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CGM and FlashMedicationsCGM and Flash are ways of measuring bloodsugar levels without having to finger prick.As well as insulin, there are several medicationsavailable to help treat type 2 diabetes – two ofthem are sometimes used to help treat type 1diabetes, too. They work in a variety of ways, sosome people will use a combination of medications.The monitors measure the amount of glucose inthe fluid surrounding the cells, called interstitialfluid. This lags behind blood sugar levels a little.These are the different types and what they do:Both CGM and Flash involve a small sensorbeing worn just under the skin, for a set timeuntil it needs replacing.CGMBiguanide (metformin): This is usually the firstdiabetes medication prescribed if a healthy dietand physical activity alone hasn’t sufficientlyhelped to manage blood sugar levels.CGM shows trends in blood sugar levels andalerts people to highs and lows. It measuresevery few minutes.Sulphonylureas: These are tablets that stimulatethe cells in the pancreas to make more insulin,helping it to work better.There are two types of CGM: real time, whichchecks blood sugar levels at any time, withdownloadable results; and retrospective,which doesn’t check in real time, althoughresults can be downloaded to refer to.Alpha-glucosidase inhibitor (acarbose): Slowsdown the intestine’s absorption of starchy foods,which, in turn, slows down any rise in blood sugarlevels after eating.A CGM has three parts. There is a sensorwhich sits just under the skin. This is attachedto a transmitter, which sends blood sugarlevels to a display device to show the levels.The display device is either a separatehandheld device (standalone CGM)or a pump (integrated system).FlashMore people are choosing to use Flash to checktheir blood sugar levels.A reader scans the sensor whenever peoplewant, giving access to the last eight hours ofsugar levels. It also comes with software sopeople can analyse results and see patterns intheir sugar levels. But, unlike a CGM, it won’talert any high or low blood sugar levels. or CGM and Flash product information,Fsee page 18.For information on how to access Flash,go to www.diabetes.org.uk/med-flashPrandial glucose regulators: Similar tosulphonylureas, this stimulates the cells in thepancreas to produce more insulin. They work morequickly than sulphonylureas but only last for a shorttime, so they need to be taken half an hour beforeeach meal.“ Flash has significantlychanged how I managemy diabetes. I now testmultiple times a day –typically up to 20 times– yet it’s far easier andmore discreet than fingerprick testing. And, I’mable to keep far closerto target levels – not onlyby reacting to the currentblood glucose reading,but more importantlyto the trend arrow.”Adrian, who has been using a flashglucose monitor for more than four years. ead Adrian’s story s (glitazones): Reduces insulinresistance and improves sensitivity, allowing theinsulin that the body produces to work more effectively.It also helps to protect the cells in the pancreas,which enables them to produce insulin for longer.GLP-1s (incretin mimetics): Increases the levelof incretins in the body. Incretins are a type ofhormone that help produce more insulin whenit’s needed and reduce the amount of glucoseproduction when it’s not needed. They reducethe rate at which the stomach digests foodand empties, and can also reduce appetite.DPP-4 inhibitors (gliptins): These workby blocking the action of DPP-4, an enzymethat destroys incretin.SGLT2 inhibitors: This medication reducesthe amount of glucose absorbed by your kidneysand