabetes/
General advice and links for adults living with Type 2 diabetes

https://www.fitfortravel.nhs.uk/advice/general-travel-health-advice/diabetes  
General advice on traveling with diabetes.

https://www.carbsandcals.com/
Carbs and Cals Book and app that makes carbohydrate counting easier using photos of different portion sizes. You can also subscribe to their YouTube channel for weekly videos on carb counting, diabetes, recipes, takeaways, low-carb & weight loss.

https://abcd.care/dtn/educational-resources-people-living-diabetes
ABCD DTN- UK contains self-management videos and resources supporting patients using diabetes technology.

https://pocketmedic.org/

Pocket Medic is a library of over 50 self-management films to share the experiences of people living with Type 1 diabetes.

Welcome - BERTIE Online

BERTIE online  contains general advice and links for adults living with Type 1 diabetes

https://mytype1diabetes.nhs.uk/
A website with many  resources to learn about type one diabetes in several languages

 

We would encourage patients who live in Salford and have diabetes to sign up to diabetes my way.

  • The website Diabetes My Way https://diabetesmyway.nhs.uk/registration gives you access to your NHS clinic results and contains information and resources that help you understand more about diabetes and explains how to manage the condition more effectively.

Here is a video about the platform https://vimeo.com/443196236

People who use the service say that it improves their knowledge and helps them meet goals, it improves motivation and acts as a reminder for discussions with medical staff during appointments. The service is not a replacement for your normal care, but helps you get advice and monitor your results before, during and after contacts with your healthcare team.

Please sign up using NHS login;

If you have any other questions, please email the Diabetes My Way team at manchester@mwdh.co.uk or visit their contact page for more details https://diabetesmyway.nhs.uk/contact-us/

Every year your G.P will invite you annually for all clinical screening including blood tests, urinary screening, observations such as blood pressure and weight, and foot checks. Eye screening is carried out at a different location due to the equipment required. This is to monitor your ongoing health and to help reduce your risk/prevent/slow down any long-term conditions.

A full list of the checks your G.P will be preforming and the reasons for them are below we strongly recommend all patients with diabetes attend their screening appointment. If you think its been more than a year since your last check please contact your G.P to arrange a diabetes review.

Contents

Driving and diabetes

Travel and diabetes

Sex and diabetes

Pregnancy and diabetes  

Diabetes and Emotional wellbeing.

Exercise and diabetes

Exercise resources for Salford patients with type 1 diabetes

Driving and diabetes

If you take insulin to manage your diabetes its very important to be aware of the laws around safe driving and insulin further information can be found below

  • DVLA  

https://www.gov.uk/driving-medical-conditions
Information about medical conditions, disabilities and driving

  • Trend

https://trend-uk.org/wp-content/uploads/2018/03/A5_6pp_Driving_TREND_CONNECT.pdf
Safe driving and diabetes leaflet

Travel and diabetes

Below is advice for before going on a trip if you feel you need to speak with us please contact our team at least 2 weeks before you go away. Also check you have appropriate insurance.

Travel:

https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/travel

Travel letters

For who use insulin to manage their diabetes we provide travel letters (free of charge) to support your journey through security and customs with any diabetes related equipment and medication you are carrying. We personalise the letter to you and your therapy and any technology you use.

Sex and diabetes

We would encourage all patients who are sexually active and not trying to get pregnant to use contraception. For patients with type one diabetes the contraception method you choose may affect your diabetes control for further information please review  the website below.

https://jdrf.org.uk/information-support/living-with-type-1-diabetes/health-and-wellness/contraception/

Having diabetes doesn’t mean you will have problems with sex, but we know that many patients with diabetes find sex a cause of worry or anxiety if this is the case for you there are things that can help.

You can find more information and support here Sex and diabetes | Diabetes UK | Sex, Relationships and Diabetes

Some complications of diabetes can lead to sexual dysfunction. If you believe this may be affecting you, we encourage you to speak to your G.P as they can review the concern and offer things to help.  

Pregnancy and diabetes  

Many patients with diabetes have a healthy pregnancy and give birth to a healthy baby. However, having diabetes means that you and your baby are more at risk of serious health complications during pregnancy and childbirth. The good news is that by planning and getting support from your diabetes team, you can really reduce the risks involved.

