Saying Goodbye to GERTI
I recently had to say goodbye to GERTI. I felt quite sad and a little anxious.
So, who is GERTI?
GERTI was a cgm (continuous glucose monitor), in this case it was as Libre 2.
In February I decided that I needed to understand what all this fuss was about with cgmβs. things like TIR (time in range), was quite alien to me a person with type 2 diabetes.
As someone who advocates for diabetes, I thought that I needed to understand for myself so that I could help other people with diabetes. So, for 16 weeks I self-funded with the FreeStyle Libre 2 which is a Flash glucose monitor. (People with type 2 diabetes, and some with type 1 do not get given a cgm or a Flash glucose monitor by the NHS). So why the FreeStyle Libre 2? This is the one that NHS give out on prescription.
For the past 22 years plus, I have fingered pricked to test my sugar levels. Because that is what we did. It would tell me a figure and if the reading were high, I would inject insulin to try and reduce the level, and if it were too low, I would have to eat or drink some carbs (carbohydrates) to bring it back to a satisfactory level. The trouble with this is that I did not know if the reading was going up or down or staying the same. So, it was pure guess work. Mostly this was ok but other times it was not.
When I first wore GERTI it was a complete revelation to me. For the first time in my diabetes life, I could see what was happening in my body. How the food I ate affected my glucose levels, how various exercise would affect the levels, and various other information that was now available to me to help me manage my diabetes 24/7, 365 days a year.
So, what did I learn?
- How various foods would spike the levels. Some high some not so high and others that had little impact.
- When the best time to take my fast-acting insulin. Not very fast I found out, usually about 2/3 hours after I had taken it
- The best time appeared to be after I had eaten as it seemed to flatten the spike to a more respectable level.
- I learned that if I had tested my glucose level, by finger pricking, two hours after I had eaten then I would have had a high which would be starting to come down quite quickly, and would have been quite bad for me to inject insulin then as it would lead me into a possible Hypo (hypoglycaemic episode)
- Having the alarms set for to go off when the level was high, and low was an absolute boon. Especially at night while sleeping as I did not need to worry of not waking if I was going into a hypo.
- I was also able to go to bed with a reading of 6/7 and know that GERTI would wake me if I went too low. Whereas previously I would have eaten carbs to raise my glucose levels so that hopefully I would not have a hypo while I was sleeping. Having GERTI meant that I had a better sleep pattern even though sleep is not great due to other complications.
- I also understood which types of exercise works best for me when I have a high reading. This is thanks to my Personal Trainer. Where we recorded both types of measurement finger pricking and technology, to see how they differ. Before exercise finger pricking would be higher, at the end they would both be remarkably similar.
- How difficult it was to be continually TIR mine varied from the 20βs to the 80βs percent.
So, what did GERTI give me.
- Peace of mind
- Allowing me to manage my diabetes better
- Putting me back in control
- Less worries re hypos
- Better QoL (Quality of Life)
- Finally understanding what TIR means and how to get there.
HCP Access
The thing I really liked about the Libre 2 was the ability of Health Care Professionals (HCP) can access my data at any time. This allows them to make recommendations to the person with diabetes to help them manage their diabetes. This information is available 24/7, 365 days and does not just rely on the HbA1c (blood test for glucose levels over a 2/3-month period) which may only be done once a year. The HCP has no idea what is happening the other 9/10 months of the year.
My problem however was that my HCP, my GP who is looking after my diabetes was unable to get this information due to the fact that they are not allowed to monitor PWDβs with type 2 diabetes until they have been trained. This is unlikely to happen in the near future until people with type 2 diabetes can get access to the technology via the NHS.
Conclusion
Why do People with type 2 Diabetes need a cgm or a sensor-based glucose monitor?
I read a great analogy about cgm or a sensor-based glucose monitor.
If you are on oral medications, then it is like driving through London with a blindfold. If you are lucky enough to finger prick then it is like driving through London with a blindfold but occasionally being able to see for a brief moment of where you are, but not knowing which direction you are going in. However, if you have a cgm or a glucose monitor it is like driving through London without a blindfold and with a SATNAV.
Having a sensor-based glucose monitor or any type of cgm needs to be available to everyone who has diabetes and not just the few. If we have the technology, then we can manage our diabetes and have a better QoL.
So, what does GERTI stand for?
Getting Educated Ready To Inform
What others are saying
Ken Tait is a person with type 2 diabetes who has been on insulin for 22 years. He is a Diabetes Advocate and has been involved since 2019 in giving talks about diabetes and stress and other emotional problems. He is involved in many diabetes projects, locally, nationally and internationally. As a firm believer in the #nothingaboutuswithoutus, he is on the board of local and national diabetes healthcare committees and involved with two European projects (IMI)
Hypo-Resolve and Trials@Home as a Patient Advisory Committee (PAC) and Patient Expert Panel (PEP) respectively.