your blood. s with any medication, check the patientAinformation leaflet. People should talk to theirdiabetes team if they have any questionsor experience any side effects.Free prescriptionsPeople who live in England and use insulinor medicine to manage their diabetes areentitled to free prescriptions. But, if they’reunder 60, they need to have a medicalexemption certificate before they canclaim them.People should ask for the application formfor the certificate – called FP92A. They willneed to fill it in, and then their doctor willsign it and send it off. Find out more s are free for everybody inScotland, Wales, and Northern Ireland.We also know that some people withdiabetes who need to test their bloodsugars are having problems getting teststrips on prescription. For informationgo to www.diabetes.org.uk/med-stripsFor more on these types of medications, see page 20.6 www.diabetes.org.ukDiabetes UK Meds & Kit 2020 7

InsulinInsulin pumpsEveryone with type 1 diabetes, and some peoplewith type 2 diabetes, need to take insulin usingan insulin pen or an insulin pump.An insulin pump gives people the insulin theyneed throughout the day and night. A pumpcan be an excellent alternative to injecting withan insulin pen and give people more flexibilitywhen managing their diabetes.There are five different types of insulin which allwork in slightly different ways to help managediabetes.Rapid-acting insulin: Sometimes knownas fast-acting insulin, it’s taken shortly beforemeals. It works quickly, and it’s usually takenalongside intermediate-acting insulin orlong-acting insulin. The dose dependson how many carbohydrates are eaten.ContactlessContactlessDownloadDownloadtoto FreeFree AppShort-acting insulin: This is similar torapid-acting insulin but works slightly slower.Because of this, it needs to be taken about25 minutes before eating.Mixed insulin: This is a combination of shortor rapid-acting insulin. It’s taken twice a daybefore breakfast and dinner.Intermediate-acting insulin: Also known asbackground insulin or basal insulin. This meansit works throughout the day. It’s taken onceor twice a day. Glucose & Ketones on One Meter Automatic Download to Smartphone App Glucose & Ketones on One Meter Accuracy Exceeding all International Standards Automatic Download to Smartphone App The Finest Ultra-Thin Lancet Accuracy Exceeding all International Standards The Finest Ultra-Thin Lancet19877 - 2 01TO APPLY FOR A FREE UPGRADE VISIT: www.glucomen.co.uk/areoupgradeOr call: 0800 085 2204 (0118 9444128) Quoting ref: AD101978 7 - 2 01Talk to your healthcare professional to see if this meter is right for youLong-acting insulin: Another type of backgroundor bolus insulin, it is slower acting than intermediateinsulin but very similar in how the body processesit. It’s usually taken once a day.There are two types of insulin pumps: atethered pump and a patch pump. Both areattached to the body by a tiny tube called acannula, which goes just under the skin. Thecannula needs to be changed every two or threedays and moved to a different place every time.Tethered pumps: This is attached to the bodyby another small tube that connects to thecannula. The pump itself usually houses allthe controls and can be carried on a belt,in a pocket, or a body band worn underclothing if people don’t want it on show.Patch pumps: These attach directly onto thebody where the cannula is placed. Popularchoices include legs, arms, or stomach. There’sno extra tubing, which means the pump sitsdirectly onto the skin and is operated by aremote. Patch pumps are temporary, so thewhole device needs to be changed whenthe pump sends