If you are thinking of having a baby, please contact us before you come off birth control so we can assist you to prepare. Once you inform us you are thinking of starting a family, we will make you an appointment in our pre-pregnancy clinic to discuss optimising your diabetes and general health. It important that your diabetes is well controlled before and during your pregnancy for both yours and your baby’s health.

You can find further information on what is required to prepare for your pregnancy as well  as well as testimony from women with diabetes at Pregnancy and diabetes | Diabetes UK

If you are pregnant, please contact our service or your G.P urgently we will refer you to the diabetes specialist midwifes to support you.

Diabetes and Emotional wellbeing

Diabetes doesn't just affect you physically, it can affect you emotionally too. Whether you've just been diagnosed or you've lived with diabetes for a long time, you may need support for all the emotions you're feeling.

Diabetes UK can offer support in many ways there is some further information and tips on managing diabetes and emotional wellbeing here.

Emotions and diabetes | How to cope | Diabetes UK

If you are feeling overwhelmed or down about your diabetes management, we would encourage you to talk about how you are feeling to your G.P or diabetes specialist. They can explore your feelings and if needed refer you for more specialist support such as a counselling service that specialises in patients living with a long-term health condition.

You can also call diabetes U.Ks helpline on 0345 123 2399 or email helpline@diabetes.org.uk to speak to a trained counsellor. They can give you information about your condition, take time to talk things through and explore how you’re feeling.

Exercise and diabetes

Being physically active is very good for diabetes. Whether you feel able to go for a run or a swim or can manage some arm stretches or on-the-spot walking while the kettle boils, it all makes a difference.

You can find further information here  Diabetes and exercise | Type 1 and type 2 | Diabetes UK

We have provided Links to programs and resources below to assist you in getting started. This list only includes services which you can self-refer to regardless of your diabetes type.

There are additional services in Salford that can help you be more active or lose weight. Please discuss with your G.P or your specialist team and they will make you a referral to the service best suited to achieve your goal.

  • Health Improvement Service

Salford patients living with diabetes can access the Health Improvement Service. This service offers a wide range of physical activities – there is something for everybody. Such as chair-based exercise classes, group dance classes, walking and cycling groups, as well as a tennis session and beginners bowls.

You can find further information here Getting more active • Salford City Council

You can self-refer to this service by calling 0800 952 1000. or by accessing the following website   

 Refer yourself, a patient or client to the Health Improvement Service • Salford City Council

  • JDRF Peak Empower you.

Empower You works with communities to support disabled people to lead active lifestyles. The programme offers 8 weeks of support to engage disabled people to be more active, making activities of interest accessible, to support long-term independent engagement and maintenance of activity.

You can find further information here Beyond Empower - helping places #DoItDifferently

You can self-refer or support someone to refer by accessing the following website  Referral – Beyond Empower Social Impact System

  • Weigh Ahead

Weigh Ahead is a six-week weight management programme focusing on making healthy and sustainable dietary changes to help you reach or maintain a healthy weight. We run face to face groups across the city, or there is the option of an online group accessed via Microsoft Teams.

You can learn more and self-refer accessing the following website  Weight management • Salford City Council

Exercise resources for Salford patients with type 1 diabetes

We recognize that there are often additional challenges that come with exercising when you have type 1 diabetes. There are many excellent resources and support groups below to support you in exercising while managing your diabetes. You can also speak to your diabetes specialists for support, as we have plenty of knowledge and skills to support you in all aspects of physical activity and exercise

A NHS website that includes  eLearning courses for adults with type 1 diabetes, to help increase understanding and confidence in self management.  

  • Diathlete

https://diathlete.org/sport-and-type-1-diabetes/
A community of people striving for empowerment through education for people with Type 1 diabetes

The diabetes football community for anyone with type one diabetes  playing football

  •  RunSweet  

http://www.runsweet.com/
Diabetes and sport, helping people with diabetes become winners.

  • EXTOD

http://www.extod.org/patient-advice
Website aimed at providing advice and guidance to people with Type 1 diabetes on safely and confidently managing blood glucose levels before, during, and after exercise

  • JDRF Peak

https://www.jdrf.org/t1d-resources/hcp/peak-program/
JDRF Exercise and Knowledge (PEAK) Program is a unique outreach initiative that gives clear guidance on how to safely pursue exercise. PEAK provides education on the environmental, dietary, and physiologic elements that affect physical activity in those with Type 1 diabetes.

We are happy for patients who are currently under our care to contact us for support with their diabetes management either by email or phone. However, we ask that you first review our FAQ as they may answer your question.

