I recently had to say goodbye to GERTI. I felt quite sad and a little anxious.

So, who is GERTI? GERTI was a Flash glucose monitor - in this case it was the FreeStyle Libre 2 system.

In search of more information

In February, I decided that I needed to understand what all this fuss was about with Flash glucose monitors and CGMs (Continuous Glucose Monitors). Things like TIR (time in range) were quite alien to me as 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 the FreeStyle Libre 2 system, 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 NHS¹.

For the past 22 years plus, I have finger pricked to test my sugar levels. Because that is what we did when I was diagnosed. It would tell me a figure and if the reading was high, I would inject insulin to try and reduce the level, and if it was 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 guesswork. Mostly this was ok but sometimes it wasn’t.

When I first wore GERTI (the FreeStyle Libre 2 system), 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 different types of 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^φ.

What I learned

1.    How various foods would make my levels spike. Some high, some not so high and others had little impact

2.    When the best time to take my fast-acting insulin was. Not very fast I found out; I would usually see the effect about 2-3 hours after I had taken it

3.    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 it would have been quite bad for me to inject insulin then as it would lead me into a possible hypo (hypoglycaemic episode)

4.    Having the alarms set to go off when my glucose level was high, and low, was an absolute boon^◊. Especially at night while sleeping as I did not need to worry about not waking up if I was going into a hypo

5.    I was also able to go to bed with a reading of 6/7 mmol/L and know that GERTI (the FreeStyle Libre 2 system with alarms) 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, and the reassurance of the alarms, meant that I had a better sleep pattern

6.    I also understood which types of exercise work best for me when I have a high reading. This is thanks to my personal trainer. We recorded both types of glucose measurements, finger pricking and technology, to see how they differed. Before exercise, finger pricking would be higher than the reading from the FreeStyle Libre 2 system; at the end of the session, the readings would be remarkably similar

7.    How difficult it was to be continually in range. My TIR varied from 20 to 80 percent!

So, what did this technology give me?

1.       Peace of mind

2.       Allowed me to manage my diabetes better

3.       Put me back in control

4.       Less worries about hypos

5.       Better quality of life

6.       Finally an understanding of what TIR means and how to get there

Sharing my glucose data

The thing I really liked about what the FreeStyle Libre 2 system offers was the ability to share my glucose data with healthcare professionals at any time ^₼. This allows them to make specific recommendations to the person with diabetes to help them manage their condition better. 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 healthcare professional has no idea what is happening the other 9-10 months of the year.

So I was looking forward to that feature. The problem however was that my GP, who helps me look after my Type 2 diabetes, was unable to get this information because they are not allowed to monitor people with Type 2 diabetes with this technology 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 FreeStyle Libre 2 system via the NHS².

Access for all

Why do people with Type 2 diabetes need access to this technology?

I read a great analogy. If you are on oral medications, then it’s like driving through London with a blindfold. If you are lucky enough to finger prick, then it’s like driving through London with a blindfold but occasionally being able to see for a brief moment where you are, but not knowing which direction you are going in. However, if you have a sensor-based glucose monitor, it’s like driving through London without a blindfold and with a SATNAV.

Sensor-based glucose monitoring technology needs to be available and accessible to everyone who has diabetes and not just the few. If we have the technology, then we can manage our diabetes more effectively and have a better quality of life.

So, if you’re still wondering what GERTI stands for…it’s Getting Educated Ready To Inform.

Ken Tait is a person living with Type 2 diabetes who has been on insulin for 22 years. He is a diabetes advocate and psychotherapist who is passionate about supporting others to manage their condition, including the stress and other emotional problems that come with living with diabetes. You can follow Ken on Twitter @bromleydiabetic