an alert, not just the infusionset and location. For a guide to pumps, see page 28. ind out the different types of insulinFavailable on page 24.For more information on insulin, go towww.diabetes.org.uk/med-insulinInsulin pensPen injectors are relatively easy to use, andthere’s a whole range to suit different insulin.There are two main types: a disposable penthat already contains the insulin, which youthrow away once empty; and a reusable penwith replaceable insulin cartridges.Access to technologySome diabetes technology can be difficultto access, and people with diabetes mightneed to meet specific criteria set bythe NHS or by the National Institute forHealth and Care Excellence (NICE) or,in Scotland, the Scottish IntercollegiateGuidelines Network (SIGN). If they areunsure, people should check with theirdiabetes team. See page 26 for our guide to insulin pens.For top tips and our video on injecting, goto www.diabetes.org.uk/med-insulinTO APPLY FOR A FREE UPGRADE VISIT: www.glucomen.co.uk/areoupgradeOr call: 0800 085 2204 (0118 9444128) Quoting ref: AD10Talk to your healthcare professional to see if this meter is right for you8 www.diabetes.org.ukDiabetes UK Meds & Kit 2020 9

Blood glucose meters123456789101112FreeStyleOptium NeoAbbottWaveSense JAZZAgaMatrix Europe LtdWaveSense JAZZWIRELESSAgaMatrix Europe LtdContour Next OneAscensia Diabetes CareContour NextAscensia Diabetes CareContourNext LinkAscensiaDiabetes CareContour NextLink 2.4AscensiaDiabetes CareContour XTAscensia Diabetes CareContour PlusAscensia Diabetes CareContour TSAscensia Diabetes CareContour(black and silver)Ascensia Diabetes CareFORA AdvancedGD40hB. Braun Medical Ltd131415161718192021222324Omnitest 3B. Braun Medical LtdOmnitest 5B. Braun Medical LtdMicrodot Cambridge SensorsLimitedMicrodot MaxCambridge SensorsLimitedGlucoMen AreoGlucoMenGlucoMen Areo 2KGlucoMenGlucoRx NexusGlucoRxGlucoRx Nexus BlueGlucoRxGlucoRx NexusMini UltraGlucoRxGlucoRx Nexus VoiceGlucoRxGlucoRx GOGlucoRxGlucoRx Rx HCTGlucoRxGlucoRx HCT ConnectGlucoRxGlucoRx HCTConnect iGlucoRxGlucoRx QGlucoRxAccu-Chek MobileRoche Diabetes CareAccu-Chek AvivaRoche Diabetes CareAccu-ChekPerforma NanoRoche Diabetes CareAccu-ChekAviva ExpertRoche Diabetes CareAccu-Chek ActiveRoche Diabetes Care4SURE Smart MeterNipro DiagnosticsUK Ltd4SURE SmartDuo MeterNipro DiagnosticsUK LtdTEE2 Spirit Healthcare“ Advances to equipment and technologyhave been life-changing.”Peter, diagnosed with type 1 diabetes in 1956.373839404142CareSens DualSpirit HealthcareTRUE METRIX AIRTrividia HealthTRUE METRIX GOTrividia HealthVivaChek InoVivaChekLaboratories, Incmylife PuraYpsomedmylife UnioYpsomed10 www.diabetes.org.uk43 Read Peter’s story at www.diabetes.org.uk/med-petermylife Unio NevaYpsomedDiabetes UK Meds & Kit 2020 11

Blood glucose meters1Meter & manufacturerStrip/test cassette requiredSamplevolume (µL)Timefor ery lifeNumber of tests storedwith date & timeLength x width xdepth (cm)Suitable forperitonealdialysis?Suitable foralternativesite testing?Includesintegratedfingerpricker?FreeStyle Optium NeoAbbottFreeStyle Optium Blood GlucoseTest Strips0.651.1–27.8No codingrequiredUp to3,000 tests1,000 (7-, 14- & 30-day averages)8.68 x 5.97 x 0.8 * deviceinside package1,000 tests1,865 (14-, 30- and 90-day,pre-meal & post-meal averages& standard deviation)1,000 tests300 in the meter memory,unlimited within the app (7-, 14-,30- & 90-day, fasting, pre-meal& post-meal averages)6.5 x 3 x 1 9.7 x 2.8 x 1.5 Can test forketones?Batteryreplaced freeof charge? but meter2WaveSense JAZZAgaMatrix Europe Ltd3WaveSense JAZZWIRELESSAgaMatrix Europe LtdWaveSense JAZZ &WaveSense JAZZ Duo