Please note if you are not under our care for your diabetes then please contact your G.P to discuss your diabetes management. They will be able to help you with your diabetes and can refer you to our service if they feel you require further specialist support.  

Content: Please click on the question to be taken to the answer

I have had bloods taken to review my diabetes such as Hba1c could you tell me the result?

I am not feeling very well, and I take insulin to manage my diabetes what do I do?

I have heard about an alternative way to test my blood glucose instead of pricking my finger can I get access to this?

I was given new diabetes medications or supplies (needles/ strips ect) in the diabetes clinic or at Salford royal hospital how do I get more?

I was taking a GLP-1 medication  (ie Dulaglutide (Trulicity®), Exenatide (Bydetta® or Bydureon®), Semaglutide (Ozempic® or Rybelsus®), Liraglutide (Victoza®), Lixisenatide (Lyxumia®) my pharmacist has said it has run out.

I am going to for a procedure and I have been told to stop eating and I want to know what to do about my diabetes medications? 

I would like to rearrange my appointment with your service how do I do that?

I am having a technical issue with my Libre sensors what do I do?  

I am having a technical issue with my Dexcom one sensors what do I do?

My blood glucose meter is no longer working what should I do?

Can I recycle my insulin pens and diabetes devices?

I was using the Accu-Chek Aviva Expert meter/ I have heard there are apps which help to calculate the amount of rapid acting insulin to give with food what do you recommend?

I would like to go on an insulin pump how would I go about this?

I am having technical issues with my insulin pump what do I do?

How to I order more supplies for my insulin Pump?

 

I have had bloods taken to review my diabetes such as Hba1c could you tell me the result?

In order to get your results please contact your G.P alternatively you please go to the Tab diabetes my way and sign up for this service. Diabetes my way allows you to review all your blood results in real time as well as additional useful information about your diabetes.

I am not feeling very well, and I take insulin to manage my diabetes what do I do?

When you are unwell it is normal for your blood glucose levels to rise as your body requires more insulin when we are poorly. If unwell we advise you continue taking you insulin (even if you are eating less than normal) and testing your blood glucose regularly you may need to adjust the dose depending on what is happening with your blood glucose levels.

Please read the advice below and if you need further assistance, please contact us for support. Please note we are not an emergency service so we may not get back to you the same day if you are extremely unwell and need an urgent review then please contact 111 or 999 for support .

For patients who take empagliflozin, dapagliflozin or canagliflozin to manage their diabetes please stop this tablet while you are feeling unwell and restart it once you are feeling better.

If you have type 2 diabetes please read the below advice

  • Trend UK – Type 2 Diabetes Sick day rules

A5_T2Illness_TREND_FINAL.pdf (trenddiabetes.online)

If you have type 1  diabetes please read the below advice

  • Trend UK – Type 1 Diabetes Sick day rules

https://trenddiabetes.online/wp-content/uploads/2020/03/A5_T1Illness_TREND_FINAL.pdf

I have heard about an alternative way to test my blood glucose instead of pricking my finger can I get access to this?

CGM/FGM sensors are only available on the NHS to people who meet the criteria set by NHS England.

If you have type one diabetes, please ask your GP to refer you to our service and we will book you an appointment to start you on it please note the sensors are in high demand so there is a wait list.

Most patient with T2DM don’t meet the criteria to go on the sensors via the NHS however your G.P will discuss with you if they feel you, are an exception.

All patients regardless of type of diabetes can also self-fund the sensors see below websites for more details.

Dexcom Continuous Glucose Monitoring | Dexcom

Home | FreeStyle Libre | Abbott

I was given new diabetes medications or supplies (needles/ strips ect) in the diabetes clinic or at Salford royal hospital how do I get more?

After we review you, your DSN or DSD will write a letter electronically instructing your G.P what supplies you need going forward. Then you will need to contact your G.P to ask them to prescribe further supplies which will then go to your pharmacy of choice for you to pick up.

I was taking a GLP-1 medication  (ie Dulaglutide (Trulicity®), Exenatide (Bydetta® or Bydureon®), Semaglutide (Ozempic® or Rybelsus®), Liraglutide (Victoza®), Lixisenatide (Lyxumia®) my pharmacist has said it has run out.

Unfortunately, there is a worldwide shortage, and we are unable to get a hold of these medications. For further information please go to leaflets and read GLP1 shortage  - Patient leaflet

If you are concerned about your diabetes since stopping this medication, please contact us with your blood glucose levels we can then assist you to adjust your medication if needed. If you are not currently under our care, you can self-refer for education on or you can contact your G.P for a diabetes review.