Test Strips0.551.1–33.3No codingrequiredWaveSense JAZZ &WaveSense JAZZ Duo Test Strips0.550.6–33.3No codingrequired1,000 tests800 on meter, 1,000 tests or 100days, whichever is sooner, on theapp. Unlimited up to 8 years’storage on the Contour CLOUD(7-, 14-, 30- & 90-day averages)51.1–33.3No codingrequired8.3 x 4.6 x 2 deviceinside packagegives ketonewarning withblood glucosereadings 13.3mmol/l but meter deviceinside package4Contour Next OneAscensia Diabetes CareContour Next Test Strips0.6 (also featuressecond-chancesampling)5Contour NextAscensia Diabetes CareContour Next Test Strips0.6 (also featuressecond-chancesampling)50.6–33.3No codingrequired1,000 tests800 (7-, 14- & 30-day averages& pre-/post-meal marking)8 x 5.3 x 1.2 6Contour Next LinkAscensia Diabetes CareContour Next Test Strips0.6 (also featuressecond-chancesampling)51.1–33.3No codingrequired1,000 tests1,000 test memory (7-, 14-,30- & 90-day averages)9.7 x 3.1 x 1.6 7Contour Next Link 2.4Ascensia Diabetes CareContour Next Test Strips0.6 (also featuressecond-chancesampling)51.1–33.3No codingrequired1,000 tests1,000 test memory (7-, 14-,30- & 90-day averages)9.7 x 3.1 x 1.6 deviceinside package8Contour XTAscensia Diabetes CareContour Next Test Strips0.6 (also featuressecond-chancesampling)50.6–33.3No codingrequired1,000 tests480 (7-, 14- & 30-day averages)7.7 x 5.7 x 1.6 deviceinside package9Contour PlusAscensia Diabetes CareContour Plus Test Strips0.6 (also featuressecond-chancesampling)50.6–33.3No codingrequired1,000 tests480 (7-, 14- & 30-day averages& pre-/post-meal marking)7.7 x 5.7 x 1.9 deviceinside package10Contour TSAscensia Diabetes CareContour TS Test Strips0.650.6–33.3No codingrequired1,000 tests250 (14-day averages)7.1 x 6 x 1.9 deviceinside package11Contour (black & silver)Ascensia Diabetes CareContour Test Strips0.650.6–33.3No codingrequired1,000 tests480 (7-, 14- &30-day averages)7.7 x 5.7 x 1.9 deviceinside package12FORA Advanced GD40hB. Braun Medical LtdFORA Blood Glucose Test Strips& FORA Ketone Test Strips0.8 for glucose& 1 for ketones5 forglucose& 8 forketones0.5–33.3 forglucose &0.1–8 forketonesNo codingrequiredMinimum1,000 tests1,000 test results (7-, 14-, 21-,28-, 60-, 90-day averages)10.7 x 5.7 x 1.8 deviceinside package13Omnitest 3B. Braun Medical LtdOmnitest 3 Test Strips0.330.6–33.3No codingrequiredMinimum3,000 tests500 test results with date & time(3 different averages which can beset specifically for requirements)8.3 x 5.6 x 1.8 deviceinside package14Omnitest 5B. Braun Medical LtdOmnitest 5 Test Strips0.550.6–33.3No codingrequiredMinimum1,000 tests500 test results with date and time(7-, 30- and 90-day averages)7.5 x 4.1 x 1.5 deviceinside package15Microdot Cambridge Sensors LimitedMicrodot Test Strips0.6101.1–29.2No codingrequired1,500 tests, or1 year’s testing3 times per day5008.3 x 5.2 x 1.9 deviceinside package16Microdot MaxCambridge Sensors LimitedMicrodot Max Blue Glucose Test Strips0.550.6–33.3No codingrequiredRechargeablebattery5006.2 x 1.2 x 8 deviceinside package deviceinside packagegives ketonewarning withblood glucosereadings 13.3mmol/l deviceinsidepackage deviceinsidepackage*With extraneal (Icodextrin) dialysis solution12 www.diabetes.org.ukDiabetes UK Meds & Kit 2020 13

Blood glucose metersMeter & manufacturerStrip/test cassette requiredSamplevolume (µL)Timefor ery lifeNumber of tests storedwith date & timeLength x width xdepth (cm)Suitable forperitonealdialysis?Suitable foralternativesite testing?Includesintegratedfingerpricker?17GlucoMen AreoGlucoMenGlucoMen Areo Sensors0.551.1–33.3No codingrequired1,000 tests730 (1-,7-,14-,30-,60- & 90-day averages)8.5 x 5.6 x 1.8 deviceinside package18GlucoMen Areo 2KGlucoMenGlucoMen Areo SensorsGlucoMen Areo β-Ketone Sensors0.5 for glucose &0.8 for ketones5 forglucose& 8 forketones1.1–33.3 forglucose &0.1–8 forketonesNo codingrequired1,000 tests730 (1-,7-,14-,30-,60- & 90-day averages)8.5 x 5.6 x 1.8 deviceinside package19GlucoRx NexusGlucoRx1.1–33.3No codingrequired2 x AAAbatteries give 500 tests20GlucoRx Nexus BlueGlucoRxGlucoRx Nexus Test Strips0.551.1–33.3No codingrequired2 x AAAbatteries give 500 tests1,0009.6 x 6.1 x 2.6 21GlucoRx Nexus Mini UltraGlucoRxGlucoRx Nexus Test Strips0.551.1–33.3No codingrequired1 x AAA batterygives 500tests1,0009.8 x 3.6 x 1.8 22GlucoRx Nexus VoiceGlucoRxGlucoRx Nexus Test Strips0.551.1–33.3No codingrequired2 x AAAbatteries give 500 tests4509.5 x 5.2 x 2 23GlucoRx GOGlucoRxGlucoRx Nexus Test Strips0.551.1–33.3No codingrequired1 x CR2032battery gives 500 tests9994.4 x 3.9 x 2.4 deviceinside package24GlucoRx GO ProfessionalGlucoRxGlucoRx Nexus Test Strips0.551.1–33.3No codingrequired1 x CR2032battery gives 500 tests9994.4 x 3.9 x 2.4 deviceinside package25GlucoRx HCTGlucoRxGlucoRx HCT Glucose Test Strips &GlucoRx HCT Ketone Test Strips15 forglucose& 10 forketones0.5–38.9for glucose& 0.1–8 forketonesNo codingrequired2 x AAAbatteries give 500 tests50.5 –38.9for glucose& 0.1–8 forketonesNo codingrequiredPoweredby Androiddevice and1 x CR2032battery, giving 500 testsUnlimited readings stored inGlucoRx HCT app on smartphoneNo codingrequiredPowered byiOS device,giving 500testsUnlimited readings stored inGlucoRx HCT app on smartphone5.1 x 2.4 x 0.9 GlucoRx Nexus Test Strips0.55Can test forketones?Batteryreplaced freeof charge? but meter1,0009.6 x 6.1 x 2.6 deviceinside packagegives ketonewarning withBG readings 15mmol/l but meter deviceinside package deviceinside packagegives ketonewarning withBG readings 15mmol/l but meter deviceinside packagegives ketonewarning withBG readings 15mmol/l but meter1,0009.6 x 6.1 x 2.6 deviceinside packagegives ketonewarning withBG readings 15mmol/l but meter devicegives ketonewarning withblood glucosereadings 15mmol/l26GlucoRx HCT ConnectGlucoRxGlucoRx HCT Glucose Test Strips &GlucoRx HCT Ketone Test Strips27GlucoRx HCT Connect iGlucoRxGlucoRx HCT Glucose Test Strips &GlucoRx HCT Ketone Test Strips150.5–38.9for glucose& 0.1–8 forketones28GlucoRx QGlucoRxGlucoRx Q Test Strips0.771.1–33.3No codingrequired1 x AAA batterygives 500tests4509.3 x 3.6 x 2.13 deviceinside package 29Accu-Chek MobileRoche Diabetes CareMobile Test Cassette0.35 (approx)0.6–33.3No codingrequired500 tests or1 year approx2,000 (7-, 14-, 30& 90-day averages)12.1 x 6.3 x 2 30Accu-Chek AvivaRoche Diabetes CareAviva Test Strips0.650.6–33.3No codingrequiredApprox 1,000tests or 1 yearwith 3tests per day500 (7-, 14-, 30- & 90-day& pre-/post-meal averages)9.4 x 5.2 x 2.1 deviceinside package 14 www.diabetes.org.uk15.3 x 3.2 x 1.3 inside package but meter deviceinside package gives ketonewarning withBG readings 15mmol/lN/ADiabetes UK Meds & Kit 2020 15

Blood glucose metersMeter & manufacturerStrip/test cassette requiredSamplevolume (µL)Timefor ery lifeNumber of tests storedwith date & timeLength x width xdepth (cm)Suitable forperitonealdialysis?Suitable foralternativesite k Performa NanoRoche Diabetes CarePerforma Test Strips0.650.6–33.3No codingrequired500 tests or1 year approx500 (7-, 14-, 30- & 90-day& pre-/post-meal averages)6.9 x 4.3 x 2 deviceinside package32Accu-Chek Aviva ExpertRoche Diabetes CareVariesdepending onusage ofdifferentfeatures1,000 (7-, 14-, 30- & 90-dayaverages) can be shown as colourgraphs & charts on meter screen)9.4 x 5.5 x 2.5 deviceinside packageAviva