I am going for a Colonoscopy and I want to know what to do about my diabetes medications?  

If you are going for a Colonoscopy please review the Patient Information Leaflet for advice. If you have further  questions following this then please feel free to contact us.

I would like to rearrange my appointment with your service how do I do that?

If you can’t attend the appointment you were given please email diabetes.admin1@nca.nhs.uk they will offer you the next available appointment.

You can also call on 0161 206 8802

Please  kindly inform us that you cant attend as soon as you become aware so you appointment can be offered to other patients.

I am having a technical issue with my Libre sensors what do I do? 

If you are concerned the Libre may not be working, always use your finger-prick result to decide on any treatment

If you have any issues with the sensor falling off, giving lots of errors, or not giving accurate readings, please contact Abbott on 0800 170 1177 or via their online form on www.freestyle.abbott/uk-en/support/contact

We recommend you turn off automatic software updates on your phone until Libre notifies you they have updated the app to match the new software. We have provided information to answer the most common questions we get from patients below.

 Alarms

  • General advice is to set the low alarm between 3.8 to 4.5
    • The low alarm will only sound once, and will not repeat if your level continues to drop
  • The high alarm is optional, but if you want it on we recommend to set it above 17 initially so it doesn’t go off constantly
    • Once you are more used to the Libre and your normal patterns, you can lower the high target if you want to aim for tighter glucose control  

If you are unsure please contact the team to discuss the best targets for you

  • Car or motorcycle drivers (Group 1) can use their Libre for the purposes of driving, and the level must be above 5.0mmol to safely drive

When you need to scan

  • You can still scan to save a reading as often as you like, but as long as you are within 6 metres of your phone, the sensor will send it a new reading every 1 minute
  • If you have been away from your phone and the app is showing ‘Signal Loss’, scan the sensor to connect it back up again
  • If you are using the handset instead of the mobile app you will need to scan to get the glucose result

Try not to panic if you see the arrow going up or down; think if you’ve just had something to eat or given some insulin

Common Issues:

‘Scan again in 10 minutes’ this can happen as your blood glucose may be changing too rapidly, or you may be dehydrated

    • Make sure to allow over 10 minutes before rescanning or the timer will reset

Low alarms when asleep

    • You may get false low readings if you are lying on the arm your sensor is in
    • If your graph looks like a flat red line, this could be a false low
    • Always test your level with a finger-prick blood glucose test to double check if you need any hypo treatment as it may be a false reading.

Sensor level not matching how you feel

  • There is a time-delay of at least 5 minutes between the sensor and your finger-prick
    • This could be longer if you have exercised, just eaten or given insulin
    • Always finger-prick if how you are feeling does not match the reading the Libre is giving you
    • Always use your finger-prick result to decide on any treatment

If you take Vitamin C supplements this can sometimes cause your level to read lower on the sensor than the finger-prick

If you take Aspirin this can sometimes cause your level to read higher on the sensor than the finger-prick

It is recommended you complete the libre academy training (https://progress.freestylediabetes.co.uk/) as soon as you are started on the Libre to allow you to get most out of your technology.

I am having a technical issue with my Dexcom one sensors what do I do?   

If you are concerned the Dexcom may not be working, always use your finger-prick result to decide on any treatment.

If you have any issues with your blood glucose levels or insulin doses, contact the Community Diabetes Team on 0161 206 8802 or salford.diabetescare@nca.nhs.uk

If you have any issues with the sensor falling off, giving lots of errors, or not giving accurate readings, please contact Dexcom  on 0800 031 57 63 or fill out their online support form on Product Support Request (custhelp.com)

You can also find a list of common errors and how to resolve them on their website at Dexcom ONE CGM System troubleshooting FAQs | Dexcom

We have provided information to answer the most common questions we get from patients below.  

We recommend you turn off automatic software updates on your phone until Dexcom notifies you they have updated the app to match the new software.