Test StripsCan test forketones?Batteryreplaced freeof charge? ketonetest reminder 0.650.6–33.3No codingrequired0.6–33.3Auto codingby insertinga code chipApprox 1,000tests or 1 year500 (date/time, 7-, 14-,30- & 90-day averages)9.8 x 4.7 x 1.9 deviceinside package33Accu-Chek ActiveRoche Diabetes CareActive Test Strips1–2Approx 5(teststrip inmeter)/ 8 (teststripoutsidemeter)344SURE Smart MeterNipro Diagnostics UK Ltd4SURE Test Strips0.550.5–33.3No codingrequired1,000 tests1,000 (7-, 14-, 30-,60- & 90-day averages)9 x 5.5 x 1.8 deviceinside package0.5–33.3for glucose& 0.1–8 forketonesNo coding required(blood glucose).Coding needed whenusing new vial ofketone test strips1,000 tests1,000 (7-, 14-, 30-,60- & 90-day averages)9 x 5.5 x 1.8 deviceinside package354SURE Smart Duo MeterNipro Diagnostics UK Ltd4SURE Test Strips& 4SURE Ketone Test Strips0.5 for glucose &0.8 for ketones5 forglucose& 8 forketones36TEE2 Spirit HealthcareTEE20.551.1–33.3No codingrequired1,000 tests1,000 (1-,7-,14-, 30-,90-day pre & post meal averages)10.8 x 5.6 x 1.5 deviceinside package37CareSens DualSpirit HealthcareCareSens Pro Glucose Test Strips &KetoSens Ketone Strips0.451.1–33.3No codingrequired1,000 tests1,000 (1-,7-,14-, 30-,90-day pre & post meal averages)10.6 x 5.8 x 1.7 deviceinside package deviceinside package deviceinside package as long38TRUE METRIX AIRTrividia HealthTRUE METRIX Test Strips0.5As fastas 41.1–33.3No codingrequiredApprox 1,000tests or 1 year1,0008.7 x 5.5 x 1.7as thehematocritlevels fallwithin theparametersof 20-70%.HCP todetermine ifthe meter isappropriate as longas thehematocritlevels fallwithin theparametersof 20-70%.HCP todetermine ifthe meter isappropriate39TRUE METRIX GOTrividia HealthTRUE METRIX Test Strips0.5As fastas 41.1–33.3No codingrequiredApprox 1,000tests or 1 year5004.1 x 3.5 x 2.240VivaChek InoVivaChek Laboratories, IncVivaChek Ino Test Strips0.550.6–33.3No codingrequired12 months or1,000 tests9008.2 x 5 x 1.5 deviceinside package41mylife PuraYpsomedmylife Pura Test Strips150.6–33.3No codingrequiredApprox1,000 tests500 (7-, 14-, 30& 90-day averages)9.1 x 4.6 x 1.7 deviceinside package42mylife UnioYpsomedmylife Unio Test Strips0.750.6–33.3No codingrequiredApprox600 tests1,000 (7-, 14-, 30-, 60& 90-day averages)7.1 x 3.9 x 1.4 deviceinside package43mylife Unio NevaYpsomedmylife Unio Test Strips0.750.6–33.3No codingrequiredApprox600 tests1,000 (7-, 14-, 30-, 60& 90-day averages)7.1 x 3.9 x 1.4 deviceinside package16 www.diabetes.org.ukDiabetes UK Meds & Kit 2020 17

Flash and CGMsWater resistant?SensortypeFreeStyleLibre FlashGlucoseMonitoringSystemAbbottYes, sensor is waterresistant in up to 1m ofwater for a maximum of30 minutesFlashGlucose14 daysDexcom G6DexcomG6 transmitter IP28 upto 2.4m for 24 hoursCGMUp to 10days2.2–22.2GlucoMenDay CGMGlucoMenYes, submerged up to1m for up to 30 minutesActualReal-TimeCGM 15 days2.2–22.2Up to 6daysFlash & CGMSensorlifeLicensed fortreatmentdecisions?Blood glucose range(mmol/l)Weight(g)GuardianLink 3MedtronicIP48: up to 2.4m forup to 30 minutesIP48: up to 2.4m forup to 30 minutesGuardianSensor 3Up to 7daysIPX8: 2.5m forup to 60 minutesActualReal-TimeCGMUp to7 daysSensor size(h x w x d)in cmTransmittersize (h x wx d) in cm N/A0.5 (h) x3.5 (d)N/A 90 daywarrantyN/A4.6 x 3x 1.5N/AYes*N/ANo ca

Including a handy duration chart 26 Insulin pens All you need to know, with pictures 28 Insulin pumps Specifications and special features 31 Manufacturer contacts Websites and telephone numbers Contents Joy S. since 2014 Brad G. since 2007 Alexis B. since 2013 Clare F. since 2013 Patrick D. since 2014 Nathaniel P. since 2014 Ka'e R. since .