•             The app will not override your phone settings; so if your phone is on silent, the alarms will not sound

•             The transmitter is reusable for 3 months, you can check when it was activated under the Transmitter information

Alarms

General advice is to set the low alarm between 3.8 to 4.5

We recommend setting up the Snooze reminder for 20 minutes. This will then go off if your blood glucose level is still at or below your low glucose target after 20 minutes

The high alarm is optional, but if you want it on we recommend to set it above 17 initially so it doesn’t go off constantly

We recommend setting the Delay First Alert to 1 hour. This will mean the high alarm only goes off if you have been above your high glucose target for 1 hour

Once you are more used to the sensors and your normal patterns, you can lower the high target if you want to aim for tighter glucose control.  If you are unsure please contact your specialist clinician to discuss the best settings for you

Car or motorcycle drivers (Group 1) can use their Dexcom for the purposes of driving, and the level must be above 5.0mmol to safely drive

Try not to panic if you see the arrow going up or down; think if you’ve just had something to eat or given some insulin

Common errors:

Low alarms when asleep You may get false low readings if you are lying on the arm your sensor is in. If your graph looks like a flat red line, this could be a false low. Always test your level with a finger-prick blood glucose test to double check if you need any hypo treatment

Sensor level not matching how you feel. There is a time-delay of at least 2.5 minutes between the sensor and your finger-prick, This could be longer if you have exercised, just eaten or given insulin. Always finger-prick if how you are feeling does not match the reading the Dexcom is giving you. Always use your finger-prick result to decide on any treatment when unsure.

If you take Vitamin C supplements this can sometimes cause your level to read lower on the sensor than the finger-prick

If you take Aspirin this can sometimes cause your level to read higher on the sensor than the finger-prick

My blood glucose meter is no longer working what should I do?

You can order a new blood glucose meter from the company who make them, and they will send you a new one first class. The free phone number to order a new blood glucose meter can be found on the box and on your blood glucose meter itself.

Can I recycle my insulin pens and diabetes devices?

Unfortunately, much your medical equipment is not recyclable we are aware this is an important issue and we have been informed there are plans to change this in the future.

The good news is some insulin pens can now be recycled If you take Levemir, Tresiba, Novorapid, Fiasp, or  Novomix 30 you can use the Pen recycling scheme.

if you use any of these products you can order cardboard recycling boxes to be delivered from www.pen-cycle.co.uk.

Once you have filled the box you can post it off to be recycled at any royal mail postbox and at some participating pharmacies (ask your local pharmacy if they are part of the scheme)

You can also request from your diabetes specialist nurse to change your disposable insulin to a fixed pen which you then fill with insulin yourself to reduce plastic use.   

I was using the Accu-Chek Aviva Expert meter/ I have heard there are apps which help to calculate the amount of rapid acting insulin to give with food what do you recommend?

Unfortunately the Accu-Chek Aviva Expert meter has been discontinued and there are no other bolus calculator meters on the market. We are recommending patients who are used to having support calculating the amount of insulin with their carbs download a Bolus calculator app on their phone. We also recommend these apps for all type one patient who carb count their meals as many patients have found them useful.

A list of recommended apps is below we advise you try a few of them and pick the one right for you. If you would like support in setting up a bolus calculator, please contact us and we will arrange this. We can do this over the phone, via video consultation or in person.

I would like to go on an insulin pump how would I go about this?

Insulin pumps are an alternative way of managing diabetes for patients with type one diabetes. An insulin pump is a small electronic device that releases the regular insulin your body needs through the day and night. Insulin pumps do not currently take over the management of your diabetes for you, they still require very  close management and good carb counting skills. In order to go on an insulin pump patients must meet strict criteria set by NHS England. If you are eligible for an insulin pump your diabetes specialist will discuss the pros and cons of pump therapy with you. Following this discussion if you then wish to apply to go onto a pump an appointment will be made in the pump clinic with the diabetes consultant who will review your diabetes and decide if an insulin pump is the right therapy for you.

I am having technical issues with my insulin pump what do I do?

If your blood glucose is high and you are concerned your insulin Pump may not be working, Check Ketones and follow sick day rules leaflet as advised by your specialist pump team.

If you need advice on your diabetes management or you need support to change back to subcut injections contact the team at salford.diabetescare@nca.nhs.uk or 0161 2068802

If you have any issues with your pump such as: charging problems, connectivity issues, problems downloading data,  lost or damaged pumps or handsets, error messages and pump failure then please contact you pump company below as they can support you in fixing these issues.

How to I order more supplies for my insulin Pump?

If you are under the Salford diabetes team and need to order more pumps supplies, please email diabetes.orders@nca.nhs.uk

Please note we ask all patients to order new supplies at least 6 weeks before they have run out.

 

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